The Interaction of Donor Human Milk Availability and Race/Ethnicity on Provision of Mother's Own Milk for Very Low Birth Weight Infants

Esquerra-Zwiers, Anita; Schoeny, Michael; Engstrom, Janet L.; Wicks, Jennifer; Szotek, Jennifer; Meier, Paula P.; Patel, Aloka L.

doi:10.1089/bfm.2020.0212

Cited by 12 publications

(16 citation statements)

References 28 publications

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“…There are racial disparities in DM provisions and breastfeeding rates in the US. 31 The majority of mothers in this study were White. Fourteen and nine percent of the population is Black in the United States (US)…”

Section: Discussionmentioning

confidence: 86%

A Pilot Single-Site Randomized Control Trial: Investigating the Use of Donor Milk in the Late Preterm and Term Infant in the Neonatal Intensive Care Unit

Pithia¹,

Grogan²,

Garg

et al. 2023

Preprint

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Objective: We aimed to study the use of donor milk (DM) in term and late preterm infants (LPIs) when mother’s own milk (MOM) was unavailable. We hypothesized this study would be feasible and breastfeeding attempts and the percentage of MOM (MOM%) would increase with DM without adversely affecting growth. Study Design: This was a pilot study (n=32). Infants with gestational age >34 weeks admitted to the neonatal intensive care unit were included. Infants were randomized to: the human milk (MOM+DM) or formula (MOM+F) groups. Result: Consent rate was 52%. Breastfeeding attempts increased significantly over time in the MOM+DM group compared to the MOM+F group (group p=0.41, time p =0.02, group*time p=0.01). Growth at multiple time points was similar when the two groups were compared. Conclusion: A study randomizing term infants and LPIs to DM or formula when MOM is unavailable is feasible. DM may increase breastfeeding attempts without compromising growth.

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Section: Discussionmentioning

confidence: 86%

A Pilot Single-Site Randomized Control Trial: Investigating the Use of Donor Milk in the Late Preterm and Term Infant in the Neonatal Intensive Care Unit

Pithia¹,

Grogan²,

Garg

et al. 2023

Preprint

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“…This means that infants who received PDHM can correctly identify 73% of infants who will be discharged on any IF and correctly identify 86% of infants who will be discharged on MOM Exclusively. 13,14 A number of studies including a pre-post observational cohort study by Parker et al found that MOM consumption decreased following implementation of a Donor Human Milk program in extreme preterm infants. 13 This may be reflective of barriers and enablers to establishing MOM supply in different settings, which we have not investigated as part of this study.…”

Section: Discussionmentioning

confidence: 99%

“…Exposure to PDHM and the outcome of discharge nutrition had a sensitivity of 0.73 and a specificity of 0.86 respectively. This means that infants who received PDHM can correctly identify 73% of infants who will be discharged on any IF and correctly identify 86% of infants who will be discharged on MOM Exclusively 13,14 . A number of studies including a pre‐post observational cohort study by Parker et al .…”

Section: Discussionmentioning

confidence: 99%

Pasteurised donor human milk audit: What is happening in the neonatal critical care unit?

Page

Gilroy

Joseph

et al. 2021

J Paediatrics Child Health

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Aim Human milk with fortification, providing additional energy, protein and micronutrients, is considered the optimal form of nutrition for preterm infants as it provides protection against infections and improves outcomes. Mothers' own milk (MOM) is the preferred choice, however in situations where MOM is insufficient or contraindicated; Pasteurised donor human milk (PDHM) is the preferred alternative. This study aimed to identify whether PDHM during neonatal critical care unit (NCCU) admission is associated with discharge nutrition in preterm infants. Methods A retrospective observational cohort study was conducted over a 12‐month period in 2017. This included all inborn infants admitted to the NCCU with gestational age ≤ 28 weeks or ≤ 1000 g birthweight, who survived until discharge. Multivariate logistic models were used to detect the association between study groups (PDHM vs. No PDHM) and discharge nutrition. Results Seventy‐seven infants were included; 35 infants received PDHM during admission. At discharge, infants who received PDHM were significantly more likely to be on infant formula (IF) (86%) than infants who did not receive PDHM (26%). In contrast, infants who did not receive PDHM (No PDHM) were significantly more likely to be receiving MOM exclusively at discharge (74%), than those who did receive PDHM (14%). The odds of an infant being discharged on IF were 16.91 times higher if they received PDHM. Conclusion In this study, infants born at ≤28 weeks or ≤ 1000 g who received PDHM were more likely to receive IF at NCCU discharge than infants who did not receive PDHM.

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“…Esquerra-Zwiers et al showed similarly reduced exclusive MOM use in the rst two weeks of life with DHM availability compared to a pre-DHM cohort. However, in these studies enteral feeds were commenced earlier, and infants were exposed to formula later in life in after DHM introduction (33). Tshamala et al also reported earlier start of enteral feeding and unchanged proportion of infants fed exclusively with maternal breastmilk at discharge after implementation of a DHM programme (34).…”

Section: Donor Human Milkmentioning

confidence: 98%

A protocol for a randomised controlled trial exploring human milk, nutrition, growth, and breastfeeding rates at discharge: the Hummingbird study

Chmelova

Berrington

Shenker

et al. 2022

Preprint

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Background Mother’s own breast milk (MOM) is the optimal nutrition for preterm infants as it reduces the incidence of key neonatal morbidities and improves long-term outcomes. However, MOM shortfall is common and either preterm formula (PF) or pasteurised donor human milk (DHM) may be used, although practice varies widely. Limited data suggest that the use of DHM may impact on maternal beliefs and behaviours and may therefore impact on breastfeeding rates. The aim of this pilot study is to determine if the duration of DHM exposure impacts on breastfeeding rates, and maternal breastfeeding self-efficacy. Methods The Human Milk, Nutrition, Growth, and Breastfeeding Rates at Discharge (Hummingbird) study is a feasibility and pilot, non-blinded, randomised controlled trial (RCT) with a contemporaneous qualitative evaluation. Babies born at less than 33 weeks gestation or with birth weight <1500 grams whose mothers intend to provide MOM are randomly assigned to either control arm (DHM used to make up shortfall until full feeds, then PF used thereafter) or intervention arm (DHM used to make up shortfall until 36 weeks corrected age or discharge if sooner). The primary outcome is breastfeeding rates at discharge. Secondary outcomes include growth, key neonatal morbidities, length of stay, breastfeeding self-efficacy and postnatal depression using validated questionnaires. Qualitative interviews using a topic guide will explore perceptions around use of DHM and will be analysed using thematic analysis. Discussion The provision of DHM is a complex intervention as it impacts on infant health and disease, as well as impacting on maternal and healthcare staff belief and behaviour. This is the first RCT to investigate the impact of DHM duration on breastfeeding rates and maternal self-efficacy. Trial registration: Trial was registered prospectively on 4th May 2021 (ISRCTN 57339063).

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The Interaction of Donor Human Milk Availability and Race/Ethnicity on Provision of Mother's Own Milk for Very Low Birth Weight Infants

Cited by 12 publications

References 28 publications

A Pilot Single-Site Randomized Control Trial: Investigating the Use of Donor Milk in the Late Preterm and Term Infant in the Neonatal Intensive Care Unit

A Pilot Single-Site Randomized Control Trial: Investigating the Use of Donor Milk in the Late Preterm and Term Infant in the Neonatal Intensive Care Unit

Pasteurised donor human milk audit: What is happening in the neonatal critical care unit?

A protocol for a randomised controlled trial exploring human milk, nutrition, growth, and breastfeeding rates at discharge: the Hummingbird study

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