Improving Access to Lactation Consultation and Early Breast Milk Use in an Outborn NICU

Leeman, Kristen T.; Barbas, Kimberly H.; Strauss, Julia; Adams, S.; Sussman-Karten, Karen; Kelly, Alyssa; Parker, Margaret G.; Hansen, Anne

doi:10.1097/pq9.0000000000000130

Cited by 12 publications

(15 citation statements)

References 19 publications

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“…Positive correlations have been seen in NICUs with dedicated LCs in increasing breastfeeding rates through discharge. [34][35][36][37] In our own institution, we have seen an increase in the percentage of neonates receiving any HM, especially in the outborn population, 37 with the addition of a dedicated LC. We were able to financially support increase in LC staffing by receiving grants from the W.K.…”

Section: Discussionmentioning

confidence: 96%

“…[26][27][28][29][30][31][32][33][34][35] Over time, we improved access to lactation consultants (LCs) in labor and delivery (L&D), postpartum and outpatient, included a Spanish-speaking LC, and incorporated an HM cream fortifier, all in an effort to increase the lactation success of these high-risk mothers. 36,37 The primary purpose of this study was to assess the success of our Liquid Gold bundle in the provision of MOM over time, specifically at first enteral feed and at discharge. The secondary aim was to assess the impact of our bundle across racial subgroups to determine whether disparities would persist despite this standardized approach.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

“Liquid Gold” Lactation Bundle and Breastfeeding Rates in Racially Diverse Mothers of Extremely Low-Birth-Weight Infants

Obaid

Igawa

Maxwell

et al. 2021

Breastfeeding Medicine

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

“Liquid Gold” Lactation Bundle and Breastfeeding Rates in Racially Diverse Mothers of Extremely Low-Birth-Weight Infants

Obaid

Igawa

Maxwell

et al. 2021

Breastfeeding Medicine

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“…In a mixed inborn/referral NICU, Dweck et al (2008) reported that only outborn infants showed increased in-NICU and discharge MOM provision after an IBCLC was hired to see all patients upon admission, but infants with surgical conditions and anomalies, which are typically the population sent to a referral NICU, were excluded. Leeman et al (2019) recently published a quality improvement intervention very similar to ours that took place at a referral children's hospital NICU in which a part-time dedicated IBCLC was hired to supplement hospital-wide lactation service to increase availability of lactation care in the NICU. With proactive approaches like an automatic order for am IBCLC consult for infants admitted at < 48 hr of age, percentage of infants fed MOM on Day 7 of age increased from 76% to 90%; MOM provision throughout hospitalization or at discharge was not reported.…”

Section: Discussionmentioning

confidence: 99%

Proactive Lactation Care is Associated With Improved Outcomes in a Referral NICU

et al. 2021

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Background Mother’s milk improves outcomes. Referral neonatal intensive care units face unique lactation challenges with maternal–infant separation and maternal pump dependency. Little is known about lactation resource allocation in this high-risk population. Research Aims To determine differences in human milk outcomes, (1) the proportion of infants fed exclusive or any mother’s milk and (2) recorded number and volume of pumped mothers’ milk bottles, between two models of lactation care in a referral neonatal intensive care unit. Methods This retrospective, longitudinal, two-group comparison study utilized medical record individual feeding data for infants admitted at ≤ Day 7 of age and milk room storage records from reactive and proactive care model time periods (April, 2017–March, 2018; May, 2018–April, 2019). The reactive care model ( n = 509 infants, 58% male, median birth weight and gestational age of 37 weeks,) involved International Board Certified Lactation Consultant referral for identified lactation problems; whereas, the proactive model ( n = 472 infants, 56% male, median birth weight and gestational age 37 weeks) increased International Board Certified Lactation Consultant staffing, who then saw all admissions. Comparisons were performed using chi square, Mann Whitney, and t-tests. Results A proactive lactation approach was associated with an increase in the receipt of any mother’s milk from 74.3% to 80.2% ( p = .03) among participants in the proactive model group. Additionally, their milk room mean monthly bottle storage increased from 5153 ( SD 788) to 6620 ( SD 1314) bottles ( p < .01). Conclusions In this retrospective study at a tertiary referral neonatal intensive care unit, significant improvement inhuman milk outcomes suggests that increased resources for proactive lactation care may improve mother’s milk provision for a high-risk population.

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“…The health status of babies at the time of birth, birth weight, age of pregnancy and medications used during pregnancy can influence the ability to start and continue breastfeeding in an effective way 5 .Many newborns, who are followed up and treated in the newborn care unit due to prematurity and other diseases cannot be breastfed directly. In such situations, mothers are required to ensure and maintain milk production via breast pumps 6 . A certain proportion of these babies can be fed with milked breast milk via methods such as feeding with a nasogastric tube, an orogastric tube, a syringe, a dropper and a cup 7 .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Health Problems at Birth on Breastfeeding: A Cross-Sectional Study in a Third Step Hospital

Akbayram

2020

Dicle Tıp Dergisi

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Objective:The health status at birth can affect infant's ability to start suckling and the breastfeeding process. The aim of this study is to compare the process of starting and continuing breastfeeding of healthy babies and infants born with health problems and also to evaluate the effect of health problems at birth on breastfeeding.Method: 460 mothers with infants between 6-24 months of age who admitted to the pediatric outpatient clinics were enrolled in the study.Results: It was found that 19.2% health problems at birth. Among healthy babies the rate of breastfeeding as first nutrition and breastfeeding in first hour after delivery was found to be 82% and 67% respectively. These rates were 49.5% and 32.3% in infants born with health problems, respectively (p <0.001). The rate of breastfeeding in healthy babies for the first six months of life was 39.9% and this rate was very low in babies born with health problems (23.2%) (p <0.001).It was found that 31.9% of infants born with health problems were feed by formula in the first month and 67% within six months. In the study, 59.9% of healthy babies and 39.6% of babies born with health problems continued to receive breast milk (p <0.001). Conclusions:It was found that being born with health problems delays the time to start breastfeeding, increases the risk of feeding with formula in the first month and in the first six months of age, and adversely affects the continuation of breastfeeding.

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Improving Access to Lactation Consultation and Early Breast Milk Use in an Outborn NICU

Abstract: Supplemental Digital Content is available in the text.

Cited by 12 publications

References 19 publications

“Liquid Gold” Lactation Bundle and Breastfeeding Rates in Racially Diverse Mothers of Extremely Low-Birth-Weight Infants

“Liquid Gold” Lactation Bundle and Breastfeeding Rates in Racially Diverse Mothers of Extremely Low-Birth-Weight Infants

Proactive Lactation Care is Associated With Improved Outcomes in a Referral NICU

The Effect of Health Problems at Birth on Breastfeeding: A Cross-Sectional Study in a Third Step Hospital

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