Original Research

Milk Volume Outcomes in Pump-Dependent Mothers of Critically Ill Infants

Bendixen, Marion M. PhD, MSN, RN, IBCLC; Weaver, Michael T. PhD, RN, FAAN; Parker, Leslie A. PhD, APRN, FAANP, FAAN

Editor(s): Dowling, Donna PhD, RN, Section Editors; Newberry, Desi M. DNP, NNP-BC, Section Editors; Parker, Leslie PhD, APRN, FAAN, Section Editors

Author Information

College of Nursing, University of Florida, Gainesville FL.

Correspondence: Marion M. Bendixen, PhD, MSN, RN, IBCLC, College of Nursing, University of Florida, PO Box 100197, Gainesville, FL 32610 ([email protected]).

Previous Presentations:

1. Lactation Success in Mothers of Critically Ill Infants. National Association of Neonatal Nurses Research Summit; April 2018; Scottsdale, AZ.

2. Bendixen M, Weaver M, Parker L. Lactation success in mothers of critically ill infants [abstract]. Adv Neonatal Care. 2018;18(3):E3-E13. doi:10.1097/ANC.0000000000000508.

Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under University of Florida Clinical and Translational Science Awards TL1TR001428 and UL1TR001427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Dr Parker, who is a section editor for Advances in Neonatal Care and the coauthor and mentor to the primary author, was not involved in the editorial review or decision to publish this article. The entire process from submission, referee assignment, and editorial decisions was handled by other members of the editorial team for the journal. The other authors have no conflicts of interest.

Advances in Neonatal Care 22(3):p 253-260, June 2022. | DOI: 10.1097/ANC.0000000000000888

Abstract

Introduction:

Mother's own milk improves health outcomes in infants of all gestational ages. Although pump-dependent mothers of extremely premature infants are at risk of insufficient milk production, whether mother's milk production is impacted by gestational age and pump dependency in mothers of more mature critically ill infants is unknown.

Purpose:

To determine whether there is a relationship between gestational age, milk production, and time to secretory activation in mothers delivering a critically ill infant.

Methods:

A convenience sample of 136 pump-dependent mothers whose infants were admitted to the neonatal intensive care unit was enrolled between 2013 and 2016 as part of a quality improvement project. Group 1 (early preterm) delivered infants at 30 to 33 weeks of gestation (n = 41), group 2 (late preterm) 34 to 36 weeks (n = 48), and group 3 (term) 37 weeks and more (n = 47). Milk volume on days 1 to 7 was measured by weighing each vial of expressed milk and compared using general linear mixed-model analysis. Time to the onset of secretory activation was compared using censored regression analysis.

Results:

Main effect for gestational age controlling for day was statistically significant (P = .0234). The early preterm group produced more milk over the 7-day study than the term (P = .01) and late preterm (P = .02) groups. The early preterm group achieved secretory activation earlier than the late preterm group (adjusted P = .039).

Implications for Practice:

Pump-dependent mothers of all infants admitted to the neonatal intensive care unit may be at risk of inadequate milk production and delayed secretory activation and may therefore benefit from early milk production monitoring and lactation support.

Implications for Research:

Further studies should examine targeted interventions to increase milk production in pump-dependent mothers.

Article Keywords

Keywords
breast milk expression, gestational age, human milk, infant, lactation, mother's own milk, neonatal intensive care, pump-dependent mothers, secretory activation

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Milk Volume Outcomes in Pump-Dependent Mothers of Critically Ill Infants