Study protocol for reducing disparity in receipt of mother’s own milk in very low birth weight infants (ReDiMOM): a randomized trial to improve adherence to sustained maternal breast pump use

Background Black very low birth weight (VLBW; < 1500 g birth weight) and very preterm (VP, < 32 weeks gestational age, inclusive of extremely preterm, < 28 weeks gestational age) infants are significantly less likely than other VLBW and VP infants to receive mother’s own milk (MOM) through to discharge from the neonatal intensive care unit (NICU). The costs associated with adhering to pumping maternal breast milk are borne by mothers and contribute to this disparity. This randomized controlled trial tests the effectiveness and cost-effectiveness of an intervention to offset maternal costs associated with pumping. Methods This randomized control trial will enroll 284 mothers and their VP infants to test an intervention (NICU acquires MOM) developed to facilitate maternal adherence to breast pump use by offsetting maternal costs that serve as barriers to sustaining MOM feedings and the receipt of MOM at NICU discharge. Compared to current standard of care (mother provides MOM), the intervention bundle includes three components: a) free hospital-grade electric breast pump, b) pickup of MOM, and c) payment for opportunity costs. The primary outcome is infant receipt of MOM at the time of NICU discharge, and secondary outcomes include infant receipt of any MOM during the NICU hospitalization, duration of MOM feedings (days), and cumulative dose of MOM feedings (total mL/kg of MOM) received by the infant during the NICU hospitalization; maternal duration of MOM pumping (days) and volume of MOM pumped (mLs); and total cost of NICU care. Additionally, we will compare the cost of the NICU acquiring MOM versus NICU acquiring donor human milk if MOM is not available and the cost-effectiveness of the intervention (NICU acquires MOM) versus standard of care (mother provides MOM). Discussion This trial will determine the effectiveness of an economic intervention that transfers the costs of feeding VLBWand VP infants from mothers to the NICU to address the disparity in the receipt of MOM feedings at NICU discharge by Black infants. The cost-effectiveness analysis will provide data that inform the adoption and scalability of this intervention. Trial registration ClinicalTrials.gov: NCT04540575, registered September 7, 2020.

Pengaruh Hypnopressure terhadap Produksi Air Susu Ibu (ASI) dan Kepercayaan Diri Menyusui

Breastfeeding is an obligation that must be given to babies during their growth period. Consistent breast milk production and confidence to breastfeed are very necessary for the success of exclusive breastfeeding. Hypnopressure is one method that can increaseand maintain breastmilk production and breastfeeding confidence. The purpose of this project is to analyze the effect of hypnopressure on breast milk production and breastfeeding confidence. This study uses Quasy Eksperimental with Pretest dan Posttest Controlled Group Design. There were 28 postpartum mothers who were divided into two groups and taken with simple random sampling. Production of breast milk was measured by electric breast pump and breastfeeding sel efficacy was measured Breastfeeding Self Efficacy Scale (BSES). Data were analyzed using paired and unpaired t-test. Primary outcomes of this study will be effect of the intervention on breastmilk production and breastfeeding confidence. We conclude that hypnopressure could improve breastmilk production (p=0.00) and breasfeeding confidence (p=0.00) and breastfeeding confidence (p=0.00). Result of this greater understanding about increase breast milk production and confidence which influence the success of breastfeeding by hypnopressure then be useful targets for midwife intervention in post partum.

Bad Mother / Good Mother

Bad Mother / Good Mother is an audiovisual performance that explores societal perceptions about ideal and non-ideal motherhood through sound and projected visuals. The sound comes from an amplified breast pump, while the visuals are projected on a single screen. In the performance, the artist plays the breast pump at different speeds. She plays it as a solo instrument and as part of an arrangement, and---at certain points in the performance---processes the breast pump sound using filters. This paper situates the performance within a discussion of how audiovisual performance can help express the relationship between gender and invisible labor.