654 - Alignment Between Feeding Intention and Outcome in Newborns During Birth Hospitalization

Publication Number: 654.3738

Alyssa Alvarado, Medical College of Wisconsin, Wauwatosa, WI, United States; Mahua Dasgupta, Medical College of Wisconsin, Milwaukee, WI, United States; Ke Yan, Medical College of Wisconsin, Milwaukee, WI, United States; Kelsey Ryan, Medical College of Wisconsin, Milwaukee, WI, United States; Erwin T. Cabacungan, Medical College of Wisconsin, Milwaukee, WI, United States; Ashley Bolin, Medical College of Wisconsin, Milwaukee, WI, United States

Background: Human milk is the ideal form of infant nutrition. Intention to breastfeed is a strong predictor of breastfeeding practices. Studies have shown similar breastfeeding intentions but significant differences in breastfeeding rates based on maternal race and ethnicity. We hypothesize that there is a relationship between specific maternal and infant characteristics, exclusive breastfeeding and feeding alignment, at our level IV perinatal center, where all families may access Mom’s Own Milk (MOM), Donor Human Milk (DHM), or formula.

Objective: To determine the rate of exclusive breastfeeding, the rate of alignment between feeding intention and feeding outcome, and factors associated with alignment during the birth hospitalization.

Design/Methods: This is a retrospective review of randomly selected electronic health records (EHR) of 300 term infants born vaginally at a single center from 7/2021 to 3/2024. EHR data were mined using I2B2/Honest Broker and supplemented with manual chart review. The outcome variable was feeding alignment, defined as identical feeding intention and feeds received during the birth hospitalization. Receiving MOM or DHM were both considered exclusive breastfeeding and aligned with intention to breastfeed. Birth parent demographics, antepartum and newborn variables were compared using T-test/Mann-Whitney/Chi-square/Fisher’s exact test as appropriate. Feeding type alignment was evaluated by pairwise comparisons.

Results: 288 subjects with available data for primary outcome alignment were analyzed, with 191 (66.3%) exclusively breastfed during the birth hospitalization. Feeding intention and outcome were aligned in 82% of subjects during the birth hospitalization. (Fig. 1). There was no significant difference between alignment based on race/ethnicity, pregnancy number, maternal age, marital status, infant gestational age, infant sex, infant birth weight, type of delivery or length of stay (Table 1). Infants who received MOM + formula had significantly lower alignment compared to all other groups (Fig. 2).

Conclusion(s): Amongst live-born term singleton infants born via vaginal delivery, the availability of DHM contributed to higher alignment during the birth hospitalization. Lower alignment for dyads receiving MOM + formula suggests potential for further DHM utilization. Future studies will compare the alignment and feeding outcomes of additional newborn populations.

Figure 1. Chart Selection Process & Feeding Alignment


Table 1. Alignment of Feeding Intention & Outcome


Figure 2. Alignment Based on Feeding Outcome
*The infants who received breastmilk and formula had significantly lower alignment between feeding intention and outcome compared to all other groups using multiple pairwise comparisons with FDR-adjusted p-values of p<0.0001.