Donor Human Milk Use in Advanced Neonatal Care Units — United States, 2020

Boundy, Ellen O.; Anstey, Erica Hesch

doi:10.15585/mmwr.mm7133a1

Cited by 13 publications

(9 citation statements)

References 7 publications

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“…Sometimes mother's own milk is not available or su cient so availability of donor milk as the recommended substitute is important. Although availability of donor milk in Level III and Level IV ANCUs (where infants with VLBW typically receive care) has increased over time (39), disparities in access to and use of donor milk in the U.S. remain (40). A study linking 2015 mPINC data with racial data by postal code found that donor milk and mother's own milk use in the NICU was lower in areas with higher percentages of black residents (40).…”

Section: Discussionmentioning

confidence: 99%

Maternity Care Practices Supportive of Breastfeeding in U.S. Advanced Neonatal Care Units, United States, 2022

Anstey,

Noiman,

Boundy

et al. 2024

Preprint

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Objective: To describe breastfeeding-supportive practices in U.S. maternity hospitals with advanced neonatal care units (ANCU). Study Design: Using 2022 mPINC data, we calculated the percent of hospitals reporting 1) breastfeeding-supportive practices for “most” (≥80%) mother-baby dyads in ANCUs, by hospital demographic characteristics and 2) infant receipt of mother’s own milk or donor milk at any time while in the ANCU, by ANCU level. Results: More than 90% of hospitals reported that “most” mothers (≥80%) were advised on some breastfeeding-supportive practices. Fewer hospitals reported that “most” mothers expressed milk within one hour of birth (37%) or that kangaroo care was practiced for “most” eligible newborns (63%). Receipt of mother’s own milk varied by unit level and state. Conclusion: Breastfeeding-supportive practices requiring the technical competency of healthcare providers (e.g., early milk expression, kangaroo care) are less likely to be implemented in ANCU settings compared to practices centered around providing advice or education.

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Section: Discussionmentioning

confidence: 99%

Maternity Care Practices Supportive of Breastfeeding in U.S. Advanced Neonatal Care Units, United States, 2022

Anstey,

Noiman,

Boundy

et al. 2024

Preprint

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“…In this respect, Gianni et al (4) observed that enteral energy intake, the severity of BPD and the presence or otherwise of NEC are the main determinants of the speed of weight gain in the first weeks of life. In VLBW infants, breast-feeding and the use of probiotics are associated with a lower prevalence of NEC (44,49,50) . Achieving adequate weight gain to week 36 PMA is associated with favourable neurodevelopment (12) , while BPD is known to have an unfavourable impact on cognitive outcomes in very preterm infants (51) .…”

Section: Changing Epidemiology Of Bronchopulmonary Dysplasia Over The...mentioning

confidence: 99%

Breast-feeding as protective factor against bronchopulmonary dysplasia in preterm infants

Uberos,

Sanchez-Ruiz,

Fernández-Marin

et al. 2024

Br J Nutr

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Breastfeeding is associated with fewer comorbidities in very low birth weight (VLBW) preterm infants. Bronchopulmonary dysplasia (BPD) of VLBW infants is a multifactorial pathology in which nutritional aspects may be of special importance. The aim of this study is to determine, in a cohort of VLBW infants, whether breast milk nutrition is associated with a reduced prevalence and severity of BPD. A retrospective study was conducted to record the intake of mother’s own milk (MOM), pasteurised donor human milk (DHM) or preterm formula milk in the first two weeks of postnatal life of 566 VLBW newborns at our hospital during the period January 2008 – December 2021. After applying the relevant exclusion criteria, data for 489 VLBW infants were analysed; 195 developed some degree of BPD. Moderate or severe BPD is associated with less weight gain. Moreover, the preferential ingestion of breast milk in the first and second postnatal weeks had effects associated with lower OR for BPD, which were statistically demonstrable for mild (OR 0.16; 95% CI 0.03 – 0.71) and severe (OR 0.08; 95% CI 0.009 – 0.91) BPD. Breastfeeding during the first weeks of postnatal life is associated with a reduced prevalence of BPD which is frequently associated with less weight gain as a result of greater respiratory effort with greater energy expenditure.

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“…The American Academy of Pediatrics recommends DBM plus a multinutrient fortifier as the first alternative to MOM for VLBW infants [ 1 ]. DBM was available for VLBW infants in 87% of United States hospitals with level III or IV neonatal intensive care units (NICUs) in 2020 [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Growth after implementing a donor breast milk program in neonates <33 weeks gestational age or birthweight <1500 grams: Retrospective cohort study

et al. 2023

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Background Donor breast milk (DBM) feeding has been associated with less growth than formula in preterm infants. Zinc content in DBM is insufficient to support growth in preterm infants. Objective To compare growth from birth to discharge, macro- and micronutrient intake and the frequency of poor growth before (Epoch-1) and after (Epoch-2) implementing a DBM program. Methods Retrospective cohort study of 1069 infants born at < 33 weeks’ gestational age or birthweight < 1500 g and fed using our adjustable feeding protocol with accurate serial length measurements. Growth was assessed by changes in Z-scores of weight, length and fronto-occipital circumference from birth to discharge. Results Growth did not decrease significantly in Epoch-2. However, energy and protein intake increased by 5% and frequency of zinc and vitamin D supplementation increased by >30%. Conclusions DBM implementation did not significantly decrease growth from birth to discharge using our adjustable feeding protocol.

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Donor Human Milk Use in Advanced Neonatal Care Units — United States, 2020

Cited by 13 publications

References 7 publications

Maternity Care Practices Supportive of Breastfeeding in U.S. Advanced Neonatal Care Units, United States, 2022

Maternity Care Practices Supportive of Breastfeeding in U.S. Advanced Neonatal Care Units, United States, 2022

Breast-feeding as protective factor against bronchopulmonary dysplasia in preterm infants

Growth after implementing a donor breast milk program in neonates <33 weeks gestational age or birthweight <1500 grams: Retrospective cohort study

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