Pumps for Peanuts: Leveling the Field in the Neonatal Intensive Care Unit

Philipp, Barbara L.; Brown, Elizabeth R.; Merewood, Anne

doi:10.1038/sj.jp.7200365

Cited by 16 publications

(17 citation statements)

References 9 publications

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“…45 Obtaining an electric breast pump for use after hospital discharge was a challenge for many mothers. Some NICUs provide hospital-grade electric pumps free of charge to mothers for the duration of their infant's hospitalization, 20,23 and some hospitals bill the mothers' insurance for pumps (personal communication, Greta Blythe, May 2008). This is a critical aspect of lactation support and should be of highest priority for NICU lactation programs.…”

Section: Discussionmentioning

confidence: 99%

Breast Milk Expression and Maintenance in Mothers of Very Low Birth Weight Infants: Supports and Barriers

et al. 2010

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The study objective was to identify patterns of factors that supported or hindered initiation of breast milk expression and maintenance of breast milk production after the birth of a very low birth weight (VLBW) infant in a sample of US women with varied prenatal infant feeding intentions. In-depth interviews were conducted 1 to 6 months after delivery in 32 women who initiated breast milk expression after encouragement from hospital staff. Pregnancy complications, anxiety regarding their infant's health, and lack of privacy interfered with initiation of milk expression. After hospital discharge, using manual or small electric breast pumps, travel to the neonatal intensive care unit, return to work, and difficulty with time management interfered with maintenance of breast milk production. Family support, positive attitudes toward pumping, and anticipation of breastfeeding supported maintenance of breast milk production. From these data emerge points of intervention where additional support could improve mothers' experiences and increase duration of breast milk feeding.

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Section: Discussionmentioning

confidence: 99%

Breast Milk Expression and Maintenance in Mothers of Very Low Birth Weight Infants: Supports and Barriers

et al. 2010

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“…12 Infant feeding decisions are in many ways also a function of economic opportunity, because while pumping is cheaper than formula over the long haul, formula is cheaper at any single point of purchase. The Boston-based pilot project 'Pumps for Peanuts', which sought to provide subsidies for pumps so that lower-income families who had babies in a neonatal intensive care unit could purchase pumps, found that economics played a large role in infant feeding choices (Phillipp et al, 2000). One lactation consultant noted that 'for many of these families the choice they quietly faced was paying for a breast pump or meeting a basic need such as food, rent, or heat for the rest of their family' (Philipp et al, 2000, p. 250).…”

Section: Discussionmentioning

confidence: 99%

Expressing Anxiety? Breast pump usage in American wage workplaces

Boswell-Penc¹,

Boyer²

2007

Gender, Place & Culture

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This article considers the potential and problems for women seeking to combine breastfeeding with wage labor outside the home through the use of breast pumps. After locating the breast pump within cultural, historical and legislative contexts of shifting views about infant nutrition on the one hand and trends in women's participation in the wage work force on the other, we unpack how this technology has re-shaped the landscape of choices about infant feeding in the United States. Using disciplinary lenses of science and technology studies, feminist geography and women's studies, we examine how the breast pump has reshaped workplace experiences after childbirth. Based on interviews and survey data with respondents in Albany, New York across a range of class and racial backgrounds, we submit that while the breast pump does allow some women to combine breastfeeding and wage work outside the home, the advantages of breast pumps are constrained both by cultural attitudes about pumping as an activity, the lack of a sufficient legislative framework, as well as by the way workplaces themselves are designed.

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“…To initiate lactation for a VLBW infant, mothers must pay between $90 and $150 for the first month's BPRF and the purchase of the BPCK. Most payers and institutions do not reimburse or pay these costs, so they are borne by the mothers 20–24. This initial cost can be prohibitive because preterm birth means other unexpected expenses (e.g., increased insurance co-payments, hospital parking fees, lost wages).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, access to adequate amounts of HM from the infant's own mother should be a priority in the neonatal intensive care unit (NICU). However, the basic lactation equipment that these mothers need—a hospital-grade electric breast pump and a pump collection kit19,20—is not routinely reimbursed by public and private third-party payers 21. Thus, these mothers must incur the cost for the breast pump and pump kit, an economic burden that translates into a barrier20,22 to providing HM for a VLBW infant.…”

Section: Introductionmentioning

confidence: 99%

“…However, the basic lactation equipment that these mothers need—a hospital-grade electric breast pump and a pump collection kit19,20—is not routinely reimbursed by public and private third-party payers 21. Thus, these mothers must incur the cost for the breast pump and pump kit, an economic burden that translates into a barrier20,22 to providing HM for a VLBW infant. In the immediate post-birth period, a mother who cannot access a breast pump and kit has two choices: (1) attempt to initiate lactation with less costly, but significantly less effective, manual or electric pumps, thereby risking lactation complications (e.g., mastitis, lactation failure); or (2) feed donor milk and / or commercial formula.…”

Section: Introductionmentioning

confidence: 99%

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The Initial Maternal Cost of Providing 100 mL of Human Milk for Very Low Birth Weight Infants in the Neonatal Intensive Care Unit

Jegier

Meier²,

Engstrom³

et al. 2010

Breastfeeding Medicine

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Objectives Human milk (HM) feeding is associated with lower incidence and severity of costly prematurity-specific morbidities compared to formula feeding in very low birth weight (VLBW; <1,500 g) infants. However, the costs of providing HM are not routinely reimbursed by payers and can be a significant barrier for mothers. This study determined the initial maternal cost of providing 100 mL of HM for VLBW infants during the early neonatal intensive care unit (NICU) stay. Methods This secondary analysis examined data from 111 mothers who provided HM for their VLBW infants during the early NICU stay. These data were collected during a multisite, randomized clinical trial where milk output and time spent pumping were recorded for every pumping session (n = 13,273). The cost analysis examined the cost of the breast pump rental, pump kit, and maternal opportunity cost (an estimate of the cost of maternal time). Results Mean daily milk output and time spent pumping were 558.2 mL (SD = 320.7; range = 0–2,024) and 98.7 minutes (SD = 38.6; range = 0–295), respectively. The mean cost of providing 100 mL of HM varied from $2.60 to $6.18 when maternal opportunity cost was included and from $0.95 to $1.55 when it was excluded. The cost per 100 mL of HM declined with every additional day of pumping and was most sensitive to the costs of the breast pump rental and pump kit. Conclusions These findings indicate that HM is reasonably inexpensive to provide and that the maternal cost of providing milk is mitigated by increasing milk output over the early NICU stay.

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Pumps for Peanuts: Leveling the Field in the Neonatal Intensive Care Unit

Cited by 16 publications

References 9 publications

Breast Milk Expression and Maintenance in Mothers of Very Low Birth Weight Infants: Supports and Barriers

Breast Milk Expression and Maintenance in Mothers of Very Low Birth Weight Infants: Supports and Barriers

Expressing Anxiety? Breast pump usage in American wage workplaces

The Initial Maternal Cost of Providing 100 mL of Human Milk for Very Low Birth Weight Infants in the Neonatal Intensive Care Unit

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