title: Implementation of a Donor Milk Program Is Associated with Greater Consumption of Mothers' Own Milk among VLBW Infants in a US, Level 3 NICU.
abstract: BACKGROUND
  It is unclear whether use of donor milk (DM) changes the provision of mothers' own milk (MOM) to very low birth weight (VLBW) infants in the neonatal intensive care unit (NICU).
  
  
  OBJECTIVE
  To determine whether (1) the rates of any MOM and human milk consumption at feeding initiation and discharge and (2) the proportion of VLBW infants who stopped consuming any MOM and human milk during hospitalization changed in the 2 years after versus before implementation of a DM program in a US, inner-city, level 3 NICU.
  
  
  METHODS
  We studied VLBW infants admitted to Boston Medical Center in the 2 years before (n = 74) and after (n = 80) implementation of a DM program (June 2011). We used multivariable logistic regression to compare milk consumption at feeding initiation and discharge and Cox proportional hazards to compare the proportion of infants that stopped consuming milk during the hospitalization pre and post our DM program.
  
  
  RESULTS
  After adjustment for maternal race, age, insurance, delivery type, gestational age, and birth weight, we found a 6.0-fold increased odds (95% CI, 2.0-17.7) of consuming MOM at discharge and a 49% reduction in the cessation of MOM consumption during hospitalization (hazard ratio [HR], 0.51; 95% CI, 0.28-0.93) in the 2 years after versus before our DM program.
  
  
  CONCLUSIONS
  Implementation of a DM program was associated with greater consumption of MOM throughout hospitalization and at discharge among VLBW infants. Implementation of DM programs may augment support of mothers to provide breast milk in level 3 NICUs.
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA margaret.parker@bmc.org.
authors.forename: Margaret G K
authors.initials: MG
authors.lastname: Parker
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Burnham
authors.affiliation: Division of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, USA.
authors.forename: Wenyang
authors.initials: W
authors.lastname: Mao
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Philipp
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Merewood
mesh_terms: D000328:Adult; D001900:Boston; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods* / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D017784:Milk Banks / Q000706:statistics & numerical data*; D008895:Milk, Human; D016016:Proportional Hazards Models; D062606:Tertiary Care Centers
keywords: breastfeeding; donor milk; neonatal intensive care unit; prematurity; very low birth weight