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Exploring Risk Factors Associated With Early Mother's Own Milk Feeding Cessation in Very Low Birth Weight Infants
Kaan Karacan1, Nadine Scholten1, Isabella Schwab1
1Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne, Cologne, Germany.
Infants born with a very low birth weight (VLBW, < = 1.500 g) have an increased risk for medical complications and long-term impairments. Feeding these infants with their mother's own milk (MOM) reduces the risk for adverse outcomes, but many VLBW infants are not fed with MOM for the recommended duration of at least 6 months postpartum. This study examines factors associated with early cessation during the VLBW infants' neonatal intensive care unit (NICU) stay and after discharge. Data were collected from an anonymous, nationwide survey as part of the Neo-MILK study. Logistic regressions and Cox proportional hazard models were used to identify factors associated with early cessation of MOM feeding. Among the 304 mothers analysed, 19.4% of all mothers ceased MOM feeding during the infants' NICU stay. The total cessation rate before 6 months was 53.9%. An early milk volume of over 500 mL/day compared to less or equal to 500 mL/day was negatively associated with MOM feeding cessation during the infants' NICU stay (Adjusted OR: 0.14). Exclusive pumping was associated with a higher cessation rate after discharge (Adjusted HR: 2.01). Early sufficient milk volume and mixed feeding (pumping and breastfeeding) inform longer MOM feeding duration. Interventions targeting early lactation practices and promoting direct breastfeeding while helping with the transition from pumping to breastfeeding are essential for improving MOM feeding outcomes in VLBW infants. Trial Registration: German Register of Clinical Trials, ID: DRKS00024799, https://drks.de/search/en/trial/DRKS00024799.
Infants born with a very low birth weight (VLBW, < = 1.500 g) have an increased risk for medical complications and long-term impairments. Feeding these infants with their mother's own milk (MOM) reduces the risk for adverse outcomes, but many VLBW infants are not fed with MOM for the recommended duration of at least 6 months postpartum. This study examines factors associated with early cessation during the VLBW infants' neonatal intensive care unit (NICU) stay and after discharge. Data were collected from an anonymous, nationwide survey as part of the Neo-MILK study. Logistic regressions and Cox proportional hazard models were used to identify factors associated with early cessation of MOM feeding. Among the 304 mothers analysed, 19.4% of all mothers ceased MOM feeding during the infants' NICU stay. The total cessation rate before 6 months was 53.9%. An early milk volume of over 500 mL/day compared to less or equal to 500 mL/day was negatively associated with MOM feeding cessation during the infants' NICU stay (Adjusted OR: 0.14). Exclusive pumping was associated with a higher cessation rate after discharge (Adjusted HR: 2.01). Early sufficient milk volume and mixed feeding (pumping and breastfeeding) inform longer MOM feeding duration. Interventions targeting early lactation practices and promoting direct breastfeeding while helping with the transition from pumping to breastfeeding are essential for improving MOM feeding outcomes in VLBW infants. Trial Registration: German Register of Clinical Trials, ID: DRKS00024799, https://drks.de/search/en/trial/DRKS00024799.
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