New proposals to develop “mother’s own milk” for premature babies

For premature babies who cannot breastfeed on their own, “Mother’s own milk” (MOM) is the best nutrition. There is an urgent need for effective ways to increase the relatively low levels of MOM feeding for preterm infants born to Black and Hispanic mothers.

To date, research has provided little specific guidance, concluding an evidence-based study in Advances in Neonatal Care, the official journal of the National Association of Neonatal Nurses. The magazine is published in a Lippincott folder by Wolters Kluwer.

In order to conduct studies of targeted, culturally appropriate interventions, the available evidence identifies some promising approaches to overcoming barriers and enabling MOM feeds for premature babies of Black or Hispanic mothers, according to the review by Diana Cartagena, Ph.D., RN, CPNP, of Old Dominion University, Virginia Beach, Va., and colleagues.

No studies are specifically designed to promote MOM diets for Black or Hispanic preterm infants Provided mainly by expressing (pumping) breast milk, there are vital benefits at MOM diets for preterm infants – ranging from a lower risk of preterm-related complications to fewer neurodevelopmental disorders and disabilities later in childhood. The higher the “dose” of breast milk, the better the results.

There may be particular challenges regarding premature toddlers in the delivery of MOM foods. “In the United States, Hispanic and Black preterm infants are less likely than their white peers to receive foods made up of MOM,” Dr. Cartagena and coauthors write. They conducted a comprehensive review of the last decade of research, looking for evidence-based strategies to promote and improve MOM diets for this group of babies.

However, the first study identified “zero articles” – not a single study evaluating specific programs designed to promote MOM foods in preterm black or Hispanic infants.

All conventional strategies for the promotion and promotion of breast milk and breastfeeding in mothers are based on programs developed and tested mainly in White mothers. “

Diana Cartagena, PhD, RN, CPNP, Old Dominion University

The researchers therefore expanded their search for promising ways to reduce racial / ethnic differences in breast milk expression – focusing on studies that included at least 30 percent of black or white mothers. Hispanic. Based on ten such studies, Dr. Cartagena and colleagues make some recommendations to improve MOM foods, including:

• Provides a welcoming, newborn ICU environment. Professional lactation support is essential for all mothers of premature babies, including early help with expressing breast milk and access to breast pumps and supplies. Allowing mothers to provide skin-to-skin care to their babies is a promising way to establish and maintain a milk supply.
• Addressing language and cultural barriers. For Hispanic mothers, translators and the provision of educational materials in the mother tongue are important strategies to reduce disparities. In one study, lactation support from bilingual advisors increased MOM feeding at the time of release. In another study, black women who set an initial target for breastfeeding for the premature baby were more likely to give MOM after leaving hospital.
• Providing social and emotional support. Black women may not have role models and breastfeeding experience; their own mothers (the child’s grandmother) can be a particularly important source of support. For younger moms, social media and even mobile apps may be attractive options. Emotional and technical support from hospital staff may help to overcome barriers to providing MOM, such as getting and learning to use a breast pump or challenges in the home environment.

“Limited evidence suggests that differences in newborn ICU breastfeeding support practices may explain (to some extent), differences in differences and support further research in this area,” Dr. Cartagena and colleagues write.They emphasize the need for rigorous, well-designed studies “to evaluate the effectiveness of targeted and culturally sensitive lactation support interventions in Hispanic mothers and Black. “