Preterm infants' mothers' initiation and frequency of breast milk expression and exclusive use of mother's breast milk in neonatal intensive care units

Abstract

Aims and objectives: To describe preterm infants' mothers' expressing practices and exclusive use of mother's breast milk in neonatal intensive care settings, as well as to explore whether mothers' and infants' characteristics are predictors of the mother's inadequate expressing practices and nonexclusive use of mothers' breast milk.

Background: Use of their own mother's milk decreases preterm infants' mortality and morbidity, but expression is exhausting for the mothers. Mothers' and infants' characteristics are associated with milk output and exclusive breastfeeding at discharge, as well as later in infancy.

Design: Cross-sectional study.

Methods: The data were collected through questionnaires in two neonatal units. Multiple logistic regression was used to determine whether mothers' and infants' characteristics are predictors of late expression initiation (>6 hr from birth), inadequate expression frequency (≤6 times per a day) and nonexclusive use of own mother's milk.

Results: The sample consisted of 129 mothers. One-third of the mothers had adequate expression practices. Half of the infants exclusively received their mother's own breast milk. Previous neonatal intensive care unit experience, poor psychological well-being, an infant's male gender, caesarean section and high gestational birth age were significant predictors of late expression initiation. None of the studied variables were significant predictors of inadequate expression frequency. Furthermore, lack of previous expression experience, financial woes and high gestational age were predictors of nonexclusive use of own mother's milk.

Conclusions: Expression practices, as well as use of own mother's milk, were suboptimal. High gestational age was associated with both late expression initiation and nonexclusive breast milk use. The mothers maintained expression regardless of their well-being.

Relevance to clinical practice: Counselling and support are needed to avoid suboptimal expression practices. Special attention should be paid to mothers with moderately preterm infants, caesarean delivery, poor psychological well-being and financial woes.

Keywords: breast milk expression; breastfeeding; neonatal intensive care units; preterm infants.