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Milk expression within 8 hours of birth tied to successful lactation throughout NICU stay

Milk expression within 8 hours after birth in mothers with very low-birth-weight, or VLBW, infants was associated with a higher probability of being able to produce milk throughout infant hospitalization in the NICU, according to a recent study published in Obstetrics and Gynecology.

“Mothers of VLBW infants face several unique challenges in making milk owing to their higher risk of complicated delivery; comorbid health conditions that affect milk production, including diabetes and obesity; need for prolonged pumping rather than oral feedings at the breast; and prolonged mother-infant separation as compared with mothers delivering at term,” Margaret G. Parker, MD, MPH, neonatologist at Boston Medical Center, and colleagues wrote.

To evaluate milk expression in mothers with VLBW infants, researchers conducted a secondary analysis of data collected from a Neonatal Quality Improvement Collaborative of Massachusetts project, which included infants born in nine hospitals in the state between January 2015 and December 2017. Hospitals included in the study had NICUs with birth centers.

Researchers estimated HRs to compare the probability of continued provision of mother’s milk during hospitalization between mothers who began milk expression within 8 hours following delivery and those who began milk expression between 9 and 24 hours after delivery. The primary outcome was any mother’s milk available at infant discharge or transfer from the NICU.

Milk expression within 8 hours after birth in mothers with very low-birth-weight, or VLBW, infants was associated with a higher probability of being able to produce milk throughout infant hospitalization in the NICU, according to a recent study published in Obstetrics and Gynecology.

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A total of 1,157 mother-infant pairs were included in the study. Among mothers, 68% experienced first milk expression within 8 hours after delivery and 32% initiated milk expression within 9 to 24 hours.

Researchers found that first milk expression between 9 and 24 hours after birth was tied to lower odds that any amount of mother’s milk would be available for the infant on day 7 after delivery (adjusted OR = 0.39; 95% CI, 0.24-0.60), and at NICU discharge or transfer (aOR = 0.45; 95% CI, 0.33-0.62). The results were similar for the odds of infants being exclusively given mother’s milk on day 7.

Compared with those who began milk expression within 8 hours of delivery, mothers who experienced their first milk expression within 9 to 24 hours after delivery stopped providing milk earlier in their infants’ NICU stay (adjusted HR = 1.64; 95% CI, 1.33-2.01).

“Mothers who have recently delivered very low-birth-weight infants have a number of competing needs,” Parker said in a press release. “Our data-driven approach to determining optimal time of first milk expression can help providers balance the need for safe maternal care with effective support to create long-term lactation success.” – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.