Download PDF
Am J Perinatol 2014; 31(10): 891-898
DOI: 10.1055/s-0033-1363500
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Independent Predictors of Human Milk Receipt at Neonatal Intensive Care Unit Discharge

Elizabeth A. Brownell
1   The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
,
Mary M. Lussier
1   The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut
,
James I. Hagadorn
1   The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
,
Jacqueline M. McGrath
3   Nursing Research, Connecticut Children's Medical Center, Hartford, Connecticut
4   Department of Nursing, University of Connecticut, Storrs, Connecticut
,
Kathleen A. Marinelli
1   The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
,
Victor C. Herson
1   The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
› Author Affiliations
Further Information

Publication History

18 July 2013

12 November 2013

Publication Date:
17 December 2013 (online)

    Permissions and Reprints

Abstract

Objective The aim of this study is to construct a predictive model for very low birth weight (VLBW) infants' receipt of mother's own milk within 24 hours before neonatal intensive care unit (NICU) discharge.

Study Design Vermont Oxford Network (VON) clinical data were analyzed retrospectively for VLBW infants admitted between 2002 and 2012 at an inner city, level IV NICU with a well-established lactation program. Bivariate analyses compared infant characteristics between recipients and nonrecipients of human milk before 24 hours of NICU discharge. Independent predictors identified in the bivariate analyses (p ≤ 0.05), were eligible for inclusion into a multivariable logistic regression model.

Results We observed a 60.4% human milk feeding rate at NICU discharge. Multiple independent maternal (black race and Hispanic ethnicity) and clinical factors (need for mechanical ventilation, patent ductus arteriosus, late-onset sepsis, or discharge to home on a cardiorespiratory monitor) positively predicted the outcome.

Conclusions Our results were inconsistent with previous studies and suggest that a strong NICU lactation program in combination with a community-based peer counselor program may increase rates of human milk receipt among VLBW infants born to black/Hispanic mothers and those with more complicated neonatal courses.

Keywords

Vermont Oxford Network - neonatal intensive care units - breast milk expression - lactation - patient acuity - perinatology - neonatology
 

  • References

  • 1 Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012; 129 (3) e827-e841
    CrossrefPubMedGoogle Scholar
  • 2 Ip S, Chung M, Raman G , et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 2007; (153) 1-186
    PubMedGoogle Scholar
  • 3 Schanler RJ, Hurst NM, Lau C. The use of human milk and breastfeeding in premature infants. Clin Perinatol 1999; 26 (2) 379-398 , vii
    PubMedGoogle Scholar
  • 4 Meier PP, Engstrom JL, Patel AL, Jegier BJ, Bruns NE. Improving the use of human milk during and after the NICU stay. Clin Perinatol 2010; 37 (1) 217-245
    CrossrefPubMedGoogle Scholar
  • 5 Isaacs EB, Fischl BR, Quinn BT , et al. Impact of breast milk on IQ, brain size and white matter development. Pediatr Res 2010; 67 (4) 357-362
    CrossrefPubMedGoogle Scholar
  • 6 Lucas A, Cole TJ. Breast milk and neonatal necrotising enterocolitis. Lancet 1990; 336 (8730) 1519-1523
    Google Scholar
  • 7 Hylander MA, Strobino DM, Dhanireddy R. Human milk feedings and infection among very low birth weight infants. Pediatrics 1998; 102 (3) E38
    CrossrefPubMedGoogle Scholar
  • 8 Hylander MA, Strobino DM, Pezzullo JC, Dhanireddy R. Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants. J Perinatol 2001; 21 (6) 356-362
    CrossrefPubMedGoogle Scholar
  • 9 Schanler RJ, Lau C, Hurst NM, Smith EO. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116 (2) 400-406
    CrossrefPubMedGoogle Scholar
  • 10 Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birth-weight infants. Arch Pediatr Adolesc Med 2003; 157 (1) 66-71
    CrossrefPubMedGoogle Scholar
  • 11 Furman L, Wilson-Costello D, Friedman H, Taylor HG, Minich N, Hack M. The effect of neonatal maternal milk feeding on the neurodevelopmental outcome of very low birth weight infants. J Dev Behav Pediatr 2004; 25 (4) 247-253
    Google Scholar
  • 12 Vohr BR, Poindexter BB, Dusick AM , et al; National Institute of Child Health and Human Development National Research Network. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007; 120 (4) e953-e959
    Google Scholar
  • 13 Vohr BR, Poindexter BB, Dusick AM , et al; NICHD Neonatal Research Network. 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 (1) e115-e123
    Google Scholar
  • 14 Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics 2006; 117 (4) 1253-1261
    CrossrefPubMedGoogle Scholar
  • 15 Spatz DL. State of the science: use of human milk and breast-feeding for vulnerable infants. J Perinat Neonatal Nurs 2006; 20 (1) 51-55
    CrossrefPubMedGoogle Scholar
  • 16 Furman L, Minich N, Hack M. Correlates of lactation in mothers of very low birth weight infants. Pediatrics 2002; 109 (4) e57
    CrossrefPubMedGoogle Scholar
  • 17 Lee HC, Gould JB. Factors influencing breast milk versus formula feeding at discharge for very low birth weight infants in California. J Pediatr 2009; 155 (5) 657-662 , e1–e2
    CrossrefPubMedGoogle Scholar
  • 18 Pineda RG. Predictors of breastfeeding and breastmilk feeding among very low birth weight infants. Breastfeed Med 2011; 6 (1) 15-19
    CrossrefPubMedGoogle Scholar
  • 19 Davanzo R, Ronfani L, Brovedani P, Demarini S ; Breastfeeding in Neonatal Intensive Care Unit Study Group. Breast feeding very-low-birthweight infants at discharge: a multicentre study using WHO definitions. Paediatr Perinat Epidemiol 2009; 23 (6) 591-596
    CrossrefPubMedGoogle Scholar
  • 20 Vermont Oxford Network . About us. Available at: http://www.vtoxford.org/about/about.aspx . Accessed May 1, 2013
    PubMed
  • 21 Vermont Oxford Network. Vermont Oxford Network Database Manual of Operations Parts 2: Data Definitions and Data Forms for Infants Born in 2013. Burlington, VT: Vermont Oxford Network; 2012
    Google Scholar
  • 22 Powers NG, Bloom B, Peabody J, Clark R. Site of care influences breastmilk feedings at NICU discharge. J Perinatol 2003; 23 (1) 10-13
    CrossrefPubMedGoogle Scholar
  • 23 Davanzo R, Monasta L, Ronfani L, Brovedani P, Demarini S ; Breastfeeding in Neonatal Intensive Care Unit Study Group. Breastfeeding at NICU discharge: a multicenter Italian study. J Hum Lact 2013; 29 (3) 374-380
    CrossrefPubMedGoogle Scholar
  • 24 Anderson AK, Damio G, Young S, Chapman DJ, Pérez-Escamilla R. A randomized trial assessing the efficacy of peer counseling on exclusive breastfeeding in a predominantly Latina low-income community. Arch Pediatr Adolesc Med 2005; 159 (9) 836-841
    CrossrefPubMedGoogle Scholar
  • 25 Chapman DJ, Damio G, Young S, Pérez-Escamilla R. Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: a randomized controlled trial. Arch Pediatr Adolesc Med 2004; 158 (9) 897-902
    CrossrefPubMedGoogle Scholar
  • 26 Hispanic Health Council . Available at: http://www.hispanichealth.com/hhc/breastfeeding . Accessed June 30, 2013
    PubMed