Human Milk/Breastfeeding Clinical Trial
Official title:
Human Milk Feeding Rates Post-NICU Discharge
The purpose of this study is to discover the incentives and barriers to human milk use and breast-feeding in the NICU graduate. By better understanding the incentives and barriers we believe we can define better methods for promoting higher rates and longer duration of human milk use in this medically fragile population.
The AAP continues to reaffirm its recommendation of exclusive breast feeding for about 6
months, with continuation of breastfeeding as complementary feeding starts. Ideally,
breastfeeding continues for the first year of life. NICUs have implemented increasing use of
human milk with reports of more than 80 percent of infants receiving at least some human milk
at discharge. Research has shown that breastfeeding rates in preterm infants and initiation
of breastfeeding at discharge are far less than that of term infants (Mastrup, 2014). Yet
studies continue to show the ongoing benefits of breast milk initiation in low birth weight
neonates while they are in the NICU and better developmental outcomes at 30 months of age
(Vohr, Poindexter, Dusick, McKinley, et al., 2007). A large cohort of low birth weight
infants studied revealed that those who were given breast milk early in their hospitalization
and continued receiving it , whether expressed or breast fed, had less frequent
re-hospitalizations and higher Bayley Developmental scores for emotional regulation at 30
months of age. Additionally, as their breast milk volume exposure increased, these children
had improved mental development index and total behavioral index improvement as well.
In a CQI survey done in three NICU follow up clinics, we discovered that only about 30
percent were still breastfeeding at 1-3 months post discharge. There are a few studies
investigating factors which contribute to increased human milk post discharge. Factors
studied include kangaroo care, quick access to pumping support, and history of breast feeding
while in the NICU.
There are a few studies investigating factors which contribute to increased human milk use
post discharge. Callen and Pinelli found that successful breast feeding in preterm infants
(mean gestation 28 weeks) was more likely in mothers who pumped early and continued
diligently. In addition to early pumping and lactation support, kangaroo care, and having the
experience of breast feeding while still in the NICU have been associated with longer use of
human milk and successful breast feeding after discharge. Pineda (2011) looked at the effects
of breast-feeding while in the NICU and whether the first oral sucking feeding was at the
breast in preterm infants. Mean gestational age when the infant was put to breast was 33.1
weeks + 1.59 weeks. Though challenging for mothers, the ability to continue to maintain
breast-feeding during the NICU stay and until discharge as well as having the first feed be
at the breast increased overall duration of breast-feeding duration after discharge. Direct
breast-feeding also increases oxytocin levels in the mother, which leads to psychological
benefits such as improved maternal response and improved attachment behaviors. These factors
may indirectly lead to improved use of breast milk.
This study will investigate which babies are receiving human milk, either expressed or breast
fed at varying times post discharge, and further explores NICU factors which may foster or
inhibit increasing breast milk use in NICU graduates.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Active, not recruiting |
NCT05111990 -
Human Milk and Its Effect on Infant's Metabolism and Infant Gut Microbiome
|