Rebecca Hoban1,2, Harold Bigger1, Aloka L Patel1,2, Beverly Rossman2, Louis F Fogg2, Paula Meier1,2. 1. 1 Section of Neonatology, Department of Pediatrics, Rush University Medical Center , Chicago, Illinois. 2. 2 Department of Women, Children, and Family Nursing, Rush University Medical Center , Chicago, Illinois.
Abstract
BACKGROUND: Little is known about human milk (HM) feeding goals for mothers of very low birth weight (VLBW) (<1,500 g birth weight) infants, especially for black mothers, for whom rates of VLBW birth are higher and lactation rates lower. This study examined the establishment, modification, and achievement of HM feeding goals during neonatal intensive care unit (NICU) hospitalization for mothers of VLBW infants and the influence of maternal race and income. MATERIALS AND METHODS: A prospective cohort study measured maternal HM feeding goals (exclusive [EHM], partial, none) predelivery and during three time intervals: day of life (DOL) 1-14, 15-28, and 29-72. Goal achievement compared the goal for the time interval with the proportion of HM feedings received by the infant. Goal establishment, modification, and achievement were examined using chi-squared and contingency tables. RESULTS: Three hundred fifty-two mother-infant dyads (53% black; 70% low-income; mean birth weight, 1,048 g) were studied. Predelivery, 55% of mothers planned to provide EHM; fewer black and low-income mothers chose EHM. During DOL 1-14, 63% of mothers chose EHM, and predelivery racial differences disappeared. Only 10% of mothers chose exclusive at-breast EHM feedings. EHM feeding goals decreased during NICU hospitalization, especially for black mothers. Whereas most mothers met their HM feeding goals initially, achievement rates declined during hospitalization. Mothers' EHM goal achievement was not influenced by race or income. CONCLUSIONS: Mothers changed their predelivery HM feeding goals after birth of a VLBW infant. Longitudinally, HM feeding goals and achievement reflected less HM use, highlighting the need to target lactation maintenance in this population.
BACKGROUND: Little is known about human milk (HM) feeding goals for mothers of very low birth weight (VLBW) (<1,500 g birth weight) infants, especially for black mothers, for whom rates of VLBW birth are higher and lactation rates lower. This study examined the establishment, modification, and achievement of HM feeding goals during neonatal intensive care unit (NICU) hospitalization for mothers of VLBW infants and the influence of maternal race and income. MATERIALS AND METHODS: A prospective cohort study measured maternal HM feeding goals (exclusive [EHM], partial, none) predelivery and during three time intervals: day of life (DOL) 1-14, 15-28, and 29-72. Goal achievement compared the goal for the time interval with the proportion of HM feedings received by the infant. Goal establishment, modification, and achievement were examined using chi-squared and contingency tables. RESULTS: Three hundred fifty-two mother-infant dyads (53% black; 70% low-income; mean birth weight, 1,048 g) were studied. Predelivery, 55% of mothers planned to provide EHM; fewer black and low-income mothers chose EHM. During DOL 1-14, 63% of mothers chose EHM, and predelivery racial differences disappeared. Only 10% of mothers chose exclusive at-breast EHM feedings. EHM feeding goals decreased during NICU hospitalization, especially for black mothers. Whereas most mothers met their HM feeding goals initially, achievement rates declined during hospitalization. Mothers' EHM goal achievement was not influenced by race or income. CONCLUSIONS: Mothers changed their predelivery HM feeding goals after birth of a VLBW infant. Longitudinally, HM feeding goals and achievement reflected less HM use, highlighting the need to target lactation maintenance in this population.
Authors: Betty R Vohr; Brenda B Poindexter; Anna M Dusick; Leslie T McKinley; Rosemary D Higgins; John C Langer; W Kenneth Poole Journal: Pediatrics Date: 2007-10 Impact factor: 7.124
Authors: Erin Fleurant; Michael Schoeny; Rebecca Hoban; Ifeyinwa V Asiodu; Brittany Riley; Paula P Meier; Harold Bigger; Aloka L Patel Journal: Breastfeed Med Date: 2016-12-01 Impact factor: 1.817
Authors: Andrew Romaine; Reese H Clark; Briana R Davis; Kaitlin Hendershot; Vance Kite; Madeleine Laughon; Isaac Updike; Marie Lynn Miranda; Paula P Meier; Aloka L Patel; P Brian Smith; C Michael Cotten; Daniel K Benjamin; Rachel G Greenberg Journal: J Pediatr Date: 2018-08-28 Impact factor: 4.406
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
Authors: Brittany Riley; Michael Schoeny; Laura Rogers; Ifeyinwa V Asiodu; Harold R Bigger; Paula P Meier; Aloka L Patel Journal: Breastfeed Med Date: 2016-06-27 Impact factor: 1.817