Breastfeeding and human milk bank in a neonatal intensive care unit: impact of the COVID-19 pandemic in an Italian cohort of very low birth weight infants

International Breastfeeding Journal

Research

Caterina Cazzaniga¹  Camilla Sangiorgio¹  Lorenza Bertù¹  Laura Morlacchi²  Maria Elena Bolis²  Angela Bossi²  Ilia Bresesti³  Massimo Agosti³ 

[1] Department of Medicine and Surgery, University of Insubria, Varese, Italy;Division of Neonatology, Woman and Child Department, “F. Del Ponte” Hospital, ASST-Settelaghi, University of Insubria, 21100, Varese, Italy;Division of Neonatology, Woman and Child Department, “F. Del Ponte” Hospital, ASST-Settelaghi, University of Insubria, 21100, Varese, Italy;Department of Medicine and Surgery, University of Insubria, Varese, Italy;

关键词: Preterm infants;    Neonatal nutrition;    Donated human milk;    Parental stress;    COVID-19 pandemic;   

DOI  :  10.1186/s13006-022-00529-x

 received in 2022-04-02, accepted in 2022-12-09,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundParental stress in neonatal intensive care units (NICU) is well known, as is the stress induced by the COVID-19 pandemic. This combination might increase stress to the extent of affecting the availability of maternal expressed milk and the success of establishing breastfeeding. This is particularly relevant in very preterm infants.MethodsWe conducted a single-centre retrospective analysis in two cohorts of very low birth weight infants born in a hospital in Italy. Babies born before the pandemic (September 2017 – December 2019) (n = 101) and during the pandemic (March 2020 – December 2021) (n = 67) were included in the analysis. We compared the rate of babies fed with maternal milk (both expressed and / or donated) at the achievement of full enteral feeding and the rate of those exclusively breastfed at discharge in the two groups. Then, we analysed the impact of donated human milk availability on infant formula use. We also compared mother’s need for psychological support during NICU stay and the duration of psychological follow-up after discharge.ResultsIn our NICU the availability of expressed maternal milk significantly decreased during the COVID-19 pandemic (86.1% before the pandemic vs 44.8% during the pandemic, p < 0.001) at the time of full enteral feeding achievement. Thanks to the availability of donated human milk, the rate of formula-fed babies remained almost unchanged (13.9% vs 14.9%). At discharge, the rate of breastfeeding was similar (73.3% vs 72.7%). The maternal need for psychological support was significantly higher during the pandemic (33% vs 64%, p < 0.001), as well as the duration of follow-up > 6 months (1% vs 15%, p < 0.001). No differences in the main clinical outcomes were found.ConclusionPandemic-induced stress had a significant impact on the availability of expressed maternal milk in NICU. However, the presence of human donated milk was fundamental in preventing increased use of infant formula during NICU stays. This underlines how strategies to implement the widespread establishment of donor milk banks on a national level are warranted. Further research is desirable to optimise the use of donated human milk banks during emergency situations.

【 授权许可】

CC BY   
© The Author(s) 2022

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