Nitrous oxide for pain and anxiety management in elderly patients after THA rehabilitation: a study protocol for a randomized controlled trial.

Preterm birth, defined as delivery before 37 weeks of gestation [], affects approximately 9.9% of live births globally [], with China contributing 7.5% of these cases []. Preterm birth is a leading cause of neonatal mortality, accounting for 35% of newborn deaths []. In China, the first month after childbirth, known as postpartum confinement, involves traditional rest at home, limiting mothers’ mobility and access to professional support. Breast milk is critical for preterm infants, offering immunological protection, promoting gut maturation, reducing complications like necrotizing enterocolitis and sepsis, and supporting cognitive development, which are vital for infants vulnerable to infections and developmental delays []. However, breastfeeding preterm infants is challenging due to physiological immaturity, weak sucking reflexes, low birth weight, respiratory issues requiring tube feeding, and prolonged mother-infant separation in NICUs, particularly in China, where restrictive visiting policies limit maternal involvement []. Additional barriers include maternal postpartum recovery challenges, such as pain from cesarean sections or insufficient milk supply []. In China’s NICU settings, mothers are often instructed to pump breast milk, which is delivered to the hospital by family members, but standardized guidance on pumping techniques, storage, and transportation is rarely provided, leading to issues like improper handling or reduced milk production [, ]. Healthcare strategies, such as lactation counseling, peer support groups, skin-to-skin contact initiatives, and telehealth follow-ups, have shown promise in promoting breastfeeding among preterm mothers [, ]. For example, structured lactation programs in NICUs can increase exclusive breastfeeding rates by providing hands-on guidance and emotional support []. However, these interventions are often inconsistent, and mothers report receiving haphazard support dependent on healthcare providers’ expertise []. Qualitative studies highlight that mothers seek recognition of their unique breastfeeding needs, yet these remain poorly understood, particularly in the Chinese context []. This study aims to explore the breastfeeding support needs and experiences of Chinese mothers of preterm infants during NICU hospitalization, 2–3 days before discharge, and up to 6 months post-discharge, to inform targeted interventions for improving breastfeeding rates. This qualitative descriptive study used semi-structured video interviews to explore the breastfeeding support needs and experiences of mothers of preterm infants across three stages: NICU hospitalization, 2–3 days before discharge, and up to 6 months post-discharge. Video interviews were chosen due to postpartum confinement practices and COVID-19 restrictions, which limited face-to-face interactions.