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

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.