title: Trying to Live With Pumping: Expressing Milk for Preterm or Small for Gestational Age Infants.
abstract: OBJECTIVE
  To describe mothers' experiences with expressing breast milk for preterm or SGA infants.
  
  
  METHODS
  This is a descriptive qualitative study involving 130 mothers of preterm or SGA infants admitted to a neonatal intensive care unit. Data were collected in collaboration with two Finnish peer support associations. An Internet-based questionnaire with open-ended questions was administered to respondents. Responses were analyzed with inductive content analysis.
  
  
  RESULTS
  Mothers had to try to manage daily life and breast pumping. The combination of preterm birth and separation from the hospitalized infants served simultaneously as motivating factors and obstacles. Mothers tried to look beyond the unnatural and difficult process of milk expression, looking forward to eventual breastfeeding. Concerns about time and scheduling, equipment, environment, and sufficient milk supply were prevalent, as well as feelings of unfamiliarity, difficulty, frustration, and loneliness.
  
  
  CONCLUSIONS
  Expressing breast milk should be considered as a helpful factor for preterm or SGA infants' mothers. Separation between mother and infant should be avoided. Mothers need adequate equipment and a private space for expressing milk, in addition to assistance with their daily routines. For mothers to successfully manage expression, they also require an environment that fosters a sense of caring, normality, and hope, as well as frequent care for their emotional needs.
authors.affiliation: Riikka Ikonen is a doctoral candidate, University of Tampere, School of Health Sciences, Arvo Building, FI-33014, Tampere, Finland. The author can be reached via e-mail at riikka.e.ikonen@uta.fi Eija Paavilainen is a Professor, University of Tampere, School of Health Sciences, Etelä-Pohjanmaa Hospital District, Tampere, Finland. Marja Kaunonen is a Professor, University of Tampere, School of Health Sciences, Pirkanmaa Hospital District, General Administration, Tampere, Finland.
authors.forename: Riikka
authors.initials: R
authors.lastname: Ikonen
authors.forename: Eija
authors.initials: E
authors.lastname: Paavilainen
authors.forename: Marja
authors.initials: M
authors.lastname: Kaunonen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D061186:Breast Milk Expression / Q000523:psychology*; D005260:Female; D005387:Finland; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D020407:Internet; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult