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 Preemies who consume breast milk may be less likely to develop
infections or neurological problems than infants who don't, previous
research suggests. But mothers who deliver early may be unable to
breastfeed right away if their milk hasn't come in yet and they may
also have a low milk supply because preemies are often unable to
latch on to the breast and nurse efficiently to stimulate milk
production.
For the current study, researchers examined data on 346,248 mothers
and their very low birthweight preemies born at 802 hospitals
nationwide from 2008 to 2017. Over the decade, the proportion of
tiny preemies discharged with human milk to drink increased from 44%
to 52%
"While human milk use has improved in the last decade among very low
birthweight infants infants, there are considerable disparities by
U.S. region and race/ethnicity that need to be addressed," said Dr.
Margaret Parker, lead author of the study and a researcher at Boston
Medical Center and Boston University School of Medicine.
Pregnancy normally lasts about 40 weeks, and babies born after 37
weeks are considered full-term. In the weeks immediately after
birth, preemies often have difficulty breathing and digesting food.
Some premature infants also encounter longer-term challenges such as
impaired vision, hearing and cognitive skills as well as social and
behavioral problems.
Pediatricians recommend that mothers exclusively breastfeed infants
until they're at least 6 months old because it can bolster babies'
immune systems and reduce their risk of ear and respiratory
infections, sudden infant death syndrome, allergies, obesity and
diabetes.
The American Academy of Pediatrics recommends pasteurized human
donor milk when mother's milk is not available.
"Currently, the vast majority of hospitals that care for very low
birth weight infants offer donor milk for this purpose," Parker said
by email. "If a hospital does not offer it, mothers can ask their
hospital providers to obtain it.
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In the study, all of the babies were born weighing no more than
1,500 grams (about 3.3 pounds), at just 22 to 29 weeks' gestation.
Human milk provision was higher in western and northeastern states
than elsewhere in the country. It was also more common with multiple
births, researchers report in JAMA Pediatrics.
Asian mothers got human milk at discharge more often than white
women, while this happened less often among black, Hispanic, and
Native American mothers.
The study wasn't a controlled experiment designed to prove whether
or how factors like race or ethnicity might directly impact whether
women received human milk at hospital discharge.
One limitation of the study is that researchers only looked at human
milk use at a single point in time, and they didn't have data on how
many mothers continued to use human milk for the first several weeks
after they went home.
Ideally, mothers of preemies should start expressing milk with a
breast pump within a few hours of birth and do this as often as
possible to stimulate supply while preemies are too tiny and weak to
nurse effectively, Parker advised. Mothers should also visit babies
as often as possible, nurse when they can, and do skin to skin
contact with infants.
"This is hard work and supportive family and friends can make a big
difference," Parker said. "Low milk supply is common among mothers
of very low birth weight infants."
SOURCE: http://bit.ly/2NNcCew JAMA Pediatrics, online September 3,
2019.
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