Association Between Mothers' Milk Supply and Subsequent Direct Breastfeeding Success Among Preterm Infants: A Pilot Study
Jackson, Cynthia Cable
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Background For mothers of preterm infants, an established breastmilk supply is essential for reaching the goal of successful transition to direct breastfeeding after the infants' discharge from the neonatal intensive care unit (NICU). The purpose of this study was to evaluate the association between maternal breastmilk supply at 7 and 14 days post-birth and subsequent direct breastfeeding at 42 weeks gestational age of preterm infants. Methods A prospective cohort design was utilized. The independent variable was pumped breastmilk supply of ≥500 ml/24 hours. The dependent variable was transition to direct breastfeeding (>80% of daily feeds by direct breastfeeding) measured at 42 weeks gestational age. Subjects were mothers of infants born <34 weeks gestation, admitted to the NICU between November 2013-April 2014. The initial phase included collection of demographic information and 24-hour pumped milk volumes and pumping frequencies at days 7 and 14 and on infant's day of discharge. Subsequent data were obtained through phone interviews at approximately 42 weeks gestation to evaluate direct breastfeeding status post discharge from the NICU. Results Breastmilk volumes and frequency data were collected from 47 women. Follow-up interviews were conducted for 31 women. By day 7, 22 of the mothers (47%) had attained the breastmilk volume goal of 500ml/day. By day 14, 31 (66%) of the mothers had achieved this goal. At follow-up interviews at approximately 42 weeks gestational age, three (10%) of women reported full transition to direct breastfeeding (>80% feeds at breast). Thirteen (42%) reported that all feedings were provided by bottle alone and they had stopped providing any direct breastfeeding to their infants. The remaining 15 women (48%) reported feeding by combination of bottle and breast. Of the women with < 500 ml/day breastmilk volume at day 14, none reported any direct breastfeeding at the follow-up interview. In contrast, of the women with ≥500 ml/day at day 14, 13 (43%) reported providing some direct breastfeeding, either alone or in combination with bottle supplementation (p = .032). Conclusion The results of this study indicate that maternal breastmilk volume ≥ 500m/day at day 14 post-birth is associated with significantly higher likelihood of any direct breastfeeding and of direct breastfeeding for ≥50% of feedings following discharge from the NICU. The findings of this study provide valuable information regarding the challenges to breastfeeding faced by mothers of premature infants following discharge from the NICU. More research is needed in the area of post discharge nutritional needs for preterm infants, as well as effective feeding methods for provision of necessary additional fortification, to support mothers in their efforts to transition to direct breastfeeding for preterm infants.
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