Factors Affecting Mother’s Own Milk (MOM) Usage in the NICU – A Cross-sectional Study

Excerpt

To the Editor: Neonates admitted to neonatal intensive care unit (NICU) need to be initiated on early enteral feeding with mother’s own milk (MOM) to protect them from the risk of infection, necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP) while promoting growth and development [1]. Early provision of MOM to the sick newborn may be delayed due to a lot of factors. We conducted a cross-sectional study from December 2022 through February 2023 to identify maternal factors affecting provision of early MOM (within 48 h) to the neonates. Mothers who were sick and/or admitted to ICU were excluded from the study. We developed a questionnaire comprising 39 items grouped under 5 domains: awareness of breastfeeding practices, kangaroo mother care (KMC) awareness, nursing and lactation support, difficulty in milk expression and psychosocial difficulties. Based on the mothers’ response to the questionnaire, each domain was scored. Mothers of 125 neonates (out of 132 approached) admitted to NICU responded to the questionnaire. Seventy percent were low birthweight (LBW) and 52% were preterm. Eighty-four percent (105/125) were giving some MOM to their neonates by 48 h of life, while 30% (37/125) mothers were giving exclusively MOM. When we compared the two groups (mothers giving MOM vs. those unable to provide any MOM), we found that delivery by LSCS (Odds ratio/OR – 3.3 [95% CI: 1.2–8.9]), lack of breastfeeding awareness (OR – 3.3 [95% CI: 1.1–10.3]), and psychosocial difficulties (OR – 3.1 [95% CI: 1.03–9.1]) significantly affected ability of mothers to provide early MOM. Similar studies from high-income countries have shown that cesarean section, maternal stress and lack of lactation support impair mothers’ ability to provide MOM [2‐4]. The findings of the study suggest the need to address the above-mentioned factors, to improve MOM usage in the NICU. …