The authors report no conflict of interest or relevant financial relationships.
Biophysiologic and Social Stress Relationships with Breast Milk Feeding Pre- and Post-Discharge from the Neonatal Intensive Care Unit
Article first published online: 17 MAY 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 41, Issue 3, pages 347–357, May/June 2012
How to Cite
Purdy, I. B., Singh, N., Le, C., Bell, C., Whiteside, C. and Collins, M. (2012), Biophysiologic and Social Stress Relationships with Breast Milk Feeding Pre- and Post-Discharge from the Neonatal Intensive Care Unit. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: 347–357. doi: 10.1111/j.1552-6909.2012.01368.x
- Issue published online: 17 MAY 2012
- Article first published online: 17 MAY 2012
- Manuscript Accepted: JAN 2012
- University of California, Los Angeles (UCLA). Grant Number: T32 NR0070077
- breastfeeding duration;
- biophysiologic stress;
- social stress;
To determine influences on incidence of breast milk feeding (BMF) at time of discharge and 6 months later among infants cared for in the neonatal intensive care unit (NICU).
A 2-year prospective descriptive NICU hospital-based cohort design.
Academic Center Level III-IV NICU.
Five hundred and thirty-five infants cared for in NICU and a subgroup of one hundred twenty-nine participant mothers who answered questionnaires.
Predischarge data were collected using maternal and infant medical records. Post-discharge data were collected from maternal questionnaires.
At NICU discharge, biophysiologic stressors predictive of not receiving BMF included birth weight <1500 grams (p < .035), heart surgery (p = .014), and inhaled nitric oxide treatment (p = .002). Teenage mothers were less likely to BMF (p = .022). After discharge, BMF duration correlated with BMF duration of a prior infant (p < .009). Most mothers reported BMF >4 months, 91% continued pumping, and 89% indicated an interest in a hospital support group. Logistic regression analysis (R2 0.45) identified factors that significantly increased the likelihood of BMF > 4 months: BMF plan (p < .001), convenience (p = .018), and family as resource (p = .025). Negative associations were: awareness of immune benefits (p = .025), return to work (p = .002), and infants requiring surgical ligation of the patent ductus arterious (p = .019).
Social and medical stressors contribute to BMF duration pre- and post-NICU discharge. We speculate that active NICU BMF support targeting vulnerable infants and their families and assisting with plans for BMF pre- and post-discharge will help overcome barriers.