Human Milk Feedings in the Neonatal Intensive Care Unit

Meier, Paula P.; Patel, Aloka L.; Bigger, Harold R.; Chen, Yimin; Johnson, Tricia J.; Rossman, Beverly; Engstrom, Janet L.

doi:10.1007/978-1-4614-7836-2_126

Cited by 14 publications

(72 citation statements)

References 73 publications

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“…14-16 32 33 Furthermore, these protective OMM components are highly concentrated in colostrum and transitional milk, and are optimally preserved in fresh versus frozen milk. 34 OMM may also impact the risk of BPD indirectly by reducing the incidence of NEC and sepsis, morbidities which have been linked to subsequent development of BPD. 35 36 The protective impact of OMM on NEC and sepsis and associated costs is well established.…”

Section: Discussionmentioning

confidence: 99%

Influence of own mother's milk on bronchopulmonary dysplasia and costs

Patel

Johnson

Robin

et al. 2016

Arch Dis Child Fetal Neonatal Ed

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Background Human milk from the infant’s mother (own mother’s milk; OMM) feedings reduces the risk of several morbidities in very low birthweight (VLBW) infants, but limited data exist regarding its impact on bronchopulmonary dysplasia (BPD). Objective To prospectively study the impact of OMM received in the neonatal intensive care unit (NICU) on the risk of BPD and associated costs. Design/methods A 5-year prospective cohort study of the impact of OMM dose on growth, morbidity and NICU costs in VLBW infants. OMM dose was the proportion of enteral intake that consisted of OMM from birth to 36 weeks postmenstrual age (PMA) or discharge, whichever occurred first. BPD was defined as the receipt of oxygen and/or positive pressure ventilation at 36 weeks PMA. NICU costs included hospital and physician costs. Results The cohort consisted of 254 VLBW infants with mean birth weight 1027±257 g and gestational age 27.8±2.5 weeks. Multivariable logistic regression demonstrated a 9.5% reduction in the odds of BPD for every 10% increase in OMM dose (OR 0.905 (0.824 to 0.995)). After controlling for demographic and clinical factors, BPD was associated with an increase of US $41 929 in NICU costs. Conclusions Increased dose of OMM feedings from birth to 36 weeks PMA was associated with a reduction in the odds of BPD in VLBW infants. Thus, high-dose OMM feeding may be an inexpensive, effective strategy to help reduce the risk of this costly multifactorial morbidity.

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Section: Discussionmentioning

confidence: 99%

Influence of own mother's milk on bronchopulmonary dysplasia and costs

Patel

Johnson

Robin

et al. 2016

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

show abstract

“…19,26–35 In particular the concentrations of high molecular weight bioactive proteins (including growth factors, secretory IgA, lactoferrin, interleukin 10, and soluble CD14) in preterm MOM are highest in colostrum but remain elevated through the first month of lactation. 36 The Table contrasts MOM and DHM as a function of mammary maturity and stage of lactation for MOM.…”

Section: Mom and Dhm: Compositional And Bioactive Differences That Immentioning

confidence: 99%

“…51–54,56 DHM may also decrease growth due to the inconsistent delivery and utilization of MOM lipid. 36,60 Freeze-thaw cycles alter the structure of the fat globule membrane and its tightly regulated core and surface lipids, 61 and multiple transfers of DHM during storage and handling result in adherence of the non-homogenized lipid to container surfaces. 36,60 Furthermore, bile salt stimulated lipase and lipoprotein lipase are completely inactivated and MOM amylases and proteases are reduced with pasteurization, 62 affecting macronutrient utilization even though baseline values may be preserved with processing.…”

Section: Mom and Dhm: Impact On Potentially Preventable Morbidities Amentioning

confidence: 99%

“…6,8,36 These comparisons raise the question as to how investments in human milk feeding should be targeted. Investing in DHM is often easier than addressing barriers to the provision of MOM in the NICU, but most lactation barriers in this population are modifiable when evidence-based practices and resources are prioritized.…”

Section: The Economics Of Mom and Dhm And Prioritization Of Resourcesmentioning

confidence: 99%

“…85 The research literature is replete with strategies to acquire and feed MOM in the NICU, including: assuring access to effective and efficient hospital-grade electric pumps, double collection kits and customized breast shield sizing; 86 implementing breast pump use within 1 hour post-birth; 87 avoiding exclusive hand expression in the early days post-birth; 88 proactively monitoring pumped MOM volume during the critical first two-weeks post-birth when breast-pump dependent mothers are at risk for long-lasting MOM volume problems; 86 integrating NICU-based breastfeeding peer counselors as direct lactation care providers; 85,89 and incorporating tested lactation technologies such as milk analysis and test-weighing to objectively manage growth on MOM feedings. 36 …”

Section: The Economics Of Mom and Dhm And Prioritization Of Resourcesmentioning

confidence: 99%

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