Intervention for promoting breast milk use in neonatal intensive care unit: a pilot study

Abstract Objective: The health benefits provided by breast milk are significant in preterm infants. Despite recommendations, rates of breastfeeding in preterm infants are lower than in term infants. The aim of this study was to evaluate the efficacy of a multidisciplinary intervention in promoting any breastfeeding in preterm infants at discharge. Methods: A prospective non-randomized interventional cohort study was conducted. One hundred and twenty-two preterm infants constituted the historical group. A multidisciplinary intervention was performed including staff training and setting up and implementation of a written breastfeeding procedure. Results: One hundred and ten preterm infants were enrolled in the intervention group. The percentage of infants fed human milk at discharge was 69 and 62 in the intervention group and in the historical group, respectively. The percentage change from any breastfeeding at full enteral feeding attainment to formula feeding at discharge was lower in the intervention group than in the historical group (−9 versus −23). Belonging to the intervention group and having at least one stress factor during pregnancy were independently associated with any breast milk feeding at discharge. Conclusions: The multidisciplinary intervention performed appears to be effective in promoting any breastfeeding in preterm infants at discharge.

[1]  M. Georgieff,et al.  Breastfeeding and the Use of Human Milk. , 2014, Nursing for women's health.

[2]  M. Giannì,et al.  Implementation of Nutritional Strategies Decreases Postnatal Growth Restriction in Preterm Infants , 2012, PloS one.

[3]  P. Sharek,et al.  A Quality Improvement Project to Increase Breast Milk Use in Very Low Birth Weight Infants , 2012, Pediatrics.

[4]  U. Kotagal,et al.  The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants. , 2012, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[5]  A. Eidelman,et al.  Breastfeeding and the Use of Human Milk , 2005, Pediatrics.

[6]  R. Schanler.  Outcomes of human milk-fed premature infants. , 2011, Seminars in perinatology.

[7]  S. Quandt,et al.  Breast Milk Expression and Maintenance in Mothers of Very Low Birth Weight Infants: Supports and Barriers , 2010, Journal of human lactation : official journal of International Lactation Consultant Association.

[8]  L. Ronfani,et al.  Breast feeding very-low-birthweight infants at discharge: a multicentre study using WHO definitions. , 2009, Paediatric and perinatal epidemiology.

[9]  H. Bauchner,et al.  Maternal Birthplace and Breastfeeding Initiation Among Term and Preterm Infants: A Statewide Assessment for Massachusetts , 2006, Pediatrics.

[10]  T. Fenton,et al.  A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format , 2003, BMC pediatrics.

[11]  N. Chawla,et al.  The Baby-Friendly Hospital Initiative Increases Breastfeeding Rates in a US Neonatal Intensive Care Unit , 2003, Journal of human lactation : official journal of International Lactation Consultant Association.

[12]  S. Haase,et al.  The Impact of Peripartum Factors on the Onset and Duration of Lactation , 2003, Neonatology.

[13]  M. Dueñas,et al.  Evaluation, development, and implementation of potentially better practices in neonatal intensive care nutrition. , 2003, Pediatrics.

[14]  P. Auld,et al.  Soluble E-selectin, soluble L-selectin and soluble ICAM-1 in bronchopulmonary dysplasia, and changes with dexamethasone. , 2003, Pediatrics.

[15]  R. Pérez‐Escamilla,et al.  Identification of risk factors for delayed onset of lactation. , 1999, Journal of the American Dietetic Association.

[16]  J. Morton.  Breastfeeding: A Guide for the Medical Profession , 1990 .

[17]  F. Lefebvre,et al.  Incidence and duration of lactation and lactational performance among mothers of low-birth-weight and term infants. , 1989, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[18]  K. Hirose.  Premature Infants and Breast-Feeding , 1983 .

[19]  M. J. Bell,et al.  Neonatal Necrotizing Enterocolitis: Therapeutic Decisions Based upon Clinical Staging , 1978, Annals of surgery.

[20]  R. Lawrence.  Chapter 15 – Premature Infants and Breastfeeding , 2011 .