title: The Association of Low Social Support with Breast Milk Expression in Low-Income Mother-Preterm Infant Dyads.
abstract: BACKGROUND
  Premature infants benefit from receiving expressed breast milk (BM), but expressing breast milk is difficult for new mothers. Little is known about mothers' social support and BM expression during the premature infant's hospital stay.
  
  
  OBJECTIVE
  We examined whether low maternal social support was associated with breast milk expression initiation and low breast milk expression among low-income mothers of premature infants.
  
  
  METHODS
  Maternal intake interview data and daily infant data on proportion of nutrition from BM during hospitalization were analyzed from a larger randomized trial testing a developmental intervention on 181 mother-premature infant dyads with at least 2 of 10 social-environmental risks. Multivariable modified Poisson regression was used to examine the relationship between social support (Personal Resources Questionnaire 2000; dichotomized as low for lowest quartile), initiation (any breast milk expressed vs none), and low breast milk expression (if BM was < 30% of infant total milk/formula intake during hospitalization).
  
  
  RESULTS
  Breast milk expression was initiated by 70.2% of mothers, and 32.3% of those mothers had low breast milk expression. In adjusted multivariable analyses, social support did not relate to the initiation of breast milk expression but was significantly associated with low breast milk expression among mothers who initiated (adjusted relative risk = 1.57; 95% confidence interval, 1.00-2.47).
  
  
  CONCLUSIONS
  Low social support was not associated with initiation but was associated with low breast milk expression during hospitalization. Interventions to enhance social support for mothers of premature infants, especially those reporting low social support from family and friends, may increase in-hospital expression and long-term breastfeeding.
authors.affiliation: Section of Family Planning and Contraception Research, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Camille
authors.initials: C
authors.lastname: Fabiyi
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Rankin
authors.affiliation: Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Norr
authors.affiliation: Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Yoder
authors.affiliation: Mercy Hospital and Medical Center, Chicago, IL, USA Department of Pediatrics, University of Chicago, Chicago, IL, USA.
authors.forename: Rohitkumar
authors.initials: R
authors.lastname: Vasa
authors.affiliation: Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA Children's Hospital of Wisconsin, Children's Research Institute, Milwaukee, WI, USA rwhite-traut@chw.org.
authors.forename: Rosemary
authors.initials: R
authors.lastname: White-Traut
mesh_terms: D000328:Adult; D061186:Breast Milk Expression / Q000191:economics / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D007087:Illinois; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D016012:Poisson Distribution; D011203:Poverty; D012044:Regression Analysis; D012944:Social Support
keywords: breast milk expression; breastfeeding; low-income mothers; preterm infants; social support