Human and Donor Milk Use Post NICU Discharge

Abstract

Background: The health benefits of feeding all infants human milk are well established but the use of human milk after infants are discharged from the Neonatal Intensive Care Unit (NICU) remains low. Aims: Our aim was to investigate which infants were receiving human milk at discharge from the NICU and at varying times after discharge and to explore factors that foster or inhibit increasing human milk use in NICU graduates. Methods: We conducted a prospective, observational study and collected data on the use of human milk at hospital discharge and during follow-up visits in five developmental follow-up programs. These follow up programs were in 5 different large cities in 3 different states in the United States. Results: The overall rate of use of any human milk decreased from 841/1,160 (72.5%) at discharge to 233/791 (29.5%) in participants who were followed for >4 and ≤7 months after birth and this trend continued with later follow-up. In a multivariate logistic analysis, the factors found to be independently associated with the use of human milk at follow-up were: use of human milk at discharge (AOR=39.3, 14-162); white race compared to all other races/ethnicity (AOR= 2.97, 2.1-4.2); being reported preterm at birth (<=32 weeks) compared to more mature gestational age infants (AOR= 2.02, 1.4-2.9); and mother having received a breast pump within 12 hours of the birth of her infant (AOR=1.90, 1.2-3). Conclusions: Health care practices within the NICU affect the continued use of human milk after infants are discharged from the hospital. These practices could be enhanced to increase human milk usage in NICU graduates.