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Barriers to optimal breast milk provision in the neonatal intensive care unit
Meera N Sankar1, Ya'el Weiner2,3, Neha Chopra2,3
1Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA. Mnsankar@stanford.edu.
Objective:
This study examines comprehensive patient and process factors that influence breast milk use in the NICU setting.
Study Design:
We examined the association of maternal, neonatal, and family factors and lactation support systems to identify gaps in breast milk use in a retrospective study of 865 infants born in 23-41 weeks gestation admitted to the NICU.
Results:
Breast milk at discharge for all infants was 89.3%, for extremely preterm 82.3%, moderately preterm 91.4%, late preterm 86.5%, and term 92.7%. Prematurity (OR 0.31 [0.17-0.56]), low birth weight, morbidities, Black maternal race (OR 0.20 [0.07-0.57]) and public insurance (OR 0.54 [0.34-0.85]) were associated with decreased breast milk use. Early initiation of feeds was associated with increased breast milk use.
Conclusions:
There is a need to increase social as well as hospital support systems to address gaps in breast milk use in the NICU.
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