title: Goals for Human Milk Feeding in Mothers of Very Low Birth Weight Infants: How Do Goals Change and Are They Achieved During the NICU Hospitalization?
abstract: BACKGROUND
  Little is known about human milk (HM) feeding goals for mothers of very low birth weight (VLBW) (<1,500 g birth weight) infants, especially for black mothers, for whom rates of VLBW birth are higher and lactation rates lower. This study examined the establishment, modification, and achievement of HM feeding goals during neonatal intensive care unit (NICU) hospitalization for mothers of VLBW infants and the influence of maternal race and income.
  
  
  METHODS
  A prospective cohort study measured maternal HM feeding goals (exclusive [EHM], partial, none) predelivery and during three time intervals: day of life (DOL) 1-14, 15-28, and 29-72. Goal achievement compared the goal for the time interval with the proportion of HM feedings received by the infant. Goal establishment, modification, and achievement were examined using chi-squared and contingency tables.
  
  
  RESULTS
  Three hundred fifty-two mother-infant dyads (53% black; 70% low-income; mean birth weight, 1,048 g) were studied. Predelivery, 55% of mothers planned to provide EHM; fewer black and low-income mothers chose EHM. During DOL 1-14, 63% of mothers chose EHM, and predelivery racial differences disappeared. Only 10% of mothers chose exclusive at-breast EHM feedings. EHM feeding goals decreased during NICU hospitalization, especially for black mothers. Whereas most mothers met their HM feeding goals initially, achievement rates declined during hospitalization. Mothers' EHM goal achievement was not influenced by race or income.
  
  
  CONCLUSIONS
  Mothers changed their predelivery HM feeding goals after birth of a VLBW infant. Longitudinally, HM feeding goals and achievement reflected less HM use, highlighting the need to target lactation maintenance in this population.
authors.affiliation: 1 Section of Neonatology, Department of Pediatrics, Rush University Medical Center , Chicago, Illinois.|2 Department of Women, Children, and Family Nursing, Rush University Medical Center , Chicago, Illinois.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hoban
authors.affiliation: 1 Section of Neonatology, Department of Pediatrics, Rush University Medical Center , Chicago, Illinois.
authors.forename: Harold
authors.initials: H
authors.lastname: Bigger
authors.affiliation: 1 Section of Neonatology, Department of Pediatrics, Rush University Medical Center , Chicago, Illinois.|2 Department of Women, Children, and Family Nursing, Rush University Medical Center , Chicago, Illinois.
authors.forename: Aloka L
authors.initials: AL
authors.lastname: Patel
authors.affiliation: 2 Department of Women, Children, and Family Nursing, Rush University Medical Center , Chicago, Illinois.
authors.forename: Beverly
authors.initials: B
authors.lastname: Rossman
authors.affiliation: 2 Department of Women, Children, and Family Nursing, Rush University Medical Center , Chicago, Illinois.
authors.forename: Louis F
authors.initials: LF
authors.lastname: Fogg
authors.affiliation: 1 Section of Neonatology, Department of Pediatrics, Rush University Medical Center , Chicago, Illinois.|2 Department of Women, Children, and Family Nursing, Rush University Medical Center , Chicago, Illinois.
authors.forename: Paula
authors.initials: P
authors.lastname: Meier
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000379:methods*; D061186:Breast Milk Expression / Q000379:methods*; D005260:Female; D006040:Goals; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D007774:Lactation / Q000208:ethnology*; D008297:Male; D008895:Milk, Human; D009035:Mothers; D011446:Prospective Studies; D055815:Young Adult