Successes of a Focused Mothers' Own Milk (MOM) Program in Counteracting Unintended Effects of a Donor Milk Program on MOM Rates at Discharge

Karen D Hendricks-Muñoz; Nada Darwish; Nayef Chahin; Shoshana Newman-Lindsay; Lisa Shaver; Melissa Dollings; Jie Xu; Valerie Coleman

doi:10.1089/bfm.2023.0147

Successes of a Focused Mothers' Own Milk (MOM) Program in Counteracting Unintended Effects of a Donor Milk Program on MOM Rates at Discharge

Breastfeed Med. 2023 Dec;18(12):928-933. doi: 10.1089/bfm.2023.0147. Epub 2023 Nov 29.

Authors

Karen D Hendricks-Muñoz¹, Nada Darwish², Nayef Chahin¹, Shoshana Newman-Lindsay³, Lisa Shaver⁴, Melissa Dollings⁴, Jie Xu⁵, Valerie Coleman⁶

Affiliations

¹ Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
² Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
³ Division Neonatology, Department Pediatrics, UC Davis Medical Center, Sacramento, California, USA.
⁴ Neonatal Intensive Care, Children's Hospital of Richmond at VCU, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
⁵ Neonatology Research Lab, Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
⁶ Lactation Services Children's Hospital of Richmond at VCU, Virginia Commonwealth University Health System, Richmond, Virginia, USA.

PMID: 38016149
DOI: 10.1089/bfm.2023.0147

Abstract

Background: Avoidance of early formula feeding (EFF) and advancement of mother's own milk (MOM) in very low birth weight (VLBW) infants are important health influencers to decrease serious morbidities. Objective: To present the challenges and feeding strategy successes implemented to counteract a decline in MOM at discharge after initiation of donor milk (DM) to avoid EFF in racially and ethnically diverse VLBW infants. Patients and Methods: Retrospective review of prospectively tracked inborn surviving VLBW infants and their mothers admitted to neonatal intensive care unit from 2010 to 2020 during three feeding strategy implementations baby friendly (BF), DM program, and MOM bundle. Analysis included type of feeding (MOM, DM, or formula) and maternal with descriptive and comparative statistical analysis as indicated. Results: Analysis included 616 VLBW infants. Initiation of BF program resulted in 58.5% of infants discharged on MOM with 41.5% exposed to EFF. Initiation of the DM program resulted in a decline in EFF to 5% and decline in MOM at discharge to 26%. MOM bundle strategy resulted in an increase in MOM at discharge to 41% with sustained EFF exposure 0%. MOM at discharge varied among maternal racial and ethnic backgrounds in all epochs. Early DM use was not different among mothers by race or ethnicity with DM by African American (AA) mothers 89% > White mothers 83% > Other/Hispanic mothers 75%. MOM at discharge was lowest for AA mothers 33% < Hispanic mothers 40% < White mothers 55% < Asian/Other mothers at 60%. Conclusion: Changes in VLBW feeding strategies to avoid EFF utilizing DM can be successful among diverse maternal racial and ethnic populations. Nursing and maternal education coupled with early lactation support and attention to maternal individual long-term feeding plans were critical to improve MOM at discharge among mothers of all racial-ethnic backgrounds for successful attainment of MOM utilization in term corrected VLBW infants at discharge.

Keywords: enteral feeding; lactation; maternal diversity; neonatal intensive care unit; premature infant.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Breast Feeding* / methods
Female
Humans
Infant
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Milk, Human
Mothers*
Patient Discharge