UMMC issued the following press release authored by Annie Oeth.
Improving
the supply of mother’s milk for the unique needs of very low birth
weight infants receiving neonatal intensive care and minimizing
disparities that prevent mothers from providing milk is the subject of a
quality improvement project at the University of Mississippi Medical
Center.
Express
Yourself Mississippi, a three-year quality improvement project funded
by a $1,116,209 grant from the W.K. Kellogg Foundation, will identify
disparities and conditions that can be obstacles to breastfeeding for
the mothers of VLBW babies in all of the state’s 13 Level III and Level
IV neonatal intensive care units.
The
Express Yourself collaborative is geared toward provision of maternal
milk and reducing related disparities for the very low birth weight
(VLBW) infants at Level III and IV NICUs in Mississippi and in the
greater New Orleans area, Massachusetts, Michigan, and New Mexico. The
project is yet to begin in Michigan and New Mexico.
“Breast
milk is the optimal form of nutrition for babies, especially in their
first days of life,” said Dr. Mobolaji Famuyide, medical director of
Children’s of Mississippi’s NICU, housed at Wiser Hospital for Women and
Infants and principal investigator of the study. “For babies, breast
milk is not only nutrition; it is medicine. Mothers transfer immune
protective substances to their babies through breast milk to help their
immune systems to develop.”
UMMC
has the state’s only Level IV NICU, which provides the highest level of
care. The state’s Level III NICUs, which provide care to babies born at
less than 32 weeks gestation and babies born with critical illnesses at
all gestational ages, include those in Gulfport, Tupelo, Meridian,
Hattiesburg, Greenville and Jackson.
The
project’s goal is to increase the number of mothers of VLBW neonatal
intensive care patients who provide breast milk for their babies and
identify disparities related to breast milk provision and ways they can
be overcome. This will be done using quality improvement methodology and
testing/implementing evidence-based interventions. Building a secure
data infrastructure for future statewide quality improvement projects is
a secondary goal of the project.
Nationwide,
about 50 to 55 percent of mothers provide any breast milk for their
very low birth weight infants at the point of discharge from the NICU.
In Mississippi among NICUs participating in the Vermont Oxford Network,
about 25 percent of VLBW babies were discharged home on any human milk
in 2018, a number that Famuyide would like to see rise.
Disparities
involving race, ethnicity, economic status and geography may play a
role in whether a mother is able to provide breast milk. A mother having
the ability to breastfeed after a baby comes home from the hospital can
also be impacted by factors such as her own health, time, access to a
breast pump, economic stress and working conditions, Famuyide said.
“Breastfeeding
has been shown to be the best way to nurture babies, and babies in the
NICU especially need the benefits of breast milk,” she said. In addition
to giving these babies immune protective factors that help them fight
infection, breast milk reduces the risk of necrotizing enterocolitis, a
devastating disease that affects mostly the intestine of premature
infants and can be fatal.
Many
critically ill newborns are unable to breastfeed, so their mothers
provide that nourishment through pumping. The milk can then be given to
the newborn by bottle or through a feeding tube.
“It’s
the best medicine a baby can get,” said Jamie Ford, a UMMC registered
nurse certified in neonatal intensive care and International Board
Certified Lactation Consultant who is the project nurse/coordinator for
the Express Yourself Mississippi project. “When a mother has a baby in
the NICU, providing breast milk is one of the only things she can do,
and one of the most important things she can do, for her baby.”
Children’s
of Mississippi has a room adjacent to the NICU where mothers can
express milk for their babies, and mothers may also bring their babies
frozen breast milk for later use.
“Ideally,”
said Famuyide, “when pumping is successful, a mother would be able to
not only provide enough milk for her own child but enough to also donate
to the Mothers’ Milk Bank of Mississippi to help Mississippi babies.”
The
nonprofit milk bank supplies NICU babies with breast milk when mother’s
milk is not available. The organization screens donor mothers, then
collects, pasteurizes and dispenses donor human milk to hospitals,
following the guidelines of the Human Milk Banking Association of North
America.
Neonatal
intensive care is vital in Mississippi, where 14.2 percent of births
are preterm, or at less than 37 weeks gestation, the highest rate in the
country according to the 2019 March of Dimes Report Card.
Reaching
mothers of babies receiving NICU care around the state will involve
collaboration with the state’s hospitals as well as the Mississippi
Department of Health and the Mississippi Perinatal Quality
Collaborative, a statewide partnership that promotes best practices in
maternal and neonatal health.
With
the opening in fall 2020 of Children’s of Mississippi’s seven-story
hospital expansion, 88 private neonatal intensive care rooms will allow
mothers to stay with their critically ill newborns. The current NICU
space was designed as an open bay for 30 babies, but today, about three
times that number receive care there.
“This
will be a dramatic change for our NICU families and staff,” said
Famuyide, “and it will increase the likelihood that mothers will get the
support they need to provide the nutrition their babies need.”
Mississippi
has steep challenges in the health of mothers and their babies, she
said, “but we think through Express Yourself and collaboration among our
state’s NICUs and care providers, best practices can be identified and
we can give our state’s babies the best possible start.”
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