Building on the evidence that mothers’ own milk (MOM) feeding for preterm and very low birthweight infants hospitalised in neonatal intensive care units (NICUs) reduces the risk of many complications of prematurity and their associated costs, Rush University Medical Center, supported by the Family Larsson-Rosenquist Foundation (FLRF), embarked on a project to expand the feeding of MOM to other NICUs.

“While there is a substantial body of research showing that a mother’s own milk is the most effective option for greatly improving the health of hospitalised, very low birthweight infants, what is missing is the ‘how to’ take the evidence into effective clinical practices, protocols, information sheets and other strategies to actually increase the use of MOM in this specialised environment."
Paula P. Meier, PhD, RN, Director of Lactation Services, Neonatal Intensive Care Unit and Professor of Pediatrics and Nursing at Rush University Medical Center

The 13-month project, to which FLRF donated approximately USD 400,000, has three primary objectives:

1. Update and expand existing hard-copy components of the Rush Mothers’ Milk Club Toolkit with new information and photos on a range of specific topics. These educational materials will serve to standardise evidence-based NICU lactation care and ensure families receive accurate information.
2. Create electronic versions of all hard-copy materials.
3. Create NICU-specific, targeted teaching videos that can be used in ‘train the trainer’ applications and made available through social media platforms.

The partners hope that by making it easier to access and disseminate the educational materials, there will be a higher priority for the use of MOM feeding for premature and other NICU infants. Furthermore, as the evidence-based toolkit and teaching videos can be translated, culturally adapted and disseminated in different countries, the project has the potential to help remove barriers to MOM feeding for infants hospitalised in NICUs globally.

Further reading

Patra K, Greene MM, Tobin G, Casini G, Esquerra-Zwiers AL, Meier PP, et al. Erratum: Neurodevelopmental outcome in very low birth weight infants exposed to donor milk. Am J Perinatol [Internet]. 2021. DOI: 10.1055/s-0040-1722597

Patel AL, Johnson TJ, Meier PP. Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units. Pediatr Res. 2021;89(2):344–52. DOI: 10.1038/s41390-020-01263-y

Hoban R, Medina Poeliniz C, Somerset E, Tat Lai C, Janes J, Patel AL, et al. Mother’s own milk biomarkers predict coming to volume in pump-dependent mothers of preterm infants. J Pediatr. 2021;228:44-52.e3. DOI: 10.1016/j.jpeds.2020.09.010

Patel AL, Meier PP, Canvasser J. Strategies to increase the use of mother’s own milk for infants at risk of necrotizing enterocolitis. Pediatr Res. 2020;88(Suppl1):21–4. DOI: 10.1038/s41390-020-1075-3

Sorce LR, Curley MAQ, Kleinpell R, Swanson B, Meier PP. Mother’s own milk feeding and severity of respiratory illness in acutely ill children: An integrative review. J Pediatr Nurs. 2020;50:5–13. DOI: 10.1016/j.pedn.2019.09.020

Patel AL, Schoeny ME, Hoban R, Johnson TJ, Bigger H, Engstrom JL, et al. Correction: Mediators of racial and ethnic disparity in mother’s own milk feeding in very low birth weight infants. Pediatr Res. 2019;86(6):786. DOI: 10.1038/s41390-019-0290-2

Rossman B, Asiodu I, Hoban R, Patel AL, Engstrom JL, Medina-Poeliniz C, et al. Priorities for contraception and lactation among breast pump-dependent mothers of premature infants in the neonatal intensive care unit. Breastfeed Med. 2019;14(7):448–55. DOI: 10.1089/bfm.2019.0007

Meier PP. Prioritizing high-dose long exposure to mothers’ own milk during the neonatal intensive care unit hospitalization. Breastfeed Med. 2019;14(S1):S20–1. DOI: 10.1089/bfm.2019.0035

Johnson TJ, Patra K, Greene MM, Hamilton M, Dabrowski E, Meier PP, et al. NICU human milk dose and health care use after NICU discharge in very low birth weight infants. J Perinatol. 2019;39(1):120–8. DOI: 10.1038/s41372-018-0246-0

Greene MM, Schoeny M, Rossman B, Patra K, Meier PP, Patel AL. Infant, maternal and neighborhood predictors of maternal psychological distress at birth and over VLBW infants’ first year of life. J Developmental and Behavioral Pediatrics. J Dev Behav Pediatr. 2019 Jul 24. DOI: 10.1097/DBP.0000000000000704. [Epub ahead of print]

Johnson TJ, Patra K, Greene MM, Hamilton M, Dabrowski E, Meier PP et al. NICU human milk dose and health care use after NICU discharge in very low birth weight infants. J Perinatol. 2019 Jan;39(1):120-128. DOI: 10.1038/s41372-018-0246-0. Epub 2018 Oct 19.

Patra K, Hamilton M, Johnson TJ, Greene M, Dabrowski E, Meier PP et al. NICU human milk dose and 20-month neurodevelopmental outcome in very low birth weight infants. Neonatology. 2017;112(4):330-336. DOI: 10.1159/000475834. Epub 2017 Aug 3.

Patel AL, Johnson TJ, Robin B, Bigger HR, Buchanan A, Christian E et al. Influence of own mother’s milk on bronchopulmonary dysplasia and costs. Arch Dis Child Fetal Neonatal Ed. 2017 May;102(3):F256-F261. DOI: 10.1136/archdischild-2016-310898. Epub 2016 Nov 2.

Meier PP, Johnson TJ, Patel AL, Rossman B. Evidence-based methods that promote human milk feeding of preterm infants: an expert review. Clin Perinatol. 2017 Mar;44(1):1-22. DOI: 10.1016/j.clp.2016.11.005. Epub 2016 Dec 27.

Meier PP, Patel AL, Esquerra-Zwiers A. Donor human milk update: evidence, mechanisms, and priorities for research and practice. J Pediatr. 2017 Jan;180:15-21. DOI: 10.1016/j.jpeds.2016.09.027. Epub 2016 Oct 20.

Hoban R, Bigger HR, Patel AL, Rossman B, Fogg LF, Meier PP. Goals for human milk feeding in mothers of very low birth weight infants: how do goals change and are they achieved during the NICU hospitalization? Breastfeed Med. 2015 Jul-Aug;10(6):305-11. DOI: 10.1089/bfm.2015.0047. Epub 2015 Jun 25.

Johnson TJ, Patel AL, Bigger HR, Engstrom JL, Meier PP. Cost savings of human milk as a strategy to reduce the incidence of necrotizing enterocolitis in very low birth weight infants. Neonatology. 2015;107(4):271-6. DOI: 10.1159/000370058. Epub 2015 Mar 3.

Rossman B, Greene MM, Meier PP. The role of peer support in the development of maternal identity for NICU moms. J Obstet Gynecol Neonatal Nurs. 2015; 44(1): 3-16. DOI: 10.1111/1552-6909.12527. Epub 2015 Jan 7.

Patel AL, Johnson TJ, Engstrom JL, Fogg LF, Jegier BJ, Bigger HR et al. Impact of early human milk on sepsis and health care costs in very low birth weight infants. J Perinatol. 2013 Jul;33(7):514-9. DOI: 10.1038/jp.2013.2. Epub 2013 Jan 31.

Meier PP, Patel AL, Bigger HR, Rossman B, Engstrom JL. Supporting breastfeeding in the neonatal intensive care unit: The Rush Mothers’ Milk Club as a case study of evidence-based care. Pediatr Clin North Am. 2013 Feb;60(1):209-26. DOI: 10.1016/j.pcl.2012.10.007.

Rossman B, Engstrom JL, Meier PP. Healthcare providers’ perceptions of breastfeeding peer counselors in the neonatal intensive care unit. Res Nurs Health. 2012; 35: 460-474. DOI: 10.1002/nur.21496. Epub 2012 Jul 2.

Rossman B, Engstrom JL, Meier PP, Vonderheid S, Norr KF, Hill PD. They’ve walked in my shoes: Mothers of very low birthweight infants and their experiences with breastfeeding peer counselors in the neonatal intensive care unit. J Hum Lact. 2011; 27: 14-24. DOI: 10.1177/0890334410390046. Epub 2010 Dec 20.