7979 Department of Paediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, Canada.
Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Canada.
J Hum Lact. 2022 Feb;38(1):148-155. doi: 10.1177/0890334421993467. Epub 2021 Feb 13.
Mother's milk improves outcomes. Referral neonatal intensive care units face unique lactation challenges with maternal-infant separation and maternal pump dependency. Little is known about lactation resource allocation in this high-risk population.
To determine differences in human milk outcomes, (1) the proportion of infants fed exclusive or any mother's milk and (2) recorded number and volume of pumped mothers' milk bottles, between two models of lactation care in a referral neonatal intensive care unit.
This retrospective, longitudinal, two-group comparison study utilized medical record individual feeding data for infants admitted at ≤ Day 7 of age and milk room storage records from reactive and proactive care model time periods (April, 2017-March, 2018; May, 2018-April, 2019). The reactive care model ( = 509 infants, 58% male, median birth weight and gestational age of 37 weeks,) involved International Board Certified Lactation Consultant referral for identified lactation problems; whereas, the proactive model ( = 472 infants, 56% male, median birth weight and gestational age 37 weeks) increased International Board Certified Lactation Consultant staffing, who then saw all admissions. Comparisons were performed using chi square, Mann Whitney, and tests.
A proactive lactation approach was associated with an increase in the receipt of any mother's milk from 74.3% to 80.2% ( = .03) among participants in the proactive model group. Additionally, their milk room mean monthly bottle storage increased from 5153 ( 788) to 6620 ( 1314) bottles ( < .01).
In this retrospective study at a tertiary referral neonatal intensive care unit, significant improvement inhuman milk outcomes suggests that increased resources for proactive lactation care may improve mother's milk provision for a high-risk population.
母乳可改善预后。接收新生儿重症监护病房的产妇面临母婴分离和使用吸奶器的问题，母乳喂养面临独特的挑战。目前对于高危人群的母乳喂养资源分配知之甚少。
在一家接收新生儿重症监护病房，比较两种不同的母乳喂养模式，确定母乳喂养结果的差异：（1）纯母乳喂养和（2）使用吸奶器的产妇所提供的母乳的婴儿比例和泵奶量。
这是一项回顾性、纵向、两组比较研究，使用了 2017 年 4 月至 2018 年 3 月和 2018 年 5 月至 2019 年 4 月期间反应性和主动护理模型时间内的婴儿个人喂养数据和挤奶室存储记录。反应性护理模式（n=509 例，男婴占 58%，平均出生体重和胎龄为 37 周），根据识别出的母乳喂养问题，由国际认证哺乳顾问进行转介；而主动护理模式（n=472 例，男婴占 56%，平均出生体重和胎龄 37 周）增加了国际认证哺乳顾问的人员配置，主动为所有入院婴儿提供服务。采用卡方检验、Mann-Whitney U 检验和检验进行比较。
主动的母乳喂养方法与接受任何母乳的比例增加有关，从主动护理模式组的 74.3%增加到 80.2%（=0.03）。此外，他们的挤奶室平均每月奶瓶储存量从 5153（788）瓶增加到 6620（1314）瓶（<0.01）。
在这项针对三级转诊新生儿重症监护病房的回顾性研究中，母乳喂养结果的显著改善表明，增加主动母乳喂养的资源可能会改善高危人群的母乳供应。
