P3.B021: Effectiveness of Virtual Daily Pumping Log on 14-Day Breastmilk Volumes for Mothers of Very Preterm Infants

Background: Providing human milk to neonates with a very low birth weight (≤ 1,500 g) and prematurity offers short and long-term health benefits and should be considered a lifesaving medical therapy. Prompt initiation of pumping, maternal education, and alleviating any maternal pain or stress associated with pumping is directly correlated with achieving adequate supply and long-term compliance with providing Mother’s Own Milk (MOM) to intensive care infants. The 14-day volume of maternal milk is predictive of breastfeeding success throughout admission.

We hypothesized, if given a daily, email-based, Redcap survey embedded with resources, the average volume (mL) of breastmilk produced on post-delivery day 14 will be similar or greater than the pre-intervention control cohort.

Methods: This QI initiative was designed for preterm infants admitted to a single-center Neonatal Intensive Care Unit (NICU) and Pediatric Cardiac Intensive Care Unit (PCICU) within 24 h of life. Interventions were implemented between March 2022 and June 2022 and a preintervention cohort that did not have access to the virtual intervention. Medians and interquartile ranges were compared for volumes for mothers of infants of equal or less than 33 weeks completed gestational age, using a Mann-Whitney U test with significance defined as p < 0.05.

Results: Of 327 mothers enrolled, 278 (85%) used the application to enroll in WIC, 60 (18%) recorded pumping volumes on day 1, and 31 (9%) were recording volumes on day 14. When preterm infant milk volumes on day 14 were compared between the pre-cohort (n = 92) and those utilizing the virtual pumping log (n = 31), there were significantly higher volumes reported in the virtual group (424, IQR 272-697) than the historic control (258, IQR 33-525), z-score -2.83392, p-value = 0.00466. There was a 57% overall increase in volume on day 14, as compared to the control.

Conclusion: Connection to outside resources and troubleshooting common complications from pumping, a sense of community, or accountability, or just engaging with mothers of preterm infants via an email- based pumping log may support the milk production of women whose infants are hospitalized in the NICU or PCICU.