Sensory Mindfulness for NICU Mothers: Effects on Breast Milk, Well-Being, and Stress

Overview

Breast milk, which contains all the nutrients a baby needs, not only nourishes the baby but also provides many benefits for both the mother and the baby. During the first 6 months of life, breast milk is the only food that provides the energy a baby needs, supports growth and development, is easily digestible, and can be delivered to the baby without contamination due to its ready-to-use nature. Babies who are breastfed are less likely to experience oral and dental problems in later life. Breast milk strengthens the baby's immune system, protecting against conditions such as sepsis, gastroenteritis, food allergies, rhinitis, obesity, and necrotizing enterocolitis. Mothers who breastfeed their babies are less likely to experience postpartum uterine bleeding, infection, stress, and depression. Breastfeeding mothers have a lower risk of developing diseases such as breast and ovarian cancer, osteoporosis, and cardiovascular diseases compared to non-breastfeeding mothers. On the other hand, the comfort of breastfeeding and its economic accessibility are among its other benefits. Considering all these benefits of breast milk, the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) recommend that infants be be exclusively breastfed for the first six months of life, continue breastfeeding with complementary foods after six months, and continue breastfeeding until the age of two years. However, most premature infants are not mature enough to suckle or are admitted to the neonatal intensive care unit and therefore cannot be directly breastfed. For this reason, mothers should express their breast milk and provide it to the newborn until the infant is ready to breastfeed. However, research findings show that many mothers stop expressing milk within the first few weeks due to a decrease in milk supply, which hinders successful breastfeeding. Various hypotheses exist regarding the decrease in milk production, including not starting to express milk early enough after birth (it is recommended to start within the first 6-12 hours); not expressing milk frequently enough (it is recommended to express every 2-3 hours to support the development of adequate milk production); not consuming enough fluids and not getting enough rest, and not feeling psychologically adequate. Some mothers need to express milk for weeks or months without skin-to-skin contact with their babies. Therefore, in addition to educational support, emotional support is also important for mothers whose babies are in the neonatal intensive care unit. Therefore, the difficulties experienced by mothers may also affect milk production in breastfeeding mothers. Today, mindfulness-based programs are used to increase women's awareness and stress tolerance during pregnancy and the postpartum period. Mindfulness refers to conscious awareness and can be defined as a state of consciousness that aims to focus attention on the present moment. It also involves staying connected with one's own emotions, observing what is happening around with awareness, and accepting life's experiences objectively without judgment. Over the past decade, interest in mindfulness has grown as an increasing number of health professionals have shown interest in learning mindfulness techniques and integrating them into their therapeutic work. Studies have shown that mindfulness techniques reduce stress levels in mothers and increase breast milk volume, pumping duration, and frequency. However, the effectiveness of these techniques has been found to be dose-dependent. According to the results of a study investigating the effects of mindfulness practices in breastfeeding mothers, mothers who practiced meditation for two hours a day for eight weeks with guidance showed a decrease in anxiety and stress levels, while self-compassion and awareness levels increased significantly. In a study conducted by Massa and colleagues, the breast milk production of mothers who practiced mindfulness-based meditation and provided breast milk to preterm infants was compared with that of mothers who breastfed routinely. The results of the study revealed that mothers who meditated more frequently experienced easier milk expression and reduced symptoms of depression. Studies show that mindfulness benefits breastfeeding and milk-expressing mothers. Breast milk also supports newborn recovery and shortens NICU stay. However, no research has yet explored sensory mindfulness in NICU mothers feeding with expressed milk.