Early Use of Mother's Own Raw Milk, Maternal Satisfaction, and Breastfeeding Continuation in Hospitalised Neonates: A Prospective Cohort Study

Abstract

Background: Despite the critical importance of breast milk for preterm and sick neonates, there is no consensus regarding the use of raw mother's own milk (MOM) in neonatal units. Objectives: This study aimed to describe the use of raw MOM in hospitalised neonates before day 7 (early use), and to investigate: (i) related factors, (ii) maternal satisfaction, and (iii) the association with breastfeeding continuation. Methods: This prospective cohort included 516 neonates intended to be breastfed in 2 French neonatal units. Neonates receiving raw MOM before day 7 were compared to those who did not. The association between early use of MOM and breastfeeding continuation at hospital discharge, and up to 6 months later, was measured by logistic regression. Results: More than one-third (36.2%) of breastfed neonates did not receive any MOM during their first week, mainly due to organisational constraints and staff reluctance. Maternal satisfaction related to early raw MOM use was high (96%), and was coupled with a more frequent maternal feeling of being supported in breastfeeding (p = 0.003). There was a significant association between early use of MOM and breastfeeding continuation at discharge (OR 2.92, 95% CI 1.94-4.40, p < 0.0001), which persisted 6 months later (OR 2.70, 95% CI 1.21-6.03, p = 0.023). This association appeared independent in multivariable analyses (at discharge: aOR 2.03, 95% CI 1.27-3.25, p = 0.003; 6 months later: aOR 2.46, 95% CI 1.02-5.92, p = 0.045). Conclusion: While the early use of raw MOM in hospitalised neonates can be limited by multiple factors, it appears supportive for mothers, and might represent a simple opportunity to improve breastfeeding in neonatal units.

Immunonutrition for Preterm Infants

“…Feeding with human breast milk rather than formula is the simplest family-centred, valued and effective immunoprotective strategy [49, 50]. Donor breast milk may be beneficial for infants whose mothers cannot provide expressed breast milk, but the cost-effectiveness of this policy remains to be established in some contexts and settings.…”

Development of a human milk concentrate with human milk lyophilizate for feeding very low birth weight preterm infants: A preclinical experimental study

“…Dritsakou et al suggested that feeding VLBW infants predominantly with the mother's own raw milk results in better neonatal outcomes such as higher body length and head circumference at discharge [69]. In addition, a prospective cohort study conducted with VLBW infants fed exclusively with HM demonstrated an association between the early use of the mother's own raw milk and continued breastfeeding at discharge (OR 2.92; 95% CI [1.94–4.40]), and after 6 months (OR 2.70; 95% CI [1.21–6.03]) [70].…”

Improving Neonatal and Maternal Outcome by Inducing Mild Labor before Elective Cesarean Section: The Lacarus Randomized Controlled Trial

“…Since any disturbance of the postnatal bonding period adversely affects motherhood, including lactation and breastfeeding, all measures supporting early skin-to-skin contact and avoiding division of the mother-infant dyad are welcome [27]. Lowering the incidence of neonatal respiratory morbidity helps preserve the dyad and thus increase the likelihood of successful lactation and breast-feeding [28]. The key hormone in mammalian parenting and social development is oxytocin [29].…”