Mothers' experiences of feeding their premature infants after discharge from the hospital: a systematic review and thematic synthesis.

Being born prematurely has profound implications for feeding, which is one of the most complex and developmentally significant tasks in the first year of life. Various factors influence feeding outcomes and experiences including fatigue and coordination difficulties associated with prematurity, heightened parental anxiety, and altered parent-infant interaction that can result in maladaptive mealtime routines and behaviours. The transition from hospital to home is a sensitive period for parents of premature infants. This review aims to understand parents' experiences of feeding their premature infants in the first year after discharge. This synthesis will inform the development of effective post-discharge support strategies and guide future research. A systematic search of six databases (MEDLINE via PubMed, CINAHL, EMBASE, AMED, PsycINFO, and Web of Science) was conducted. Qualitative studies published between 2000 and 2025 that describe parents' experiences of feeding their premature infants after hospital discharge were quality-appraised and analysed using thematic synthesis. Twenty-two studies conducted across 10 countries were included. All studies focused on mothers of premature infants across all levels of prematurity and most centred on breastfeeding experiences. Four main themes illustrate that feeding experiences are shaped by personal, institutional, and societal influences and that mothers across diverse countries describe remarkably similar experiences despite variations in healthcare systems and models of care. The main themes were the complex reality of the feeding journey, negotiating agency in the feeding journey, navigating the institutional landscape and the impact of societal norms on feeding experiences. The review showed that the struggle to build and sustain maternal agency and confidence in feeding their premature infants, does not end at discharge; for many, it intensifies at home. Supporting parents of premature infants requires attention not only to feeding techniques but also to the relational, institutional, and societal forces that shape maternal agency and confidence long after hospital discharge.