Masahiko Murase1, Laurie Nommsen-Rivers2, Ardythe L Morrow2, Misato Hatsuno3, Katsumi Mizuno3, Motohiro Taki3, Tokuo Miyazawa3, Yuya Nakano3, Madoka Aizawa3, Kazuo Itabashi3. 1. Showa University School of Medicine, Department of Pediatrics, Tokyo, Japan Cincinnati Children's Hospital Medical Center, Division of Neonatology, Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati, OH, USA masahiko.murase@cchmc.org. 2. Cincinnati Children's Hospital Medical Center, Division of Neonatology, Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati, OH, USA. 3. Showa University School of Medicine, Department of Pediatrics, Tokyo, Japan.
Abstract
BACKGROUND: Factors associated with successful provision of mother's own milk (MOM) for premature infants in a Japanese neonatal intensive care unit (NICU) context are not well known. OBJECTIVE: We determined the independent risk factors for low milk volume at day 4 postpartum and formula feeding at the time of NICU discharge. METHODS: We reviewed the medical records of mothers who delivered at < 32 weeks' gestation. We determined maternal, premature infant, and milk expression variables predictive of (1) day 4 postpartum milk volume being less than the cohort median and (2) formula feeding at the time of NICU discharge, reported as adjusted odds ratios (95% confidence interval). RESULTS: Among 85 dyads, median (quartile range) milk volume on day 4 postpartum was 153 (34-255) mL. The rate of formula feeding at discharge was 42%. Mothers delivering by cesarean (vs vaginal) delivery had 4.3-fold (1.5-12.4) greater odds of day 4 milk volume < median (P < .01). Pregnancy-induced hypertension, delayed milk expression initiation, and low pumping frequency were strongly associated with cesarean delivery. Subsequently, mothers with day 4 milk volume < median (vs ≥ median) had 7.1-fold (2.6-19.5) greater odds of formula feeding at discharge (P < .01). CONCLUSION: Cesarean delivery is associated with lower milk volume on day 4 but may represent a composite of underlying risk factors for low milk volume in the early postpartum period. Further, low milk volume on day 4 is a strong correlate of lack of exclusive breast milk feeding at NICU discharge.
BACKGROUND: Factors associated with successful provision of mother's own milk (MOM) for premature infants in a Japanese neonatal intensive care unit (NICU) context are not well known. OBJECTIVE: We determined the independent risk factors for low milk volume at day 4 postpartum and formula feeding at the time of NICU discharge. METHODS: We reviewed the medical records of mothers who delivered at < 32 weeks' gestation. We determined maternal, premature infant, and milk expression variables predictive of (1) day 4 postpartum milk volume being less than the cohort median and (2) formula feeding at the time of NICU discharge, reported as adjusted odds ratios (95% confidence interval). RESULTS: Among 85 dyads, median (quartile range) milk volume on day 4 postpartum was 153 (34-255) mL. The rate of formula feeding at discharge was 42%. Mothers delivering by cesarean (vs vaginal) delivery had 4.3-fold (1.5-12.4) greater odds of day 4 milk volume < median (P < .01). Pregnancy-induced hypertension, delayed milk expression initiation, and low pumping frequency were strongly associated with cesarean delivery. Subsequently, mothers with day 4 milk volume < median (vs ≥ median) had 7.1-fold (2.6-19.5) greater odds of formula feeding at discharge (P < .01). CONCLUSION: Cesarean delivery is associated with lower milk volume on day 4 but may represent a composite of underlying risk factors for low milk volume in the early postpartum period. Further, low milk volume on day 4 is a strong correlate of lack of exclusive breast milk feeding at NICU discharge.
Authors: Rebecca Hoban; Harold Bigger; Michael Schoeny; Janet Engstrom; Paula Meier; Aloka L Patel Journal: Breastfeed Med Date: 2018-01-29 Impact factor: 1.817