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Lactation Consultation Sustains Breast Milk Intake in Infants with Cystic Fibrosis

Miller, Tami*; Antos, Nicholas J.; Brock, Lisa A.; Wade, Thomas§; Goday, Praveen S.||

Journal of Pediatric Gastroenterology and Nutrition: June 7, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002415
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ABSTRACT Guidelines recommend breastfeeding in cystic fibrosis (CF) but breastfeeding rates decline rapidly in CF. We initiated a quality improvement project to improve breastfeeding in CF by incorporating International Board-Certified Lactation Consultants (IBCLC) into the initial CF-diagnosis visit to support mothers who were breastfeeding at diagnosis. In the pre-intervention group, only 8/14 (57%) continued to provide BM after the 1st visit, while post-intervention, 16/17 (94%) mothers continued to do so. (p = 0.03). The duration of any (or partial) breastfeeding increased to an average of 7.7 months from an average of 6.4 months pre-intervention (p = 0.45). The weight z score and weight-for-length z score at diagnosis showed no change at 6 or 12 months (all comparisons p value > 0.05). We conclude that mothers who met with the IBCLC were less likely to quit breastfeeding and hypothesize that lactation support to mothers can prolong the duration of breastfeeding in infants with CF.

*Clinical Dietitian Specialist, Clinical Nutrition, Children's Hospital of Wisconsin

Children's Hospital of Wisconsin, Medical College of Wisconsin, Section of Pediatric Pulmonary and Sleep Medicine, Director, Cystic Fibrosis Center, Medical Director, SE Wisconsin SAMPRO™

Lactation Management Services, Children's Hospital of Wisconsin

§Clinical Research Coordinator, Pediatric Pulmonary & Sleep Medicine, Medical College of Wisconsin

||Professor, Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226.

Address correspondence and reprint requests to Praveen S. Goday, MBBS, CNSC, Professor, Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226 (e-mail: pgoday@mcw.edu).

Received 11 December, 2018

Accepted 13 May, 2019

Funding Source: None.

Financial Disclosure: Dr Goday serves as consultant to Nutricia and serves on a Data Safety and Monitoring Board for Shire Pharmaceuticals. The remaining authors have no financial relationships relevant to this article to disclose.

Conflict of Interest: None of the authors have any conflicts of interest to disclose.

Contributors statement: TM: Contributed to the design of the work, collected data, wrote the first draft and approved the final manuscript

NJA: Contributed to the design of the work, helped with manuscript re-drafting and approved the final manuscript

LAB: Contributed to the design of the work, helped with manuscript redrafting and approved the final manuscript

TW: Collected data, helped with manuscript redrafting and approved the final manuscript

PSG: Contributed to the design of the work, interpretation of the data, helped with manuscript redrafting and approved the final manuscript

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,