368 - Association Between Engagement with Virtual Telelactation Services and Breastmilk Feeding Duration in a Prospective Cohort Study

Publication Number: 3355.368

Nisha Fahey, University of Massachusetts Medical School, Worcester, MA, United States; Julia Ferranto, University of Massachusetts Medical School, Somerville, MA, United States; Alonzo M. Aguilar, University of Massachusetts Medical School, Worcester, MA, United States; Stephanie F. Behar, University of Massachusetts Medical School, Medford, MA, United States; Xiang Li, University of Massachusetts Medical School, Worcester, MA, United States; Suzanne Goldenkranz, SimpliFed, Sacramento, CA, United States; Andrea Ippolito, SimpliFed Inc., Lansing, NY, United States; Apurv Soni, University of Massachusetts Medical School, Worcester, MA, United States

Background: The AAP recommends exclusive breastfeeding for six months and encourages continuation thereafter. Skilled lactation support improves breastfeeding outcomes, yet access is limited by geography, schedules, and workforce. Telelactation can overcome these barriers and support parental breastfeeding goals.

Objective: To assess the association of SimpliFed telelactation services with duration of feeding breastmilk to infants

Design/Methods: On-demand and as-needed telelactation services were provided to a longitudinal cohort from central Massachusetts from the peripartum period (28-wks gestation to 3-months postpartum) through the first year postpartum. Participants were grouped into exposure categories of 0, 1-2, and 3+ appointments based on their utilization of telelactation services. The outcome of breastmilk feeding duration was defined as the last survey week at which a participant reported feeding breastmilk to their infant. Linear regression was used to compare breastmilk feeding duration across appointment utilization groups, adjusting for age, race/ethnicity, education, insurance, primary language, and parity. Data analysis was performed using R.

Results: 171 mother-infant dyads were included in this analysis. Most participants (96.6%) reported feeding any breastmilk at 1 week and about half (55.3%) at 12 months postpartum. There was roughly equal distribution of utilization of telelactation services (0 appointments =59 participants, 1 or 2 appointments =57, 3+ appointments =55). English as primary language, higher education, and private insurance were associated with higher number of appointments. The mean breastmilk feeding duration increased with higher category of telelactation appointment groups (23.5, 28.6, and 33.5 weeks, p< 0.01). These differences persisted after adjusting for age, race/ethnicity, education level, insurance type, primary language, and parity such that on average those who had 1-2 appointments fed breastmilk for 5.3 weeks longer than those with no appointments and those who had 3+ appointments fed breastmilk for 8.2 longer weeks than those with no appointments (p < 0.01).

Conclusion(s): Even modest increases in breastmilk feeding duration may have meaningful public-health implications; prior studies link longer duration with stronger maternal-infant bonding, lower maternal depressive symptoms, and reduced infant infections. Enhanced access to virtual telelactation expertise could therefore yield lasting benefits for maternal and child wellbeing. Efforts tailored to Spanish-speaking and publicly insured populations are important to promote equitable uptake and sustained engagement.

Figure 1. Association of breastmilk feeding duration with telelactation appointments
Figure 1.pdf