Evidence-Based Methods That Promote Human Milk Feeding of Preterm Infants

Meier, Paula P.; Johnson, Tricia J.; Patel, Aloka L.; Rossman, Beverly

doi:10.1016/j.clp.2016.11.005

Cited by 137 publications

(146 citation statements)

References 83 publications

(120 reference statements)

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“…Despite this widely available “friendly environment,” the great variability in BMF rates at discharge in our study suggests that an in‐depth approach to better understand the complexity of BMF at discharge in VP population is important. Indeed, supporting mothers to provide their own milk during the whole NICU stay implies a change in culture, potentially achieved with the BFHI accreditation, rather than just having protocols and using donor milk …”

Section: Resultssupporting

confidence: 75%

“…They may change their pre‐delivery wishes for human milk feeding during the course of hospitalisation . In EPIPAGE‐2, policies supporting BMF maintenance and available for the study were associated with higher rates of BMF at discharge, although we were not able to explore difficulties of breast pump dependence, maternal stress and fatigue, insufficient social support, and inconsistent advice in NICUs, already described as having a negative impact on maintaining lactation. These policies may help defining strategies at unit level to support BMF.…”

Section: Resultsmentioning

confidence: 99%

“…As the evidence for the use of human milk feeding in very preterm (VP) infants is clearly identified, this has led to the development of best practices . However, the maintenance of lactation through to NICU discharge remains a challenge for many mothers and care providers .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE‐2 cohort study

Mitha

Piedvache

Glorieux

et al. 2019

Paediatric Perinatal Epid

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Background Facilitating factors and barriers to breast milk feeding (BMF) very preterm (VP) infants have been widely studied at the individual level. We aimed to describe and analyse factors associated with BMF at discharge for VP infants, with a special focus on unit policies aiming to support BMF. Methods We described BMF at discharge in 3108 VP infants enrolled in EPIPAGE‐2, a French national cohort. Variables of interest were kangaroo care during the 1st week of life (KC); unit's policies supporting BMF initiation (BMF information systematically given to mothers hospitalised for threatened preterm delivery and breast milk expression proposed within 6 hours after birth) and BMF maintenance (availability of protocols for BMF and a special room for mothers to pump milk); the presence in units of a professional trained in human lactation and regional BMF initiation rates in the general population. Associations were investigated by multilevel logistic regression analysis, with adjustment on individual factors. Results In total, 47.2% of VP infants received BMF at discharge (range among units 21.1%‐84.0%). Unit policies partly explained this variation, regardless of individual factors. BMF at discharge was associated with KC (adjusted odds ratio (aOR) 2.26 (95% confidence interval (CI) 1.40, 3.65)), with policies supporting BMF initiation (aOR 2.19 (95% CI 1.27, 3.77)) and maintenance (aOR 2.03 (95% CI 1.17, 3.55)), but not with BMF initiation rates in the general population. Conclusion Adopting policies of higher performing units could be an effective strategy for increasing BMF rates at discharge among VP infants.

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Section: Resultssupporting

confidence: 75%

Section: Resultsmentioning

confidence: 99%

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Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE‐2 cohort study

Mitha

Piedvache

Glorieux

et al. 2019

Paediatric Perinatal Epid

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“…Supporting BMF is a complex process, which is intricate to split into several policies, but has to be analysed as a whole (Meier et al, ; Rollins et al, ; Spatz, ). Multifactorial determinants are involved in BMF rate, particularly societal attitudes (Rollins et al, ).…”

Section: Discussionmentioning

confidence: 99%

The impact of neonatal unit policies on breast milk feeding at discharge of moderate preterm infants: The EPIPAGE‐2 cohort study

Mitha

Piedvache

Khoshnood

et al. 2019

Maternal & Child Nutrition

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Facilitating factors and barriers to breast milk feeding (BMF) for preterm infants have been mainly studied in very preterm populations, but little is known about moderate preterm infants. We aimed to analyze hospital unit characteristics and BMF policies associated with BMF at discharge for infants born at 32 to 34 weeks' gestation. EPIPAGE‐2, a French national cohort of preterm births, included 883 infants born at 32 to 34 weeks' gestation. We investigated kangaroo care in the first 24 hr, early involvement of parents in feeding support, volume of the unit, BMF information given to mothers hospitalized for threatened preterm delivery, protocols for BMF, presence of a professional trained in human lactation, unit training in neurodevelopmental care, and regional BMF initiation rates in the general population. Multilevel logistic regression analysis was used to investigate associations between unit policies and BMF at discharge, adjusted for individual characteristics and estimating odds ratios (ORs) and 95% confidence intervals (CIs). Overall, 59% (490/828) of infants received BMF at discharge (27% to 87% between units). Rates of BMF at discharge were higher with kangaroo care (adjusted OR 2.03 [95% CI 1.01, 4.10]), early involvement of parents in feeding support (1.94 [1.23, 3.04]), unit training in a neurodevelopmental care programme (2.57 [1.18, 5.60]), and in regions with a high level of BMF initiation in the general population (1.85 [1.05, 3.28]). Creating synergies by interventions at the unit and population level may reduce the variability in BMF rates at discharge for moderate preterm infants.

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“…Thus, the additional 88 ml of mother's own milk supply following domperidone treatment may have a clinically meaningful impact on preterm health and development. Further, higher milk supply in the postpartum period is associated with improved long‐term breastfeeding outcomes . A recent randomised study by O'Connor et al demonstrated no difference in neurodevelopmental outcomes of very preterm infants fed supplemental donor human milk compared with preterm formula, highlighting the critical importance of strategies for enhancing mother's own milk production.…”

Section: Discussionmentioning

confidence: 99%

Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta‐analysis

Grzeskowiak

Smithers

Amir

et al. 2018

BJOG

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Evidence-Based Methods That Promote Human Milk Feeding of Preterm Infants

Cited by 137 publications

References 83 publications

Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE‐2 cohort study

Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE‐2 cohort study

The impact of neonatal unit policies on breast milk feeding at discharge of moderate preterm infants: The EPIPAGE‐2 cohort study

Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta‐analysis

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