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Human Milk and Breastfeeding Outcomes in Infants With Myelomeningocele
Diane L Spatz1, Elizabeth B Froh
1University of Pennsylvania, School of Nursing, Philadelphia, PA (Dr Spatz & Dr. Froh); Children's Hospital of Philadelphia, Department of Nursing & Clinical Care Services, Philadelphia, PA (Dr Spatz & Dr. Froh).
Insights
Mothers of infants with myelomeningocele can successfully breastfeed and provide human milk with evidence-based interventions. This supports early and continued human milk feeding for infants with myelomeningocele.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Developmental pediatrics
Background:
- An enteral feeding pathway was implemented in 2015 to support breastfeeding.
- Infants with myelomeningocele often meet the criteria for this feeding pathway.
Purpose of the Study:
- To describe enteral feeding exposure and trends in infants diagnosed with myelomeningocele.
- To analyze feeding types and methods used for this specific infant population.
Main Methods:
- Retrospective descriptive cohort study design.
- Inclusion of infants with myelomeningocele (2013-2016).
- Data collected from electronic health records, including demographics and daily enteral feeding exposure.
Main Results:
- Over 80% of mothers received prenatal nutrition consultations with a goal to breastfeed for over 6 months.
- The majority of infants (79.1%) received mother's own milk as their first feed.
- 80.8% of infants were fed directly at the breast, alongside bottle or tube feeding.
Conclusions:
- Evidence-based breastfeeding interventions enable mothers of infants with myelomeningocele to provide human milk and breastfeed directly.
- Further research on post-discharge human milk and breastfeeding outcomes for infants with myelomeningocele is recommended.
- Long-term breastfeeding may play a significant role in the developmental trajectory of infants with myelomeningocele.
Background:
In 2015, the study setting instituted an enteral feeding pathway, "PO Ad Lib Feeding to Support Breastfeeding." Many infants admitted to the study setting's newborn/infant intensive care unit with a primary diagnosis of myelomeningocele fall within the setting's enteral feeding pathway's inclusion criteria.
Purpose:
The primary objective of this study is to describe the enteral feeding exposure and trends, by type and method, among infants with myelomeningocele.
Methods:
Retrospective descriptive cohort design. Participants were infants with a primary diagnosis of myelomeningocele between 2013 and 2016. The electronic health record was used to collect descriptive data (demographics and daily enteral feeding exposure). Data were analyzed using descriptive statistics.
Findings/Results:
More than 80% (n = 148, 81.3%) of the participants' mothers had a personalized prenatal nutrition consultation and the majority of those mothers (n = 102/118, 86.4%) had a goal to breastfeed for more than 6 months. The majority (n = 144/182, 79.1%) of the study cohort was exposed to mothers' own human milk as their first feed. It is also notable that 80.8% (n = 147) fed at least once directly at the breast; however, infants were also fed by bottle or by feeding tube.
Implications For Practice:
It demonstrates that with appropriate evidence-based breastfeeding interventions, mothers having infants with myelomeningocele can expect to feed their infants human milk as well as direct breastfeed.
Implications For Research:
Future research should focus on human milk/breastfeeding outcomes of infants with myelomeningocele post-hospital discharge. Long-term breastfeeding may have an important role in the development of infants with myelomeningocele.
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