Strategies to Improve Mother's Own Milk Expression in Black and Hispanic Mothers of Premature Infants

Objective To compare growth and metabolic outcomes of premature infants receiving either Enfamil liquid human milk fortifier (ELHMF) or Similac liquid human milk fortifier (SLHMF). Study Design Infants born at ≤31 weeks' gestational age (GA) with birth weights <1,500 g and exclusively fed on human milk (mother's milk and/or donor milk) were prospectively assigned alternatively to one of the two liquid human milk fortifier (LHMF) groups. Baseline demographic, growth, enteral nutrition, and laboratory data were compared after fortification. Results In total, 31 preterm infants were recruited (ELHMF = 16; SLHMF = 15) with a mean GA of 27.1 ± 2.1 weeks and birth weight of 993 ± 245 g. The SLHMF group had significantly better weight gain as measured by individual weight z-scores (p = 0.008), better median weight gain velocity (p = 0.014), and less metabolic acidosis (p = 0.016). Overall weight gain was significantly better on mother's own milk in both the fortifier groups. The SLHMF group showed a trend toward higher growth velocity on donor milk compared with ELHMF (p = 0.06). We also observed a higher reticulocyte count (p = 0.003) in the SLHMF group compared with the ELHMF group. Conclusion In premature infants, between the two liquid human milk fortifiers, ELHMF fortifier is associated with relatively less weight gain and more metabolic acidosis.

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Using a WeChat mini-program-based lactation consultant intervention to increase the consumption of mother’s own milk by preterm infants in the neonatal intensive care unit: a study protocol for a cluster randomized controlled trial

Trials ◽

10.1186/s13063-021-05731-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jie Huo ◽

Xinping Wu ◽

Chuanli Gu ◽

Zhangbin Yu ◽

Jun Zhang ◽

...

Keyword(s):

Intensive Care Unit ◽

Randomized Controlled Trial ◽

Intensive Care ◽

Premature Infants ◽

Neonatal Intensive Care ◽

Controlled Trial ◽

Lactation Consultant ◽

Randomized Controlled ◽

Cluster Randomized ◽

Mother’S Own Milk

Abstract Background The benefits of mother’s own milk (MOM) for preterm infants have been widely recognized. Many studies have shown that the rate of breastfeeding of premature infants remains very low. Although many studies use measures to promote breastfeeding, few high-quality cluster randomized controlled studies have evaluated the effectiveness of these measures. WeChat is an instant messaging software for smart terminals, and WeChat mini-programs have been widely used to promote health and self-management in China. Based on this background, we designed a randomized controlled study based on WeChat mini-programs to promote MOM feeding of premature infants in the neonatal intensive care unit (NICU). Methods/design This study will evaluate the effectiveness of WeChat mini-programs to increase the consumption of MOM feeding in twelve NICUs in Jiangsu Province, namely, six “intervention” NICUs and six “control” NICUs. The study process is as follows: (1) design and preparation, (2) NICU recruitment and training, (3) interpretation and analysis of baseline data, (4) quality control implementation process, and (5) data analysis feedback and publication of study reports. The primary outcome is the proportion of MOM feeding of premature infants during NICU hospitalization. The secondary outcomes are as follows: (1) time to initiation of MOM feeding (hours) and proportion of first-time MOM feeding (%), (2) duration of parenteral nutrition (days), (3) time to total gastrointestinal feeding (days), (4) hospitalization time and hospitalization cost, and (5) incidence of complications (necrotizing enterocolitis, bronchopulmonary dysplasia, feeding intolerance, late-onset sepsis, retinopathy of prematurity). Discussion This study is the first cluster randomized controlled trial on the intervention of using a WeChat mini-program-based lactation consultant for premature infants in the NICU in China. We hope this study can improve the consumption of MOM by NICU premature infants during hospitalization through the intervention of WeChat mini-programs. Trial registration ClinicalTrials.gov NCT04383379. Registered on May 5, 2020.

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