Barriers to optimal breast milk provision in the neonatal intensive care unit
- PMID: 34815522
- PMCID: PMC8610106
- DOI: 10.1038/s41372-021-01275-4
Barriers to optimal breast milk provision in the neonatal intensive care unit
Abstract
Objective: This study examines comprehensive patient and process factors that influence breast milk use in the NICU setting.
Study design: We examined the association of maternal, neonatal, and family factors and lactation support systems to identify gaps in breast milk use in a retrospective study of 865 infants born in 23-41 weeks gestation admitted to the NICU.
Results: Breast milk at discharge for all infants was 89.3%, for extremely preterm 82.3%, moderately preterm 91.4%, late preterm 86.5%, and term 92.7%. Prematurity (OR 0.31 [0.17-0.56]), low birth weight, morbidities, Black maternal race (OR 0.20 [0.07-0.57]) and public insurance (OR 0.54 [0.34-0.85]) were associated with decreased breast milk use. Early initiation of feeds was associated with increased breast milk use.
Conclusions: There is a need to increase social as well as hospital support systems to address gaps in breast milk use in the NICU.
© 2021. The Author(s), under exclusive licence to Springer Nature America, Inc.
Conflict of interest statement
The other authors declare no conflicts of interest relevant to this article. Dr. Lee is a paid consultant to Lansinoh Laboratories, Inc, and received research grant funding from Mead Johnson Nutrition.
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References
-
- Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Wright LL, Langer JC, et al. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics. 2006;118:e115–e123. doi: 10.1542/peds.2005-2382. - DOI - PubMed
-
- Gharib S, Fletcher M, Tucker R, Vohr B, Lechner BE. Effect of dedicated lactation support services on breastfeeding outcomes in extremely-low-birth weight neonates. J Hum Lact. 2018;34:728–36. - PubMed
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