The Effect of Antenatal Breast Milk Care Bundles on the Availability of Breast Milk in Preterms ≤32 Weeks: A Cohort Study

Abstract

Background: Though early enteral nutrition with Mother’s own milk (MOM) is the norm in preterms, it is a difficult challenge to get it into the intensive care unit due to various medical and logistic issues. Awareness about this among pregnant ladies and their caregivers from the antenatal period may help to overcome some of these difficulties. Objective: To compare the effect of the implementation of an antenatal breast milk care bundle on the availability of adequate breast milk on day 7 for preterm babies ≤ 32 weeks when compared to a postnatal breast milk care bundle alone. Methodology: This prospective study was conducted among neonates ≤32 weeks born in Government Medical College, Thiruvananthapuram from January 2021 to May 2022. Antenatal bundles were implemented in the antenatal OPDs and wards. Postnatal bundles were implemented in the NICU and postnatal wards. The outcome was compared among babies of mothers who got both the care bundles and those who received only the postnatal care bundle. Results: A total of 110 babies were included in the study. There was a 1.32 times increase in the adequacy of milk volume on day 7 (CI: 1.04–1.68), a significant increase in the proportion of mothers expressing within 24 hours, and babies getting discharged on exclusive MOM in those who received the antenatal BMC bundles. The risk for inadequate milk volume was high in those who have <2 ml of milk at 48 hours (RR: 1.67, CI:1.26–2.20]. Conclusion: Antenatal breast milk care bundles can increase the availability of adequate MOM for preterm babies.