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Factors Which May Contribute to the Success or Failure of the Use of Mother's Own Milk in a Level IV Neonatal
Mary Ann D'Ambrosio1, Lisbeth Gabrielski, Diane Melara
1Children's Hospital Colorado, Aurora (Mss D'Ambrosio, Gabrielski, and Melara and Dr Neu); Department of Pediatrics, University of Colorado School of Medicine, Aurora (Ms Pickett); School of Medicine, Biostatistics Core of Children's Hospital Colorado Research Institute, Children's Hospital Colorado, Aurora (Dr Pan); and College of Nursing, University of Colorado, Aurora (Dr Neu).
Background:
Benefits of mother's own milk (MOM) for infants in neonatal intensive care units (NICUs) are well known. Many mothers provide for their infant's feedings during their entire hospitalization while others are unable. Knowledge is limited about which infant and maternal factors may contribute most to cessation of MOM feedings.
Purpose:
Study aims were to (1) identify which maternal and infant risk factors or combination of factors are associated with cessation of provision of MOM during hospitalization, (2) develop a lactation risk tool to identify neonatal intensive care unit infants at higher risk of not receiving MOM during hospitalization, and (3) identify when infants stop receiving MOM during hospitalization.
Methods:
A data set of 797 infants admitted into a level IV neonatal intensive care unit before 7 days of age, whose mothers chose to provide MOM, was created from analysis of data from the Children's Hospital Neonatal Database. Maternal and infant factors of 701 dyads who received MOM at discharge were compared with 87 dyads who discontinued use of MOM by discharge using χ 2 , t tests, and Wilcoxon rank tests. Logistic regression was used to build a risk-scoring model.
Results:
The probability of cessation of MOM increased significantly with the number of maternal-infant risk factors. A Risk Calculator was developed to identify dyads at higher risk for cessation of MOM by discharge.
Implications For Practice:
Identifying mothers at risk for cessation of MOM can enable the healthcare team to provide optimal lactation management and outcomes.
Implications For Research:
Although the Risk Calculator has potential to identify dyads at risk of early MOM cessation, further research is needed to validate these results.
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