646 - Uptake of telelactation services and its association with early infant growth

Publication Number: 646.6929

Nadine Kridli, University of Massachusetts Medical School, Bloomfield Hills, MI, United States; Andrew W. Liu, UMass Memorial Children's Medical Center, Worcester, MA, United States; Julia M. Ferranto, University of Massachusetts Medical School, Worcester, MA, United States; Stephanie Behar, University of Massachusetts Medical School, Worcester, MA, United States; Alonzo M. Aguilar, University of Massachusetts Medical School, Worcester, MA, United States; Suzanne Goldenkranz, Simplifed, Sacramento, CA, United States; Andrea Ippolito, SimpliFed, Lansing, NY, United States; Apurv Soni, University of Massachusetts Medical School, Worcester, MA, United States; Nisha Fahey, UMass Chan Medical School, Worcester, MA, United States

Background: Limited access to lactation education and support is a significant barrier to breastfeeding. Virtual lactation support services from certified lactation experts through telemedicine has emerged as a promising solution to address provider shortages and inequities in access. However, there is a gap in evidence about the real-world impact of telelactation services.

Objective: To examine the relationship of the use of telelactation services with early infant growth outcomes.

Design/Methods: A longitudinal cohort of women recruited in the peripartum period (28-wks gestation to 3-months postpartum) from central Massachusetts were provided unlimited access to telelactation services. This study assessed the use of telelactation appointments and its association with key metrics of infant growth in the first month of life (i.e. % weight loss to nadir weight and time to regaining birthweight). Bivariate and multivariable generalized linear models were used to examine the impact of telelactation use after adjusting for potential confounders.

Results: 134 mother-infant dyads were included in this analysis. Of these, 50 (37.3%) participated in a telelactation session prior to 2-weeks and 61 (45.5%) prior to 1-month postpartum. Mothers with public health insurance were less likely to use telelactation service (aOR: 0.29 [0.09 – 0.89]). After adjusting for age, insurance status, maternal education, and parity, the use of telelactation services was associated with a lower percent change of weight loss among infants towards nadir weight ( -0.02 [-0.005 to -0.03]) while newborns of multiparous women had a slightly higher percentage of weight loss. Similarly, while not significant, the use of telelactation services was associated with a trend toward a faster return to birthweight by an average of 0.13 days (-0.04 to 0.29), but public health insurance was associated with a slightly slower return to birthweight by an average of -0.17 days (-0.39 to 0.05).

Conclusion(s): Early utilization of telelactation services may be associated with improved infant growth outcomes in the first month of life, but additional efforts are needed to improve its uptake, especially among mothers with public health insurance and limited resources.