353 - Type and volume of milk intake in very premature infants during NICU stay

Publication Number: 3340.353

Lizeth Pulido, Santa Clara Valley Medical Center, Santa Clara, CA, United States; Priya Jegatheesan, Santa Clara Valley Medical Center, San Jose, CA, United States; Dongli Song, Santa Clara Valley Medical Center, San Jose, CA, United States; Matthew Nudelman, Santa Clara Valley Medical Center, san jose, CA, United States; Sudha Rani Narasimhan, Santa Clara Valley Healthcare, San Jose, CA, United States

Background: Understanding milk intake patterns in the neonatal intensive care unit (NICU) and factors associated with exclusive human milk feeding allow for opportunities to improve preterm mother's milk feeding during NICU stay.

Objective: To quantify the type and volume of milk intake in premature infants throughout the NICU stay.

Design/Methods: This retrospective observational cohort study included infants born and admitted to the NICU at < 33 weeks gestation from January 2022 to December 2024 without contraindications for receiving mother's own milk (MOM). Daily volumes of MOM, pasteurized donor milk (PDM), and formula during the NICU stay; time to first colostrum, skin to skin, and breastfeed; and growth parameters were collected from electronic medical records. Neonatal demographics, and neonatal morbidities were obtained from NICU database. Infants were categorized as exclusive human milk diet (EHM) group if they consumed MOM and PDM or mixed diet group if they consumed formula and MOM and/or PDM.

Results: The median gestational age and birth weight of the 180 infants included in this study was 31 weeks (IQR 28.8; 32.3), and 1435 grams (IQR 1150; 1720). The median time to first colostrum was 0.8 hours (IQR 0.4; 2.9), time to first skin to skin was 57 hours (IQR 26; 114), and post menstrual age (PMA) at first breastfeed was 32.9 weeks (IQR 32.4; 33.6). The EHM group (n=64, 36%) received 98% MOM and mixed group (n=116, 64%) received 53% MOM. Only 4 infants did not receive any MOM. There was no difference in gestational age, birth weight, time to first colostrum or skin to skin, or PMA at first breastfeed between the two groups. The EHM group had a shorter length of stay compared to the mixed diet group (35 vs 44 days, p=0.048). Figure 1 shows the average percentage of feeding type in the EHM group and mixed diet group. Figure 2 shows the average percentage volume of milk type each by PMA.

Conclusion(s): In this study, 36% of very preterm infants received exclusive human milk during the entire NICU stay and went home 9 days earlier than those who received mixed diet. Majority of infants received early colostrum and skin to skin. Future efforts should focus on maintaining mother's milk volume production to improve mother's milk feeding in preterm infants.

Figure 1
Average Percentage of Feeding Type by Day of Life

Figure 2
Average Percentage of Feeding Type by PMA