Human Milk & Breastfeeding in Infants with Congenital Heart Disease

Sunday, 17 November 2013: 3:25 PM

Diane L. Spatz, PhD, RN-BC, FAAN
School of Nursing, University of Pennsylvania, Philadelphia, PA

Learning Objective 1: The learner will be able to understand the importance of human milk for infants with Congenital Heart Disease.

Learning Objective 2: The learner will be able to understand milk production for this high risk population.

Purpose: This research explores human milk (HM) and breastfeeding practices in infants born with congenital heart disease (CHD) and admitted to a cardiac intensive care unit (CICU).

 Background and Significance:  The World Health Organization recommends exclusive breastfeeding for the first six months with continued breastfeeding for one year or more.  Human milk feeding decreases the risk of necrotizing enterocolitis by 77% and decreases the risk of respiratory infections, bacteremia and sepsis.  A paucity of evidence exists on the role of HM in infants with CHD.

 Research questions: 1) What is the pumping initiation rate of mothers? 2) What is the ability of mothers to initiate and maintain milk supply throughout the duration of the infant’s hospitalization?

 Methods: This was a prospective cohort study of infants < 1week of age admitted a CICU at the Children’s Hospital of Philadelphia.  On enrollment, it was documented if the mother elected to initiate pumping or if the infant would receive only formula.  Mothers were giving a pump log and asked to record every pumping session and milk volume in milliliters.  Pump logs were photo-copied twice per week through discharge of the infant.  Data was entered into an excel file and mean number of pumps per day & mean daily milk volume were calculated. 

Results: Approximately 89% of mothers initiated pumping for their infant.  Only the first 14 days of pumping and milk volume will be presented as the majority of infants were discharged prior to 14 days. On average mothers pumped 6 times per day. Mean, median and range of milk volumes will be presented.

Clinical implications:   Mothers were able to successfully initiate lactation, however, 14 days does not provide sufficient time to establish breastfeeding.  A post-discharge model of intervention may be warranted.