title: Postdischarge breastfeeding outcomes of infants with complex anomalies that require surgery.
abstract: OBJECTIVE
  To examine the duration and exclusivity of breastfeeding and provision of human milk among infants with complex anomalies that require surgery postdischarge from a neonatal intensive care unit (NICU).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A tertiary care children's hospital with a fetal diagnostic and treatment center, special delivery unit, and NICU.
  
  
  METHODS
  Mothers who had delivered infants with complex anomalies that require surgery between 2009 and 2012 (N = 165).
  
  
  METHODS
  Phone interviews were used for data collection and were analyzed using descriptive statistics methods.
  
  
  RESULTS
  The average duration of breastfeeding/provision of human milk was 8 months. The percentage of infants who received human milk at 6 months was 60.1% (n = 98/163,; p = .0063) and at 12 months was 34.5% (n = 57/165, p = .023). Of infants in this cohort, the percentage of those infants exclusively receiving human milk was 54.3% (n = 89/164, p = .0004) at 3 months of age and 35.6% (n = 58/163, p < .0001) at age 6 months. Another clinically important finding is that 30.7% of the cohort required gavage feeds postdischarge from the NICU.
  
  
  CONCLUSIONS
  Even for the most surgically complex infant/mother dyads, breastfeeding outcomes can improve significantly with a strong prenatal lactation program, nursing staff with specific breastfeeding education, and a hospital culture that values and supports breastfeeding and the provision of human milk. These findings support the use of hospital-grade electric breast pumps postdischarge for families of infants with complex anomalies that require surgery, as approximately one third of the cohort went home on tube feeds and their mothers continued to pump their breast milk at home.
authors: Kimberly
authors: K
authors: Martino
authors: Meg
authors: M
authors: Wagner
authors: Elizabeth B
authors: EB
authors: Froh
authors: Alexandra L
authors: AL
authors: Hanlon
authors: Diane L
authors: DL
authors: Spatz
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery / Q000628:therapy; D000328:Adult; D001942:Breast Feeding / Q000379:methods / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D008895:Milk, Human; D009034:Mother-Child Relations; D009732:Nursing Care / Q000592:standards; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D015143:Philadelphia; D011184:Postoperative Period; D064186:Prenatal Education / Q000379:methods / Q000592:standards; D011446:Prospective Studies
keywords: NICU; breast milk expression; congenital anomalies; enteral nutrition; human milk; lactation