The breastfeeding support practices, related barriers and facilitators in the neonatal intensive care unit, Uttarakhand, India

Ravi Sahota; Navpreet Kaur; Bharti Gahtori; Sonam Jain; Ruchi Rastogi

doi:10.18203/2320-1770.ijrcog20240125

Authors

Ravi Sahota Department of Pediatrics, Sahota Superspeciality Hospital, Kashipur, Uttarakhand, India
Navpreet Kaur Department of Obstetrics and Gynaecology, Sahota Superspeciality Hospital, Kashipur, Uttarakhand, India
Bharti Gahtori Department of Obstetrics and Gynaecology, Sahota Superspeciality Hospital, Kashipur, Uttarakhand, India
Sonam Jain Department of Obstetrics and Gynaecology, Sahota Superspeciality Hospital, Kashipur, Uttarakhand, India
Ruchi Rastogi Department of Obstetrics and Gynaecology, Sahota Superspeciality Hospital, Kashipur, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240125

Keywords:

Barriers, Breast feeding, Facilitators, Neonates, NICU

Abstract

Background: Within the bustling and stressful neonatal intensive care unit (NICU) environment, implementing Baby-friendly practices presents numerous challenges. Breastfeeding initiation and duration rates among NICU infants are lower compared to healthy full-term infants. Objectives were to explore breastfeeding support practices and related barriers and facilitators in the NICU.

Methods: A retrospective study of 496 babies admitted to NICU of Sahota Superspeciality Hospital Kashipur, Uttarakhand during the time period March 2018 to February 2020 and examined maternal and infant factors. The 496 infants divided in two groups: group A: breast milk use at discharge (n=398) and group B: no breast milk use at discharge (n=98).

Results: The incidence of morbidity factors like sepsis, chronic lung disease, retinopathy of prematurity, intraventricular hemorrhage, gastrostomy tube feeds at discharge, gavage feeds at discharge noted more among the babies of group of ‘no breast milk use at discharge’ compared to other group (p<0.05). The usage of donor milk and formula milk is significantly very less in babies of group ‘breast milk use at discharge’ compared to other group (p<0.05). Duration of hospital stay was very less in the group A compare to group B (p<0.05). Respiratory distress was the most common diagnosis among the babies of group A and apnea was the most common among babies of group B.

Conclusions: Obstacles to maintaining breastfeeding in the NICU, which warrant focused efforts for enhancing practices, encompassed inadequate resources for facilitating parental involvement, impediments to expressing and providing maternal breast milk, and a notable prevalence of bottle-feeding supplemented with formula.

Metrics

Metrics Loading ...

References

Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: A meta‐analysis. Am J Epidemiol. 2005;162(5):397-403.

Bernard JY, De Agostini M, Forhan A, Alfaiate T, Bonet, M, Champion V, et al. Breastfeeding duration and cognitive development at 2 and 3 years of age in the EDEN mother–child cohort. J Pediatrics. 2013;163(1):36-42.

Kramer MS, Aboud F, Mironova E, Vanilovich I, Platt RW, Matush L, et al. Breastfeeding and child cognitive development: New evidence from a large randomized trial. Arch Gen Psychiatry. 2008;65(5):578-84.

Lee H, Park H, Ha E, Hong YC, Ha M, Park H, et al. Effect of breastfeeding duration on cognitive development in infants: 3‐year follow‐up study. J Korean Med Sci. 2016;31(4):579-84.

Khan J, Vesel L, Bahl R, Martines JC. Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity--a systematic review and meta-analysis. Maternal Child Health J. 2015;19(3):468-79.

National family health survey (NFHS – 5) 2019-21. Key indicators – India and 14 states/UTs (Phase – II), Ministry of health and family welfare, Government of India. 2021.

Setegn T, Gerbaba M, Belachew T. Determinants of timely initiation of breastfeeding among mothers in Goba Woreda, South East Ethiopia: A cross sectional study. BMC Public Health. 2011;11: 217.

SRS bulletin - 2022, Sample Registration System office of the Registrar General, India. 2022;55(1).

Bhanderi DJ, Pandya YP, Sharma DB. Barriers to exclusive breastfeeding in rural community of central Gujarat, India. J Family Med Prim Care. 2019;8:54-61.

Alves E, Rodrigues C, Fraga S, Barros H, Silva S. Parents’ views on factors that help or hinder breast milk supply in neonatal care units: systematic review. Arch Dis Child Fetal Neonatal Ed. 2013;98(6):F511-57.

Ikonen R, Paavilainen E, Kaunonen M. Preterm infants’ mothers’ experiences with milk expression and breastfeeding: An integrative review. Adv Neonatal Care. 2015;15(6):394-406.

Meier P, Johnson T, Patel A, Rossman B. Evidence-based methods that promote human milk feeding of preterm infants: An expert review. Clin Perinatol. 2017;44(1):1-22.

Parker M, Patel A. Using quality improvements to increase human milk use for preterm infants. Clin Perinatol. 2017; 44(1):175-86.

Sankar MN, Weiner Y, Chopra N, Kan P, Williams Z, Lee HC. Barriers to optimal breast milk provision in the neonatal intensive care unit. J Perinatol. 2022;42:1076-82.

Kair LR, Colaizy TT. Breastfeeding continuation among late preterm infants: barriers, facilitators, and any association with NICU admission? Hosp Pediatr. 2016;6:261-8.

Baley J, Committee of Fetus and Newborn. Skin-to-skin care for term and preterm infants in the neonatal ICU Pediatrics. 2015;136:596-9.

Kachoria R, Oza-Frank R. Trends in breastfeeding initiation in the NICU by gestational age in Ohio, 2006–2012. Birth. 2015;42:56-61.

Parker MG, Gupta M, Melvin P, Burnham LA, Lopera AM, Moses JM, et al. Racial and ethnic disparities in the use of mother’ s milk feeding for very low birth weight infants in Massachusetts. J Pediatr. 2019;204:134-41.

Pine da RG, Foss J, Richards L, Pane CA. Breastfeeding changes for VLBW infants in the NICU following staff education. Neonatal Netw. 2009;28:311-9.

Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta-Fobes T, Hanson-Timpson TA, et al. A quality improvement project to increase breast milk use in very low birth weight infants. Pediatrics. 2012;130:e1679-87.

Lee HC, Gould JB. Factors influencing breast milk versus formula feeding at discharge for very low birth weight infants in California. J Pediatr. 2009;155:657-62.

Brownell EA, Lussier MM, Hagadorn JI, McGrath JM, Marinelli KA, Herson VC. Independent predictors of human milk receipt at neonatal intensive care unit discharge. Am J Perinatol. 2014;31:891-8.

Fleur ant E, Schoeny M, Hoban R, Asiodu IV, Riley B, Meier PP, et al. Barriers to human milk feeding at discharge of very-low-birth-weight infants: maternal goal setting as a key social factor. Breastfeed Med. 2017;12:20-7.

Riley B, Schoeny M, Rogers L, Asiodu IV, Bigger HR, Meier PP, et al. Barriers to human milk feeding at discharge of very low-birth weight infants: evaluation of neighborhood structural factors. Breastfeed Med. 2016;11:33-42.

Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Wright LL, Langer JC, et al. NICHD neonatal research network. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics. 2006;118:e115-23.