{"id":6318,"date":"2026-10-19T09:48:46","date_gmt":"2026-10-19T09:48:46","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-hjukrunarfraedi-rakel-bjorg-jonsdottir\/"},"modified":"2026-10-19T09:48:46","modified_gmt":"2026-10-19T09:48:46","slug":"doktorsvorn-i-hjukrunarfraedi-rakel-bjorg-jonsdottir","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-hjukrunarfraedi-rakel-bjorg-jonsdottir\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed hj\u00fakrunarfr\u00e6\u00f0i – Rakel Bj\u00f6rg J\u00f3nsd\u00f3ttir"},"content":{"rendered":"
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F\u00f6studaginn 28. okt\u00f3ber ver Rakel Bj\u00f6rg J\u00f3nsd\u00f3ttir doktorsritger\u00f0 s\u00edna \u00ed hj\u00fakrunarfr\u00e6\u00f0i vi\u00f0 Hj\u00fakrunar- og lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0ideild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: Brj\u00f3stagj\u00f6f s\u00ed\u00f0fyrirbura. Upphaf, t\u00ed\u00f0ni og tengdir \u00fe\u00e6ttir hj\u00e1 einburum og tv\u00edburum. Breastfeeding of late preterm infants: Initiation, duration and associated factors for singletons and twins.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Christine Rubertsson, pr\u00f3fessor vi\u00f0 H\u00e1sk\u00f3lann \u00ed Lundi, og Helena Wigert, d\u00f3sent vi\u00f0 H\u00e1sk\u00f3lann \u00ed Gautaborg.<\/p>\n

Lei\u00f0beinendur voru dr. Ren\u00e9e Flacking, pr\u00f3fessor vi\u00f0 H\u00f6gskolan Dalarna, Sv\u00ed\u00fej\u00f3\u00f0, og \u00a0dr. Helga J\u00f3nsd\u00f3ttir, pr\u00f3fessor vi\u00f0 Hj\u00fakrunar- og lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0ideild. A\u00f0rir \u00ed doktorsnefnd voru Brynja \u00d6rlygsd\u00f3ttir, d\u00f3sent, Thor Aspelund, pr\u00f3fessor og \u00de\u00f3r\u00f0ur \u00deorkelsson yfirl\u00e6knir.<\/p>\n

Helga Bragad\u00f3ttir, pr\u00f3fessor og deildarforseti Hj\u00fakrunar- og lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0ideildar, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0asal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 13.00.<\/p>\n

\u00c1grip<\/strong><\/p>\n

Markmi\u00f0 ritger\u00f0arinnar er a\u00f0 l\u00fdsa upphafi og t\u00edmalengd brj\u00f3stagjafar hj\u00e1 m\u00e6\u00f0rum s\u00ed\u00f0fyrirbura (b\u00f6rn f\u00e6dd eftir 340 \u2013 366 vikna me\u00f0g\u00f6ngu) \u00e1samt \u00fev\u00ed a\u00f0 greina \u00fe\u00e6tti sem tengjast brj\u00f3stagj\u00f6f \u00e1 fyrsta \u00e6vi\u00e1ri. Ritger\u00f0in byggir \u00e1 tveimur ranns\u00f3knum sem birtar hafa veri\u00f0 \u00ed \u00feremur t\u00edmaritsgreinum. Fyrri ranns\u00f3knin var langt\u00edma h\u00f3pranns\u00f3kn, \u00fear sem \u00fe\u00e1tttakendur voru 129 s\u00ed\u00f0fyrirburar sem voru einburar og 277 fullbur\u00f0a einburar og leiddi h\u00fan \u00ed lj\u00f3s a\u00f0 s\u00ed\u00f0fyrirburar voru \u00ed minna m\u00e6li \u00e1 brj\u00f3sti en fullbur\u00f0a b\u00f6rn. Markt\u00e6kt f\u00e6rri s\u00ed\u00f0fyrirburar byrju\u00f0u \u00e1 brj\u00f3sti og t\u00edmalengd brj\u00f3stagjafar var tveimur m\u00e1nu\u00f0um styttri en hj\u00e1 fullbur\u00f0a b\u00f6rnunum. Einnig voru f\u00e6rri s\u00ed\u00f0fyrirburar eing\u00f6ngu \u00e1 brj\u00f3sti fyrsta m\u00e1nu\u00f0inn eftir f\u00e6\u00f0ingu en fullbur\u00f0a b\u00f6rn. A\u00f0 nota geirv\u00f6rtuhl\u00edf, gefa ekki eing\u00f6ngu brj\u00f3stamj\u00f3lk fyrstu vikuna heima e\u00f0a a\u00f0 gefa brj\u00f3st minna en t\u00edu sinnum \u00e1 dag, voru \u00fe\u00e6ttir sem juku l\u00edkurnar \u00e1 \u00fev\u00ed a\u00f0 s\u00ed\u00f0fyrirburinn v\u00e6ri ekki eing\u00f6ngu \u00e1 brj\u00f3sti vi\u00f0 eins m\u00e1na\u00f0a aldur. A\u00f0 m\u00f3\u00f0ir s\u00ed\u00f0fyrirbura\u00a0 teldi sig hafa n\u00e6ga brj\u00f3stamj\u00f3lk fyrstu vikuna heima j\u00f3k l\u00edkur \u00e1 \u00fev\u00ed a\u00f0 barn hennar v\u00e6ri eing\u00f6ngu \u00e1 brj\u00f3sti vi\u00f0 eins m\u00e1na\u00f0ar aldur. Ni\u00f0urst\u00f6\u00f0ur s\u00fdndu einnig a\u00f0 \u00feeir s\u00ed\u00f0fyrirburar sem byrju\u00f0u a\u00f0 f\u00e1 fasta f\u00e6\u00f0u fyrir fj\u00f6gurra m\u00e1na\u00f0a aldur voru l\u00edklegri til a\u00f0 h\u00e6tta fyrr \u00e1 brj\u00f3sti \u00e1 fyrsta \u00e1ri. L\u00ed\u00f0an m\u00e6\u00f0ra s\u00ed\u00f0fyrirbura var verri fyrsta \u00e1ri\u00f0 en l\u00ed\u00f0an m\u00e6\u00f0ra fullbur\u00f0a barna. Ni\u00f0urst\u00f6\u00f0ur s\u00fdndu hins vegar ekki tengsl \u00e1 milli l\u00ed\u00f0anar m\u00e6\u00f0ra s\u00ed\u00f0fyrirbura og brj\u00f3stagjafar hj\u00e1 \u00feeim.<\/p>\n

Seinni ranns\u00f3knin, sem var me\u00f0 bl\u00f6ndu\u00f0u sni\u00f0i, innih\u00e9lt megindleg g\u00f6gn fr\u00e1 44 m\u00e6\u00f0rum s\u00ed\u00f0fyrirbura sem voru tv\u00edburar\u00a0 og 82 m\u00e6\u00f0rum fullbur\u00f0a tv\u00edbura og eigindleg g\u00f6gn fr\u00e1 14 m\u00e6\u00f0rum s\u00ed\u00f0fyrirbura sem voru tv\u00edburar. Ni\u00f0urst\u00f6\u00f0urnar s\u00fdndu a\u00f0 n\u00e6stum allar m\u00e6\u00f0ur s\u00ed\u00f0fyrirburanna h\u00f3fu brj\u00f3stagj\u00f6f og t\u00ed\u00f0ni brj\u00f3stagjafar fyrsta m\u00e1nu\u00f0inn var s\u00fa sama og hj\u00e1 m\u00e6\u00f0rum fullbur\u00f0a tv\u00edbura. Hins vegar h\u00e6ttu mun fleiri m\u00e6\u00f0ur s\u00ed\u00f0fyrirbura sem voru tv\u00edburar brj\u00f3stagj\u00f6f eftir fyrsta m\u00e1nu\u00f0inn, sem leiddi til \u00feess a\u00f0 mun f\u00e6rri s\u00ed\u00f0fyrirburar voru \u00e1 brj\u00f3sti vi\u00f0 fj\u00f6gurra m\u00e1na\u00f0a aldur en fullbur\u00f0a tv\u00edburar. \u00der\u00edr lykil\u00fe\u00e6ttir h\u00f6f\u00f0u \u00e1hrif \u00e1 reynslu m\u00e6\u00f0ra s\u00ed\u00f0fyrirburanna og \u00e1kvar\u00f0anir \u00feeirra um brj\u00f3stagj\u00f6f: \u00f3\u00ferosku\u00f0 brj\u00f3stagjafaheg\u00f0un tv\u00edburanna sem kraf\u00f0ist \u00feess a\u00f0 \u00fe\u00e6r \u00feurftu a\u00f0 nota mjaltav\u00e9l samhli\u00f0a brj\u00f3stagj\u00f6f, \u00e1lagi\u00f0 sem fylgdi \u00fev\u00ed a\u00f0 fylgja verkmi\u00f0u\u00f0um f\u00e6\u00f0ugj\u00f6fum og skortur \u00e1 lei\u00f0beiningum fr\u00e1 heilbrig\u00f0isstarfsf\u00f3lki. A\u00f0 auki voru mj\u00f6g f\u00e1ir s\u00ed\u00f0fyrirburar eing\u00f6ngu \u00e1 brj\u00f3sti fyrstu fj\u00f3ra m\u00e1nu\u00f0ina.<\/p>\n

Ni\u00f0ursta\u00f0a verkefnisins er s\u00fa a\u00f0 s\u00ed\u00f0fyrirburar, b\u00e6\u00f0i einburar og tv\u00edburar, eru \u00ed minna m\u00e6li \u00e1 brj\u00f3sti en fullbur\u00f0a einburar og tv\u00edburar, b\u00e6\u00f0i hva\u00f0 var\u00f0ar eing\u00f6ngu brj\u00f3stagj\u00f6f og brj\u00f3stagj\u00f6f a\u00f0 hluta, sem er \u00e1hyggjuefni. M\u00e6\u00f0ur s\u00ed\u00f0fyrirbura eru vi\u00f0kv\u00e6mar og \u00feurfa meiri hagn\u00fdtan og tilfinningalegan stu\u00f0ning vi\u00f0 brj\u00f3stagj\u00f6f \u00e1 sj\u00fakrah\u00fasum og heima. Ni\u00f0urst\u00f6\u00f0urnar undirstrikar \u00fe\u00f6rfina \u00e1 frekari ranns\u00f3knum \u00e1 \u00edhlutunum og\u00a0 a\u00f0fer\u00f0um til a\u00f0 b\u00e6ta brj\u00f3stagj\u00f6f s\u00ed\u00f0fyrirbura. Til a\u00f0 efla og standa v\u00f6r\u00f0 um brj\u00f3stagj\u00f6f hj\u00e1 \u00feessum vi\u00f0kv\u00e6ma h\u00f3pi ver\u00f0ur a\u00f0 a\u00f0greina um\u00f6nnun \u00feeirra fr\u00e1 venjubundinni ungbarna\u00fej\u00f3nustu og tryggja a\u00f0 heilbrig\u00f0isstarfsf\u00f3lk hafi vi\u00f0eigandi menntun og \u00fej\u00e1lfun \u00e1 \u00feessu svi\u00f0i.<\/p>\n

English abstract<\/strong><\/p>\n

The overarching aim of this thesis was to describe the initiation and duration of breastfeeding in mothers of late preterm (LPT) infants and identify factors associated with breastfeeding during the first year. It is based on two studies published in three research papers. The first study, a longitudinal cohort study including 129 LPT singleton infants and 277 term singleton infants, demonstrated that LPT singleton infants were breastfed to a lesser extent than term singletons. Thus, the initiation rate was lower, and the duration of breastfeeding was 2 months shorter than in term singleton infants. Also, fewer LPT singleton infants were exclusively breastfed during the first month after birth than term infants. Using a nipple shield, not feeding breast milk exclusively during the first week at home, or feeding less than ten times per day at one month increased the odds of not breastfeeding exclusively at the breast at one month for LPT singletons. Having an abundance of breast milk during the first week at home constituted a protective factor for exclusive breastfeeding at the breast at one month for singleton LPT infants. The factor associated with ceasing breastfeeding during the first year was if the mother had started to give solids before 4 months of infant’s age. The well-being of mothers of LPT singleton infants was worse during the first year than in mothers of term singletons. However, our results did not show an association between the well-being of mothers and breastfeeding in LPT singletons.<\/p>\n

The second study, a sequential explanatory mixed-method design, encompassed quantitative data from 44 mothers of LPT twins and mothers of 82 term twins and qualitative data from 14 mothers of LPT twins. The findings showed that almost all mothers of LPT twins initiated breastfeeding, and the breastfeeding rate during the first month was the same as in mothers of term twins. However, after the first month, more mothers of LPT twins ceased breastfeeding, leading to large differences in the breastfeeding rate at 4 months of twins’ age compared to term twins. Key factors influencing LPT twin mothers\u2019 experiences and decisions around breastfeeding were their infants’ immature breastfeeding behaviours requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. In addition, very few LPT twins were exclusively breastfed during the first four months; the exclusive breastfeeding rate was significantly less than term twins during the first week at home.<\/p>\n

In conclusion, LPT singleton and twin infants are breastfed to a lesser extent than their term counterparts, both any breastfeeding and exclusive, necessitating concern. Mothers with LPT infants are vulnerable and need greater practical breastfeeding and emotional support in hospitals and at home. This highlights the need for further research to guide interventions optimising breastfeeding in LPT infants. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need proper education and training.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

Rakel Bj\u00f6rg J\u00f3nsd\u00f3ttir er f\u00e6dd \u00e1ri\u00f0 1972 \u00ed Reykjav\u00edk. H\u00fan lauk st\u00fadentspr\u00f3fi af n\u00e1tt\u00farufr\u00e6\u00f0ibraut vi\u00f0 Menntask\u00f3lann \u00ed Reykjav\u00edk \u00e1ri\u00f0 1992, BS-pr\u00f3fi \u00ed hj\u00fakrunarfr\u00e6\u00f0i \u00e1ri\u00f0 1996 og meistaragr\u00e1\u00f0u \u00ed hj\u00fakrunarfr\u00e6\u00f0i, me\u00f0 \u00e1herslu \u00e1 n\u00fdburahj\u00fakrun, fr\u00e1 Hj\u00fakrunarfr\u00e6\u00f0ideild H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2003. Rakel hefur starfa\u00f0 \u00e1 n\u00fdburagj\u00f6rg\u00e6sludeild \u2013 v\u00f6kudeild Landsp\u00edtalans fr\u00e1 \u00e1rinu 1996, sem s\u00e9rfr\u00e6\u00f0ingur \u00ed n\u00fdburahj\u00fakrun fr\u00e1 2007. Me\u00f0fram starfi \u00e1 v\u00f6kudeild hefur h\u00fan veri\u00f0 stundakennari vi\u00f0 Hj\u00fakrunarfr\u00e6\u00f0ideild fr\u00e1 \u00e1rinu 2001 og kl\u00edn\u00edskur lektor fr\u00e1 2013. Foreldrar hennar eru S\u00f3lveig Steingr\u00edmsd\u00f3ttir og J\u00f3n Bjargmundsson. Samb\u00fdlisma\u00f0ur Rakelar er Sigur\u00f0ur \u00d3li Jensson og eiga \u00feau \u00ferj\u00fa b\u00f6rn, S\u00f3lveigu, Jens og Rebekku.<\/p>\n<\/div><\/div>","protected":false},"featured_media":5599,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2022-10-28T13:00:00+00:00","_phd_date_end":"2022-10-28T16:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"Brj\u00f3stagj\u00f6f s\u00ed\u00f0fyrirbura. Upphaf, t\u00ed\u00f0ni og tengdir \u00fe\u00e6ttir hj\u00e1 einburum og tv\u00edburum. 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