vulnerable babies

  • 文章类型: Case Reports
    全球越来越认识到,围产期死亡后有关泌乳的护理需要潜在地提供孕产妇捐赠的机会。本文讨论了越南人乳银行(HMB)的经验和观点。这是一个描述性的探索性案例研究,在社会科学和健康科学中都有悠久的传统。三角数据收集涉及视频数据的审查,与捐赠者的访谈数据,和数据审查,母乳喂养卓越中心。我们发现,尽管越南的母亲向HMB捐赠母乳很普遍,这种情况在围产期损失后较少见。我们提供了一个描述双胞胎母亲损失的案例研究,以及随后选择捐赠大约1个月给达港HMB,越南的第一个HMB。我们讨论了有关围产期损失后捐赠的四个原因。(1)意识到这项服务时捐赠母乳的强烈动机,(2)捐赠母乳帮助她处理悲伤,(3)家人支持她度过这段艰难时期,支持她的决定,和(4)卫生工作人员支持她的决定。而人乳共享(例如,湿护理)已经在越南实行,失去亲人的母亲的母乳捐赠既没有得到讨论,也没有得到充分研究。因为母亲的悲伤是复杂的和个人的,决定捐赠母乳是一个需要支持的个人决定,不会为那些不希望捐赠的人带来罪恶感。
    There is a growing recognition globally that care regarding lactation following a perinatal death needs to potentially offer the opportunity for maternal donation. This article discusses this experience and perspectives from a human milk bank (HMB) in Vietnam. This is a descriptive exploratory case study that has a long tradition in both the social and health sciences. Triangulated data collection involved a review of video data, interview data with the donor, and data review for the Da Nang HMB, a Center for Excellence in Breastfeeding. We found that although it is common for mothers in Vietnam to donate breastmilk to HMBs, it is less common for this to occur following perinatal loss. We offer a descriptive case study of the maternal loss of twins and a subsequent choice to donate for approximately 1 month to the Da Nang HMB, the first HMB in Vietnam. We discuss four reasons derived from this case regarding donation following perinatal loss. (1) A strong motivation to donate breastmilk when aware of the service, (2) donating breastmilk helped her deal with grief, (3) family members supported her through this tough time and supported her decision, and (4) health staff supported her decision. While human milk sharing (e.g., wet nursing) has been practiced in Vietnam, breastmilk donation from bereaved mothers has neither been discussed nor well-researched. Because maternal grief is complex and individual, deciding to donate breastmilk is a personal decision that needs to be supported, without creating guilt for those who do not wish to donate.
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  • 文章类型: Journal Article
    Background: Perinatal Palliative Care provides comprehensive and holistic care for expectant and new parents, who receive a diagnosis of life-limiting fetal condition and opt to continue pregnancy and care for their newborn infant. Aim: To develop a service providing individually tailored holistic care during pregnancy, birth, postnatal and bereavement period. Methods: Following a baseline survey of neonatologists and discussions with key stakeholders we launched the Perinatal Palliative service at the KK Women\'s and Children\'s hospital, Singapore in January 2017. The multidisciplinary team, led by a Palliative care specialist comprised of Obstetricians, Neonatologists, nurses and medical social workers. The Birth defect clinic referred parents with antenatally diagnosed \'Lethal\' fetal conditions. The team checked the understanding and the decision making process of parents and initiated and finalized advance care plans. The service also embraced deserving postnatal referrals upon request. Results: A total of 41 cases were seen from January 2017 to December 2019. Of these, 26/41(63%) were referred antenatally and had completed advance care plans. 18/41 (44%) died during or shortly after birth and 10/41(24%) continue to survive and are supported by the community palliative team. During this time a workflow was formulated and modified based on parent and team feedback. Conclusion: Awareness of the service has increased over the years and a clear workflow has been formulated. Advance care plans are prepared and documented before birth so as to enable service teams on board to provide well timed pertinent care. Feedbacks from parents about this service were positive.
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