Study protocol for reducing disparity in receipt of mother’s own milk in very low birth weight infants (ReDiMOM): a randomized trial to improve adherence to sustained maternal breast pump use

Johnson, Tricia J.; Meier, Paula P.; Schoeny, Michael; Bucek, Amelia; Janes, Judy; Kwiek, Jesse J.; Zupancic, John A.F.; Keim, Sarah A.; Patel, Aloka L.

doi:10.1186/s12887-021-03088-y

Cited by 6 publications

(5 citation statements)

References 67 publications

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“…Certainly, longer inter-pump intervals contribute to decreased MOM synthesis via the autocrine/paracrine regulatory pathways and the lack of frequent suckling-induced prolactin secretion from the pituitary ( 60 , 61 ). While we did not routinely have pumping data available on day 5 due to the enrollment time frame through day 6 for ReDiMOM ( 52 ), we found that women were unlikely to pump in the early morning after week 1.…”

Section: Discussionmentioning

confidence: 89%

“…Although our previous research has demonstrated similar rates of MOM provision at NICU discharge by White and Hispanic mothers ( 35 ), the current data demonstrate that the pumping behavior between White and Hispanic mothers are initially similar but then diverge around 4–6 weeks postpartum. Mothers in this study were enrolled in the ReDiMOM trial, for which randomization was stratified by maternal race/ethnicity and infant GA ( 52 ). Therefore, despite the economic intervention available to the intervention arm, the three racial/ethnic groups were similarly distributed between the control and intervention study arms.…”

Section: Discussionmentioning

confidence: 99%

“…First, we relied on maternal pumping records rather than objective pumping data, however, most studies rely on self-report. ReDiMOM is collecting pumping data using a smart pump that enables electronic capture and storage of pumping behaviors for mothers in the intervention arm, so future analyses can compare the accuracy of maternal self-report with smart pump logs and milk weight data ( 52 ). Another limitation is variability in the availability of pumping data for the first week postpartum.…”

Section: Discussionmentioning

confidence: 99%

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Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors

Patel,

Tan,

Bucek

et al. 2024

Front. Nutr.

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BackgroundMothers of very preterm (<32 weeks gestational age [GA]) infants are breast pump dependent and have shorter duration of milk provision than mothers of term infants. The opportunity (i.e., time) cost of pumping and transporting mother’s own milk (MOM) from home to the NICU may be a barrier. There is a paucity of data regarding how much time mothers actually spend pumping.ObjectiveTo investigate the variation in pumping behavior by postpartum week, maternal characteristics, and infant GA.MethodsProspectively collected pump log data from mothers enrolled in ReDiMOM (Reducing Disparity in Mother’s Own Milk) randomized, controlled trial included pumping date and start time and end time of each pumping session for the first 10 weeks postpartum or until the infant was discharged from the NICU, whichever occurred first. Outcomes included number of daily pumping sessions, number of minutes spent pumping per day, and pumping behaviors during 24-h periods, aggregated to the postpartum week. Medians (interquartile ranges) were used to describe outcomes overall, and by maternal characteristics and infant GA.ResultsData included 13,994 pump sessions from 75 mothers. Maternal characteristics included 55% Black, 35% Hispanic, and 11% White and 44% <30 years old. The majority (56%) of infants were born at GA 28–31 weeks. Mothers pumped an average of less than 4 times per day, peaking in postpartum week 2. After accounting for mothers who stopped pumping, there was a gradual decrease in daily pumping minutes between postpartum weeks 2 (89 min) and 10 (46 min). Black mothers pumped fewer times daily than non-Black mothers after the first 2 weeks postpartum.ConclusionOn average mothers pumped less intensively than the minimum recommendation of 8 times and 100 min per day. However, these pumping behaviors represent significant maternal opportunity costs that should be valued by the institution and society at large.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors

Patel,

Tan,

Bucek

et al. 2024

Front. Nutr.

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“…These data suggest that some mothers of PT infants may return to work before their PT infant is discharged from the hospital. Returning to work while providing MOM requires the use of a breast pump to continue lactation processes due to physical separation from the infant, and exclusive or partial breast pump use incurs significant out-of-pocket and time (opportunity) costs [ 60 ]. A very small proportion of women have health-related contraindications to providing MOM, thus considerations regarding returning to work and decisions about MOM provision affect most mothers of PT infants who plan to return to work [ 20 , 61 ].…”

Section: The Interplay Between Work and Mom Provision In Mothers Of P...mentioning

confidence: 99%

The Role of Work as a Social Determinant of Health in Mother’s Own Milk Feeding Decisions for Preterm Infants: A State of the Science Review

et al. 2023

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In the United States, 10% of infants are born preterm (PT; <37 weeks gestational age) each year and are at higher risk of complications compared to full term infants. The burden of PT birth is borne disproportionately by Black versus non-Black families, with Black mothers significantly more likely to give birth to a PT infant. One proven strategy to improve short- and long-term health outcomes in PT infants is to feed mother’s own milk (MOM; breast milk from the mother). However, mothers must make decisions about work and MOM provision following PT birth, and more time spent in paid work may reduce time spent in unpaid activities, including MOM provision. Non-Black PT infants are substantially more likely than Black PT infants to receive MOM during the birth hospitalization, and this disparity is likely to be influenced by the complex decisions mothers of PT infants make about allocating their time between paid and unpaid work. Work is a social determinant of health that provides a source of income and health insurance coverage, and at the same time, has been shown to create disparities through poorer job quality, lower earnings, and more precarious employment in racial and ethnic minority populations. However, little is known about the relationship between work and disparities in MOM provision by mothers of PT infants. This State of the Science review synthesizes the literature on paid and unpaid work and MOM provision, including: (1) the complex decisions that mothers of PT infants make about returning to work, (2) racial and ethnic disparities in paid and unpaid workloads of mothers, and (3) the relationship between components of job quality and duration of MOM provision. Important gaps in the literature and opportunities for future research are summarized, including the generalizability of findings to other countries.

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“…Since low birth weight and very preterm infants generally do not receive mothers' milk, poor households may find the costs associated with pumping maternal breast milk unaffordable [17]. It is presumed that offsetting the maternal costs of pumping breast milk through subsidies or other alternatives may sustain breastfeeding [17].…”

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confidence: 99%

The economic cost of not practicing optimal breastfeeding: a review

Amir-ud-Din

2022

J Soc Health Sci

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Underfive child mortality is one of the world's most severe public health problems, and the developing world disproportionately bears the brunt of underfive child mortality. It is quite unlikely that developing countries will have sufficient resources, at least in the foreseeable future, to significantly reduce child mortality rates. Fortunately, optimal breastfeeding provides significant protection against child mortality, and it may well be the most practical policy intervention against child mortality in resource-constrained settings. However, the catch lies in the fact that despite the obvious benefits of breastfeeding, optimal breastfeeding is limited across the developing world. I have identified several causal mechanisms that contribute to nonoptimal breastfeeding practices. Additionally, I have drawn upon the literature that has estimated the economic cost of inadequate breastfeeding.

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Study protocol for reducing disparity in receipt of mother’s own milk in very low birth weight infants (ReDiMOM): a randomized trial to improve adherence to sustained maternal breast pump use

Cited by 6 publications

References 67 publications

Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors

Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors

The Role of Work as a Social Determinant of Health in Mother’s Own Milk Feeding Decisions for Preterm Infants: A State of the Science Review

The economic cost of not practicing optimal breastfeeding: a review

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