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Breast Feeding in NICU Babies
Current Factors Associated with Use of Breast Milk Feedings in Neonates Discharged from Neonatal Intensive Care Units. Clark RH, Powers N, Bloom BT, et al. Pediatrix Medical Group, Sunrise FL.
This study evaluated the incidence of breast milk use at discharge in 42,891 NICU admissions from 124 hospitals during 1999 and 2000. At discharge, 21,327 babies (49.7%) were receiving some breast milk, and 21,564 (50.3%) were not. The range for unit-specific success in receiving breast milk at discharge was 71% for the upper third to 35% for the lower third of study NICUs. The most important variables associated with being discharged on breast milk were white race (63% vs. 46% for non-white, p=0.001), being married (63% vs. 44% for non-married, p=0.001), and site of care. Site of care variation remained significant even after controlling for differences between sites in gestational age, race, and marital status.
Comment. There are many advantages of breast milk feedings, especially for preterm babies. While we may not be able to impact some of the variables affecting successful breast feeding of NICU babies (such as race and parents’ marital status), there remain significant differences between NICUs in breast feeding success after controlling for these variables. The next step would be to study the process differences between NICUs in the upper and lower third of the unit-specific success range to identify those practices that promote successful breast feeding. I hope this group plans to do a follow-up report that identifies the best demonstrated practices for improving successful breastfeeding rates in NICU patients.