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Predictors of NICU Admitted Newborns Receiving Mother's Own Milk as the First Feeding, during the NICU Stay, and at Discharge

Corley, Megan E
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1574417499800771

Abstract Details

2019, MS, University of Cincinnati, Allied Health Sciences: Nutrition.
Background: In the United States 10% of all infants are born preterm.1 Preterm birth, low birth weight, and NICU admissions put newborns at increased risk of morbidity and mortality.1,2 Breast milk provides NICU-admitted infants with nutritional and immunologic protections including human milk oligosaccharides, secretory IgA, hormones, growth factors, cytokines, and chemokines.3,4 The AAP states the potent benefits of human milk are such that all premature infants should receive human milk, preferably mother’s own milk (MOM).5 Objectives: Our objective was to determine the predictors of the following outcomes for NICU-admitted newborns and their mothers: mother attempting breast milk expression (Attempted Expression), mother initiating breast milk expression within 6 hours of birth (EBM First 6h), newborn receiving MOM as first feeding (MOM First Feeding), newborn receiving colostrum for oral care within the first 36 hours of life (COC First 36h), and newborn receiving any MOM at discharge (DC), or day of life 21 (DOL21) if discharged after DOL21 (MOM DC/DOL 21). Methods: We included all preterm infants born at UCMC June 1, 2018 to May 31, 2019 and examined a comprehensive set of socio-demographic, maternal, obstetric, and infant variables as being potential predictors of MOM outcome variables. We built a database by linking mother’s medical record with newborn medical record and hand extraction of additional variables from nursing notes, lactation notes, etc. All data were imported into SAS for data analysis. We used chi square analyses to examine the unadjusted associations between independent variables and MOM outcomes. We used logistic regression models to examine the adjusted associations between the independent variables and MOM outcomes. Results: It was found from our fully adjusted logistic regression model that the independent predictors of mother not attempting breast milk expression were active smoking (P<0.0001), multiparity (P=0.03), maternal pre-partum hospital stay < 2 days (P=0.004), and infant gestational age >= 33 weeks (P=0.02). A diagnosis of gestational diabetes (P=0.002) was a significant independent predictor of infant not receiving mother’s milk as the first feeding. Black or African American race (P=0.003) and gestational diabetes (P=0.006) were significant independent predictors of infant not receiving COC in the first 36 hours. Finally, a diagnosis of Hepatitis C and infant birth weight <=1500 grams (p=0.008) were significant independent predictors of infant not receiving any MOM at discharge (or day of life 21 if discharged after day 21). Conclusion: More detailed exploration of hospital practices is needed to reveal the drivers of the high variability of early initiation of breast milk expression, as well as what factors affect this outcome. Also, more maternal education is needed on the importance of sustaining the provision of breast milk through all pregnancies. Furthermore, healthcare providers must understand and acknowledge barriers from previous experiences in order to find ways to overcome the challenges in subsequent pregnancies.
Laurie Nommsen-Rivers, Ph.D. (Committee Chair)
Laura Ward, M.D. (Committee Member)
17 p.
Nutrition
mothers own milk MOM; premature infants; human milk; breast milk; infant first feeding; neonatal intensive care unit NICU

Recommended Citations

Citations

  • Corley, M. E. (2019). Predictors of NICU Admitted Newborns Receiving Mother's Own Milk as the First Feeding, during the NICU Stay, and at Discharge [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1574417499800771

    APA Style (7th edition)

  • Corley, Megan. Predictors of NICU Admitted Newborns Receiving Mother's Own Milk as the First Feeding, during the NICU Stay, and at Discharge. 2019. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1574417499800771.

    MLA Style (8th edition)

  • Corley, Megan. "Predictors of NICU Admitted Newborns Receiving Mother's Own Milk as the First Feeding, during the NICU Stay, and at Discharge." Master's thesis, University of Cincinnati, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1574417499800771

    Chicago Manual of Style (17th edition)

ucin1574417499800771
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This open access ETD is published by University of Cincinnati and OhioLINK.