Background: 

Benefits of mother's own milk (MOM) for infants in neonatal intensive care units (NICUs) are well known. Many mothers provide for their infant's feedings during their entire hospitalization while others are unable. Knowledge is limited about which infant and maternal factors may contribute most to cessation of MOM feedings.

Purpose: 

Study aims were to (1) identify which maternal and infant risk factors or combination of factors are associated with cessation of provision of MOM during hospitalization, (2) develop a lactation risk tool to identify neonatal intensive care unit infants at higher risk of not receiving MOM during hospitalization, and (3) identify when infants stop receiving MOM during hospitalization.

Methods: 

A data set of 797 infants admitted into a level IV neonatal intensive care unit before 7 days of age, whose mothers chose to provide MOM, was created from analysis of data from the Children's Hospital Neonatal Database. Maternal and infant factors of 701 dyads who received MOM at discharge were compared with 87 dyads who discontinued use of MOM by discharge using χ², t tests, and Wilcoxon rank tests. Logistic regression was used to build a risk-scoring model.

Results: 

The probability of cessation of MOM increased significantly with the number of maternal–infant risk factors. A Risk Calculator was developed to identify dyads at higher risk for cessation of MOM by discharge.

Implications for Practice: 

Identifying mothers at risk for cessation of MOM can enable the healthcare team to provide optimal lactation management and outcomes.

Implications for Research: 

Although the Risk Calculator has potential to identify dyads at risk of early MOM cessation, further research is needed to validate these results.

中文翻译：

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可能影响 IV 级新生儿重症监护病房使用母亲自己的乳汁成功或失败的因素

背景： 

母乳 (MOM) 对新生儿重症监护病房 (NICU) 中的婴儿的好处众所周知。许多母亲在婴儿住院期间提供喂养，而其他母亲则无法做到这一点。关于哪些婴儿和母亲因素可能对妈妈喂养的停止影响最大，我们的了解有限。

目的： 

研究目的是 (1) 确定哪些母婴风险因素或因素组合与住院期间停止提供 MOM 相关，(2) 开发哺乳风险工具来识别新生儿重症监护病房婴儿不接受治疗的风险较高住院期间的 MOM，以及 (3) 确定婴儿在住院期间何时停止接受 MOM。

方法： 

通过对儿童医院新生儿数据库的数据进行分析，创建了 797 名 7 天前入住 IV 级新生儿重症监护病房的婴儿的数据集，这些婴儿的母亲选择提供 MOM。^{使用 χ 2}、t检验和 Wilcoxon 等级检验对 701 名出院时接受 MOM 的夫妇与 87 名出院时停止使用 MOM 的夫妇的母婴因素进行比较。使用逻辑回归来构建风险评分模型。

结果： 

随着母婴危险因素数量的增加，停止 MOM 的可能性显着增加。开发了风险计算器来识别出院后停止 MOM 风险较高的二人组。

对实践的启示： 

识别有停止 MOM 风险的母亲可以使医疗团队提供最佳的哺乳管理和结果。

对研究的影响： 

尽管风险计算器有潜力识别有早期 MOM 停止风险的二人组，但仍需要进一步研究来验证这些结果。