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CC BY 4.0 · Journal of Child Science 2021; 11(01): e227-e232
DOI: 10.1055/s-0041-1735534
Original Article

Availability of Breast Milk for Preterm Neonates by Gestational Age during NICU Stay

Santosh Kumar Panda 
1   Department of Paediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Kalpita Sahoo
2   Department of Paediatrics, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan, Bhubaneswar, Odisha, India
,
Pratap Kumar Jena 
3   School of Public Health, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Avantika Dhanawat
1   Department of Paediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
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Abstract

The objective of this study was to explore the availability of expressed breast milk (EBM) volume for the premature neonates born from mothers in different gestational age groups during neonatal intensive care unit (NICU) stay. All preterm infants (extreme-preterm infant [EPTI, <28 weeks], very-preterm infant [VPTI, 28–316/7 weeks], and moderate-preterm infant [MPTI, 32–336/7 weeks]) and their mothers were included in the study. Infants not receiving mother's own milk and neonates deceased or discharged against medical advice, and the mother with illness during postpartum period were excluded from the study. A predesigned tool was used to collect information on maternal characteristics, neonatal characteristics, and milk diary for preterm neonates from the NICU case records. The primary outcome variable EBM volume available on day 7 was compared across three gestational groups. Logistic regression was used to predict EBM availability. A total of 78 preterm neonates, including 10 EPTI, 37 VPTI, and 31 MPTI, had average birth weight of 962.5 ± 228.25, 1,185.1 ± 183.14, and 1,293.2 ± 182.92 g, respectively. Receipt of exclusive breast milk among EPTI, VPTI, and MPTI was 80, 94, and 83.8%, respectively. Maternal characteristics were similar except for the mode of conception (p = 0.001), mode of delivery (p = 0.04), and antenatal steroid exposure (p = 0.02) among three gestational categories. The median (Q1–Q3) volume of EBM on day 7 were 160 (136.3–202.5), 150 (140–187.5), and 160 (150–220) mL for EPTI, VPTI, and MPTI neonates, respectively, without any statistical significance. Regression analysis suggests no effect of gestational age on EBM availability. The feasibility of mother's own milk use for extremely preterm neonates is similar to higher gestational preterm neonates.

Keywords

neonate - preterm birth - nutrition - human milk


Publication History

Received: 19 January 2021

Accepted: 17 July 2021

Article published online:
07 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Liu L, Oza S, Hogan D. et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 2016; 388 (10063): 3027-3035
    CrossrefPubMedGoogle Scholar
  • 2 Mangili G, Garzoli E. Feeding of preterm infants and fortification of breast milk. Pediatr Med Chir 2017; 39 (02) 158
    CrossrefPubMedGoogle Scholar
  • 3 Rose AT, Patel RM. A critical analysis of risk factors for necrotizing enterocolitis. Semin Fetal Neonatal Med 2018; 23 (06) 374-379
    CrossrefPubMedGoogle Scholar
  • 4 Karagol BS, Zenciroglu A, Okumus N, Polin RA. Randomized controlled trial of slow vs rapid enteral feeding advancements on the clinical outcomes of preterm infants with birth weight 750-1250 g. JPEN J Parenter Enteral Nutr 2013; 37 (02) 223-228
    CrossrefPubMedGoogle Scholar
  • 5 Modi M, Ramji S, Jain A, Kumar P, Gupta N. Early aggressive enteral feeding in neonates weighing 750-1250 grams: a randomized controlled trial. Indian Pediatr 2019; 56 (04) 294-298
    CrossrefPubMedGoogle Scholar
  • 6 Cregan MD, De Mello TR, Kershaw D, McDougall K, Hartmann PE. Initiation of lactation in women after preterm delivery. Acta Obstet Gynecol Scand 2002; 81 (09) 870-877
    CrossrefPubMedGoogle Scholar
  • 7 Sievers E, Haase S, Oldigs HD, Schaub J. The impact of peripartum factors on the onset and duration of lactation. Biol Neonate 2003; 83 (04) 246-252
    CrossrefPubMedGoogle Scholar
  • 8 Evans KC, Evans RG, Royal R, Esterman AJ, James SL. Effect of caesarean section on breast milk transfer to the normal term newborn over the first week of life. Arch Dis Child Fetal Neonatal Ed 2003; 88 (05) F380-F382
    CrossrefPubMedGoogle Scholar
  • 9 Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics 2008; 121 (01) e92-e100
    CrossrefPubMedGoogle Scholar
  • 10 Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012; 129 (03) e827-e841
    CrossrefPubMedGoogle Scholar
  • 11 Jahan Y, Rahman A. Human milk banking can be an innovative approach for developing countries. Health Promot Perspect 2018; 8 (04) 249-251
    CrossrefPubMedGoogle Scholar
  • 12 Lau C. Breastfeeding challenges and the preterm mother-infant dyad: a conceptual model. Breastfeed Med 2018; 13 (01) 8-17
    CrossrefPubMedGoogle Scholar
  • 13 Hill PD, Aldag JC. Milk volume on day 4 and income predictive of lactation adequacy at 6 weeks of mothers of nonnursing preterm infants. J Perinat Neonatal Nurs 2005; 19 (03) 273-282
    CrossrefPubMedGoogle Scholar
  • 14 Parker LA, Sullivan S, Krueger C, Kelechi T, Mueller M. Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study. J Perinatol 2012; 32 (03) 205-209
    CrossrefPubMedGoogle Scholar
  • 15 Powers NG, Bloom B, Peabody J, Clark R. Site of care influences breastmilk feedings at NICU discharge. J Perinatol 2003; 23 (01) 10-13
    CrossrefPubMedGoogle Scholar
  • 16 Heidarzadeh M, Hosseini MB, Ershadmanesh M, Gholamitabar Tabari M, Khazaee S. The effect of kangaroo mother care (KMC) on breast feeding at the time of NICU discharge. Iran Red Crescent Med J 2013; 15 (04) 302-306
    CrossrefPubMedGoogle Scholar
  • 17 Suman RP, Udani R, Nanavati R. Kangaroo mother care for low birth weight infants: a randomized controlled trial. Indian Pediatr 2008; 45 (01) 17-23
    PubMedGoogle Scholar
  • 18 Almeida Hd, Venancio SI, Sanches MT, Onuki D. The impact of kangaroo care on exclusive breastfeeding in low birth weight newborns. J Pediatr (Rio J) 2010; 86 (03) 250-253
    CrossrefPubMedGoogle Scholar
  • 19 Chiang KV, Sharma AJ, Nelson JM, Olson CK, Perrine CG. Receipt of breast milk by gestational age - United States, 2017. MMWR Morb Mortal Wkly Rep 2019; 68 (22) 489-493
    CrossrefPubMedGoogle Scholar
  • 20 Thakur A, Kler N, Garg P, Singh A, Gandhi P. Impact of quality improvement program on expressed breastmilk usage in very low birth weight infants. Indian Pediatr 2018; 55 (09) 739-743
    CrossrefPubMedGoogle Scholar
  • 21 Lee HC, Gould JB. Factors influencing breast milk versus formula feeding at discharge for very low birth weight infants in California. J Pediatr 2009; 155 (05) 657-62.e1 , 2
    CrossrefPubMedGoogle Scholar
  • 22 Asztalos EV, Kiss A, da Silva OP, Campbell-Yeo M, Ito S, Knoppert D. EMPOWER Study Collaborative Group. Pregnancy gestation at delivery and breast milk production: a secondary analysis from the EMPOWER trial. Matern Health Neonatol Perinatol 2018; 4: 21
    CrossrefPubMedGoogle Scholar