'My baby, the pump, and me': Reconnecting with a very low birthweight infant

Problem statement. Mothers of VLBW infants need to initiate lactation with a hospital grade electric breast pump. They remain pump dependent for an extended period of time until their infant is physiologically capable of suckling at breast for nutritional sustenance. However, little is known about this experience from the maternal perspective. The purpose of this study was to examine maternal experiences using a hospital grade electric breast pump for milk expression for VLBW infants.; Methodology. This study is a secondary analysis of an existing data set from a grounded theory study using 21 semi-structured interviews from a sample of women whose mean age was 26.5yrs, and whose infants' mean birth weight and gestational age were 705.4g, and 25.8wks, respectively. Of the mothers, 76% and 62% were African-American and low-income (LI; WIC-eligible). For this study, all original interviews were re-coded and re-analyzed, using Symbolic Interactionism from the maternal perspective of using a breast pump for a minimum of 30 days post-birth.; Results. Mothers were willing to initiate and maintain milk expression with a breast pump for this extended period of time because their pregnancy was unexpectedly and prematurely interrupted. As the mother of a VLBW infant, they found themselves disconnected from the continuous maternal-infant interaction that pregnancy provided. Using the breast pump was a way to reconnect with their baby and do something to feel like a mother. Five (24%) of the mothers said the pump became a way to "reconnect with the baby" and others (N=7;33%) used words like "bonding".; Conclusions. By developing a relationship with the pump, mothers reconnected with their baby, felt empowered as a mother, and partnered with the healthcare team to "make their baby healthy and to grow". This dissertation adds to the evidence regarding education about mothers' milk feedings, the importance of considering the maternal perspective of using the breast pump for milk expression when developing breastfeeding programs, and the significant role of the pump for mothers of VLBW infants. This information underscores the importance of healthcare provider encouragement and support of mothers initiating and maintaining milk expression with a breast pump for VLBW infants.