Anita Esquerra-Zwiers1,2, Michael E Schoeny2, Janet Engstrom2, Jennifer Wicks3, Jennifer Szotek4, Paula Meier2,5, Aloka L Patel5. 1. Department of Nursing, Hope College, Holland, Michigan, USA. 2. College of Nursing, Rush University, Chicago, Illinois, USA. 3. Department of Pediatrics, Rush University, Chicago, Illinois, USA. 4. Rush Medical College, Rush University, Chicago, Illinois, USA. 5. Section of Neonatology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA.
Abstract
Objective: To compare (1) differences in mother's own milk (MOM) provision and enteral feeding outcomes, (2) differences in preterm formula and donor human milk (DHM) uses as bridges to exclusive MOM feedings at discharge, and (3) MOM and enteral feeding outcomes for racial/ethnic subgroups before and after the implementation of a hospital DHM feeding program. Methods: Retrospective data from 313 very low birth weight (VLBW; birth weight <1,500 g) infants born between January 2011 to December 2012 (pre-DHM, n = 157) and April 2013 to March 2015 (DHM, n = 156) were analyzed. Results: For this predominantly low-income and minority VLBW infant cohort, the percent of enteral fed hospitalization days was higher in the DHM group (pre-DHM 94% [88, 97] versus DHM 98% [95, 99], p < 0.001). Although MOM remained the predominant first enteral feeding type, significantly fewer DHM infants received MOM (pre-DHM 89% versus DHM 75%, p = 0.001). During days of life 1-14, a lower percentage of DHM infants received 100% MOM (pre-DHM 68% versus DHM 55%, p = 0.02). For the entire cohort, the risk for MOM discontinuation was significantly associated with maternal young age, multiparity, non-Hispanic Black race/ethnicity, and low income. Implementation of a DHM program did not predict duration of MOM feedings. However, non-Hispanic White infants had a longer duration of MOM feedings with DHM availability. Conclusions: Our findings highlight the importance of using precise dose and exposure period methodology to determine the impact of DHM on MOM provision. In addition, DHM availability may be associated with varying effects on MOM provision among racial/ethnic groups.
Objective: To compare (1) differences in mother's own milk (MOM) provision and enteral feeding outcomes, (2) differences in preterm formula and donor human milk (DHM) uses as bridges to exclusive MOM feedings at discharge, and (3) MOM and enteral feeding outcomes for racial/ethnic subgroups before and after the implementation of a hospital DHM feeding program. Methods: Retrospective data from 313 very low birth weight (VLBW; birth weight <1,500 g) infants born between January 2011 to December 2012 (pre-DHM, n = 157) and April 2013 to March 2015 (DHM, n = 156) were analyzed. Results: For this predominantly low-income and minority VLBW infant cohort, the percent of enteral fed hospitalization days was higher in the DHM group (pre-DHM 94% [88, 97] versus DHM 98% [95, 99], p < 0.001). Although MOM remained the predominant first enteral feeding type, significantly fewer DHM infants received MOM (pre-DHM 89% versus DHM 75%, p = 0.001). During days of life 1-14, a lower percentage of DHM infants received 100% MOM (pre-DHM 68% versus DHM 55%, p = 0.02). For the entire cohort, the risk for MOM discontinuation was significantly associated with maternal young age, multiparity, non-Hispanic Black race/ethnicity, and low income. Implementation of a DHM program did not predict duration of MOM feedings. However, non-Hispanic White infants had a longer duration of MOM feedings with DHM availability. Conclusions: Our findings highlight the importance of using precise dose and exposure period methodology to determine the impact of DHM on MOM provision. In addition, DHM availability may be associated with varying effects on MOM provision among racial/ethnic groups.
Entities:
Keywords:
disparity; donor human milk; mother's own milk; very low birth weight infants
Authors: Laura Ward; Christine Auer; Carrie Smith; Pamela J Schoettker; Raymond Pruett; Nilesh Y Shah; Uma R Kotagal Journal: Breastfeed Med Date: 2012-05-21 Impact factor: 1.817
Authors: Leslie A Parker; Nicole Cacho; Clara Engelmann; Jaime Benedict; Susan Wymer; Weaver Michael; Josef Neu Journal: J Pediatr Date: 2019-05-03 Impact factor: 4.406
Authors: Kathleen A Marinelli; Mary M Lussier; Elizabeth Brownell; Victor C Herson; James I Hagadorn Journal: J Hum Lact Date: 2014-04-18 Impact factor: 2.219
Authors: Aloka L Patel; Michael E Schoeny; Rebecca Hoban; Tricia J Johnson; Harold Bigger; Janet L Engstrom; Erin Fleurant; Brittany Riley; Paula P Meier Journal: Pediatr Res Date: 2019-01-18 Impact factor: 3.756