Type and Volume of Milk Intake in Premature Infants <33 Weeks Gestational Age in the Neonatal Intensive Care Unit

Understanding the patterns of milk intake in the neonatal intensive care unit (NICU) will allow opportunities to intervene to improve mother's milk supply.

To quantify the type and volume of milk intake in premature infants throughout the NICU stay.

This retrospective observational cohort study included infants born and admitted to the NICU at <33 weeks gestation from January 2014 to December 2017 who did not have contraindications for receiving mother's own milk (MOM). Daily volume of MOM, pasteurized donor milk (PDM), and formula throughout the NICU stay were collected. Infants were categorized as exclusive human milk diet (EHM) if they consumed MOM and PDM or mixed diet if they consumed formula and MOM and/or PDM. Demographics, feeding outcomes, growth outcomes, and neonatal morbidities were collected.

Of 195 study infants, 133 (32%) received EHM. Cumulative volume and percent of MOM intake were greater in the EHM group compared to the mixed diet group. Age of first colostrum administration to infant was earlier in the EHM group than the mixed diet group (3.1 vs. 4.9, p = 0.013). By the second week of life, the EHM group received 100% of their feeds as MOM but the maximum MOM received in the mixed diet group was 63%. There was no difference in other feeding or neonatal outcomes between the groups.

The EHM group received colostrum earlier than those who received a mixed diet with formula and reached full MOM by the second week of life. This represents the opportunity to address challenges of milk supply of mothers with premature infants in the NICU in the first two weeks after birth.