WIP 39 - Long Term Outcomes of Direct Breastfeeding in the NICU: Follow Up to the Hillsboro Medical Center NICU Breastfeeding Algorithm

Publication Number: WIP 39.7394

Katrina Wakeman, Oregon Health & Science University School of Medicine, Portland, OR, United States; Maggie Jerome, Oregon Health & Science University School of Medicine, Portland, OR, United States; Maudie Demshki, Oregon Health & Science University School of Medicine, Portland, OR, United States; Angela Douglas, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States

Background: Families of preterm infants face challenges to providing breast milk including difficulty with latching, suck, and decreased milk supply. Duration of breastfeeding for preterm infants varies widely by study, but is almost always found to be shorter than full term infants. Studies have found that direct breastfeeding (DBF) during NICU admission correlates with continued breastfeeding after discharge. However, interventions that increase DBF at NICU discharge and the impact on long term breastfeeding throughout infancy are lacking.

In June 2022, a NICU feeding algorithm was implemented at Hillsboro Medical Center (HMC), a community hospital in Hillsboro, Oregon with an 8 bed combined NICU and pediatric unit. DBF at discharge increased from 26% to 81% for preterm infants, but the long term impact on breastfeeding rates and growth is unknown.

Objective: Our objective is to evaluate breastfeeding and growth after discharge from the NICU for infants born at < 36 weeks gestational age (GA) before and after implementation of a novel feeding algorithm. A secondary objective is to compare breastfeeding and growth between those who had DBF at discharge versus no DBF at discharge.

Design/Methods: Inclusion criteria: Infants < 36 weeks birth GA admitted to the HMC NICU from May 1, 2020 to December 31, 2023. Baseline data was collected via retrospective chart review from May 2020 to May 2022 on breastfeeding and growth outcomes at 3, 6, 9 and 12 months. Data includes any breastmilk vs exclusively formula fed at ages 3, 6, 9 and 12 months, and weight, length, and head circumference z-scores at 3 and 6 months of age. Data collection post feeding algorithm implementation is ongoing and will be complete December 31, 2024. Breastfeeding rates at 3, 6, 9 and 12 months pre and post algorithm implementation, and for those who discharged with DBF versus no DBF (but with breastmilk) will be compared using a chi-squared analysis. We also plan to evaluate the long term impacts of the feeding algorithm and DBF at discharge on growth.