Predictors of Mother's Own Milk Feeding at Discharge in Preterm Infants

Background: The dose-response benefits of human milk for preterm infants are well documented. Understanding factors that influence duration of mother's own milk (MOM) receipt may have important clinical implications. Purpose: To identify variables that significantly affect whether or not preterm infants receive their own mother's milk at discharge. Methods: Maternal-infant dyads were eligible for inclusion if the infant was born between August 1, 2010, and July 31, 2015, was born at 32 weeks' gestation or less, or was 1800 g or less (institutional donor milk receipt criteria). Bivariate and multivariable regression analyses were performed. Results: Of 428 observations, 258 (60.3%) received MOM at discharge and 170 (39.7%) did not. Maternal characteristics that were protective for MOM receipt at discharge were non-Hispanic race, married, partner support, more educated, and private insurance. Protective infant characteristics were higher gestational age at birth, higher percentage of MOM feedings, fewer ventilator days, and more days of direct lactation. In multivariable logistic regression, the odds of receiving MOM at discharge significantly (odds ratio = 1.93; 95% confidence interval, 1.72-2.16; P <.001) increased with the increasing proportion of MOM. Regression analysis showed that gestational age and increased maternal age increased the likelihood of MOM receipt at discharge. Implications for Practice: Clinicians will understand the significant effects even small increases in milk volume have on duration of MOM receipt at discharge, informing them of the importance of strategies to encourage and improve milk expression. Implications for Research: Future research studying critical time periods when mothers are most likely to reduce milk expression may have significant clinical importance.