Implementation of a Donor Milk Program Is Associated with Greater Consumption of Mothers’ Own Milk among VLBW Infants in a US, Level 3 NICU

Parker, Margaret G.; Burnham, Laura; Mao, Wenyang; Philipp, Barbara L.; Merewood, Anne

doi:10.1177/0890334415598305

Cited by 50 publications

(49 citation statements)

References 15 publications

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“…Consent rates appear dependent upon maternal education, marital status, and cultural context, while the effect of race or ethnicity on donor milk consent is not clear. 12,[15][16][17][18][19] A prior study assessing nonconsent rates of a local NICU program, consistent with prior research, found maternal race and marital status to be significant predictors of donor milk nonconsent. 18 However, with the implementation of intervening programmatic changes, greater recognition of donor milk as an available option and increased numbers of parents' approach to consent for donor milk over the past 5 years have highlighted the need to reevaluate consent patterns for donor milk and determine whether rates of nonconsent have improved since the earlier evaluation of the program.…”

Section: Introductionmentioning

confidence: 54%

“…18,19 In the first 18 months of the program, our group observed a 42.4% donor milk nonconsent rate, 18 while Parker et al reported a 9.6% donor milk nonconsent rate. 19 However, their 9.6% nonconsent rate underestimated their total nonconsent rate by excluding the 23.2% of those with undocumented consent status, representing those not exposed to the availability of donor milk use. The combined rate of 32.8% is similar to our initial reported nonconsent rate of 42.4%.…”

Section: Discussionmentioning

confidence: 81%

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Five-Year Secular Trends and Predictors of Nonconsent to Receive Donor Milk in the Neonatal Intensive Care Unit

Brownell

Smith

Cornell

et al. 2016

Breastfeeding Medicine

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Program duration was associated with reduced nonconsent rates and may reflect increased exposure to information and acceptance of donor milk use among neonatal intensive care unit staff and parents. Despite overall improvements in consent rates, race-specific disparities in rates of nonconsent for donor milk persisted after 5 years of this donor milk program. Further research is warranted to clarify the basis for race-based disparities in donor milk nonconsent rates, with the goal of designing interventions to reduce donor milk refusal among minority mothers.

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Section: Introductionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 81%

Five-Year Secular Trends and Predictors of Nonconsent to Receive Donor Milk in the Neonatal Intensive Care Unit

Brownell

Smith

Cornell

et al. 2016

Breastfeeding Medicine

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“…Indicators such as rates of breastfeeding at time of discharge from neonatal units suggest DM availability may improve use of MOM [9, 30], but in some scenarios it appears to hinder intake of MOM [30]. It is possible that discussions of DM with parents emphasize the importance of human milk for feedings, and when combined with lactation support, increased intake of MOM should be expected in some settings [31]. Thus, ongoing lactation support is critical for women who deliver critically ill, preterm infants and for women who may be temporarily separated due to infant transfer to another facility in the immediate postnatal period [32].…”

Section: Discussionmentioning

confidence: 99%

Donor milk intake and infant growth in a South African neonatal unit: a cohort study

et al. 2018

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BackgroundImplications of donor milk feedings on infant growth in resource limited settings remain uncertain. This knowledge gap includes the impact of donor milk availability on infant intake of mother’s own milk. Therefore, this investigation aimed to measure intake and growth in infants receiving donor milk when born to women from resource limited backgrounds with high rates of human immunodeficiency virus (HIV).MethodsA retrospective cohort study enrolled eligible infants admitted to a South African combined neonatal intensive and secondary high care unit, within a one year admission period during 2015, with signed consent for donor milk feedings. A certified milk bank provided donor milk. Daily nutritional intake during the first month was recorded. Details included proportional intake of donor milk, mother’s own milk and infant formula. The primary outcome of infant growth velocity from day back to birth weight to discharge was calculated when length of stay was ≥14 days. Analyses primarily used T-tests; mixed effects models compared weekly calorie intake.ResultsOne hundred five infants with donor milk consent were born at 30.9 ± 3.6 weeks of gestation, weighing 1389 ± 708 g. Forty percent of mothers had HIV. Infant growth velocity did not differ based on percent of feedings as donor milk (≥ 50%: 11.8 ± 4.9 g/kg/d; < 50%: 13.5 ± 5.3 g/kg/d; p = 0.3). Percent of feedings from donor milk was similar based on maternal HIV status (positive: 31 ± 25%; negative: 36 ± 29%; p = 0.4), as was percent of feedings as mother’s milk (positive: 53 ± 35%; negative: 58 ± 30%; p = 0.4). Calorie intake increased markedly during the first two weeks and then plateaued (p < 0.0001).ConclusionsDonor milk feedings in higher proportions did not further impair growth of infants managed in a South African combined neonatal intensive and secondary high care unit with growth rates already below reference ranges. The provision of donor milk contributed to feedings being composed of primarily human milk during the first month. Increasing early calorie intake may improve infant growth in this center.

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“…10, 13, 14, 15 This increase in BF rates is important because suboptimal BF contributes to an estimated 11.6% of child deaths worldwide, or about 8 00 000 deaths annually. 16, 17, 18 When MOM is unavailable, the World Health Organization (WHO), 19 American Academy of Pediatrics, 20 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition, 9 and other major policy groups recommend DHM as the next best option.…”

Section: Introductionmentioning

confidence: 99%

“…14, 15, 26 For example, one study found that the exclusive BF rate for infants discharged from NICUs with an HMB (29.6%) was significantly higher than the rate for infants from NICUs without an HMB (16.0%). 27 In another study, infants discharged 2 years after the start of a NICU HMB program had sixfold higher odds of receiving MOM at discharge as well as a 49% reduction in the cessation of MOM consumption during hospitalization as compared to infants before the start of the program.…”

Section: Introductionmentioning

confidence: 99%

Establishing an integrated human milk banking approach to strengthen newborn care

et al. 2016

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The provision of donor human milk can significantly reduce morbidity and mortality among vulnerable infants and is recommended by the World Health Organization as the next best option when a mother's own milk is unavailable. Regulated human milk banks can meet this need, however, scale-up has been hindered by the absence of an appropriate model for resource-limited settings and a lack of policy support for human milk banks and for the operational procedures supporting them. To reduce infant mortality, human milk banking systems need to be scaled up and integrated with other components of newborn care. This article draws on current guidelines and best practices from human milk banks to offer a compilation of universal requirements that provide a foundation for an integrated model of newborn care that is appropriate for low- and high-resource settings alike.

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Implementation of a Donor Milk Program Is Associated with Greater Consumption of Mothers’ Own Milk among VLBW Infants in a US, Level 3 NICU

Abstract: Implementation of a DM program was associated with greater consumption of MOM throughout hospitalization and at discharge among VLBW infants. Implementation of DM programs may augment support of mothers to provide breast milk in level 3 NICUs.

Cited by 50 publications

References 15 publications

Five-Year Secular Trends and Predictors of Nonconsent to Receive Donor Milk in the Neonatal Intensive Care Unit

Five-Year Secular Trends and Predictors of Nonconsent to Receive Donor Milk in the Neonatal Intensive Care Unit

Donor milk intake and infant growth in a South African neonatal unit: a cohort study

Establishing an integrated human milk banking approach to strengthen newborn care

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