Barriers to optimal breast milk provision in the neonatal intensive care unit

Abstract

Objective: This study examines comprehensive patient and process factors that influence breast milk use in the NICU setting. Study design: We examined the association of maternal, neonatal, and family factors and lactation support systems to identify gaps in breast milk use in a retrospective study of 865 infants born in 23–41 weeks gestation admitted to the NICU. Results: Breast milk at discharge for all infants was 89.3%, for extremely preterm 82.3%, moderately preterm 91.4%, late preterm 86.5%, and term 92.7%. Prematurity (OR 0.31 [0.17–0.56]), low birth weight, morbidities, Black maternal race (OR 0.20 [0.07–0.57]) and public insurance (OR 0.54 [0.34–0.85]) were associated with decreased breast milk use. Early initiation of feeds was associated with increased breast milk use. Conclusions: There is a need to increase social as well as hospital support systems to address gaps in breast milk use in the NICU.