Mother’s Own Milk Feeding in Preterm Newborns Admitted to the Neonatal Intensive Care Unit or Special-Care Nursery: Obstacles, Interventions, Risk Calculation
Abstract
:1. Introduction
2. Modifiable Risk Factors for NMOM Feeding at Discharge
2.1. Skin-to-Skin Contact in the Delivery Room and the NICU
2.2. Strategies of Infant Feeding and Milk Expression
2.3. Mode of Delivery
3. Unmodifiable Risk Factors for NMOM Feeding at Discharge
3.1. Demographical Risk Factors of the Infant
3.2. Demographical Risk Factors of the Mother
3.3. Health and Disease-Related Risk Factors of the Infant
3.4. Health and Disease-Related Risk Factors of the Mother
3.5. Maternal Experiences with Milk Expression
4. Identifying Mother–Baby Dyads at Risk of NMOM Feeding at Discharge
5. Checklist for Quality-Improvement Projects to Increase MOM Feeding at Discharge
- Is MOM feeding at discharge seen as an important outcome parameter?
- Is skin-to-skin care in the delivery room facilitated?
- Is skin-to-skin care in the NICU possible during the first days of life, especially in the first week of life?
- Is breast-milk expression started within 6 h after delivery?
- Do parents receive information on breastfeeding/breast-milk expression antenatally?
- Is the amount of pumped breast milk discussed at daily rounds?
- Are targeted interventions available for infants at risk, such as after abdominal surgery or below 28 weeks gestational age?
- Are targeted interventions available for mothers at risk, such as with nicotine use or gestational diabetes?
- Are targeted interventions available for mothers not achieving 500 mL per day of pumped breast milk at day 14 postpartum?
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Statistics
References
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Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
SSC in the delivery room | |||
No | 267 | 160 (60.0) | 1.00 (Reference) |
Yes | 54 | 38 (70.4) | 1.59 (0.84–2.99) |
SSC in the first week of life | |||
No | 169 | 90 (53.3) | 1.00 (Reference) |
Yes | 199 | 133 (65.8) | 1.69 (1.11–2.58) |
Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
Breastfeeding at least once during hospital stay | |||
No | 92 | 26 (28.3) | 1.00 (Reference) |
Yes | 275 | 195 (70.9) | 6.19 (3.67–10.44) |
Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
Mode of delivery | |||
Vaginal delivery | 56 | 40 (71.4) | 1.00 (Reference) |
C-section | 312 | 181 (58.0) | 0.55 (0.30–1.03) |
Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
Gestational age at birth | |||
≥28 weeks | 290 | 185 (63.8) | 1.00 (Reference) |
<28 weeks | 78 | 36 (46.2) | 0.49 (0.29–0.81) |
Multiples | |||
No | 253 | 150 (59.3) | 1.00 (Reference) |
Yes | 115 | 71 (61.7) | 1.11 (0.71–1.74) |
Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
Maternal age | |||
≥25 years | 333 | 205 (61.6) | 1.00 (Reference) |
<25 years | 35 | 16 (45.7) | 0.53 (0.26–1.06) |
Professional education | |||
No academic degree | 263 | 159 (60.5) | 1.00 (Reference) |
Academic degree | 51 | 36 (70.6) | 1.57 (0.82–3.01) |
Parity | |||
Primipara | 222 | 135 (60.8) | 1.00 (Reference) |
Multipara | 146 | 86 (58.9) | 0.92 (0.60–1.41) |
Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
Intraventricular hemorrhage, grade 2 or higher | |||
No | 345 | 211 (61.2) | 1.00 (Reference) |
Yes | 22 | 9 (40.9) | 0.44 (0.18–1.06) |
Posthemorrhagic ventricular dilatation | |||
No | 354 | 214 (60.5) | 1.00 (Reference) |
Yes | 14 | 7 (50.0%) | 0.65 (0.22–1.91) |
Abdominal surgery | |||
No | 349 | 214 (61.3) | 1.00 (Reference) |
Yes | 19 | 7 (36.8%) | 0.37 (0.14–0.96) |
Modifying Factor | MOM Feeding at Discharge | ||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
Nicotine or recreational drug use | |||
No | 332 | 214 (64.4) | 1.00 (Reference) |
Yes | 36 | 7 (19.4) | 0.13 (0.06–0.31) |
Gestational diabetes | |||
No | 331 | 205 (61.9) | 1.00 (Reference) |
Yes | 37 | 16 (43.2) | 0.47 (0.24–0.93) |
MOM Feeding at Discharge | |||
---|---|---|---|
Total | N (%) | OR (95% CI) | |
MOM feeding risk score | |||
0 | 175 | 121 (69.1) | 1.00 (Reference) |
1 | 111 | 68 (61.3) | 0.71 (0.43–1.16) |
2 | 74 | 31 (41.9) | 0.32 (0.18–0.57) |
3 | 8 | 1 (12.5) | 0.06 (0.01–0.53) |
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Heller, N.; Rüdiger, M.; Hoffmeister, V.; Mense, L. Mother’s Own Milk Feeding in Preterm Newborns Admitted to the Neonatal Intensive Care Unit or Special-Care Nursery: Obstacles, Interventions, Risk Calculation. Int. J. Environ. Res. Public Health 2021, 18, 4140. https://doi.org/10.3390/ijerph18084140
Heller N, Rüdiger M, Hoffmeister V, Mense L. Mother’s Own Milk Feeding in Preterm Newborns Admitted to the Neonatal Intensive Care Unit or Special-Care Nursery: Obstacles, Interventions, Risk Calculation. International Journal of Environmental Research and Public Health. 2021; 18(8):4140. https://doi.org/10.3390/ijerph18084140
Chicago/Turabian StyleHeller, Nadja, Mario Rüdiger, Vanessa Hoffmeister, and Lars Mense. 2021. "Mother’s Own Milk Feeding in Preterm Newborns Admitted to the Neonatal Intensive Care Unit or Special-Care Nursery: Obstacles, Interventions, Risk Calculation" International Journal of Environmental Research and Public Health 18, no. 8: 4140. https://doi.org/10.3390/ijerph18084140