To study the impact of expressing breastmilk inside the neonatal intensive care unit (NICU) besides a neonate, in comparison to expression outside the NICU: A quasi experimental study

Abstract

Introduction: The proximity of the mother to the newborn following delivery is essential for the early initiation and establishment of exclusive breast feeding. It leads to the conditioning of the oxytocin reflex, allowing the expression of breast milk. However, preterm and sick babies are nursed in an environment away from their mothers in the NICU, thus leading to delayed initiation and inadequate expression of breast milk. Objective: To estimate the volume of breastmilk expressed close to the baby in comparison to breastmilk expressed away from her baby. Method: This quasi-experimental study was conducted in a tertiary healthcare hospital in Hyderabad over a duration of one month. Postpartum mothers of newborns delivered in this hospital and admitted to the NICU were included in the study. The enrolled mothers were shown a video and poster on manual expression of breast milk and were assisted by lactational counselors for support. The enrolled mothers initially expressed milk in the mother’s room, and an average of three expressions was taken. The next day, the mother was asked to go near the baby in the NICU and express milk in front of her baby, and the average of three feeds was determined in a similar fashion. Data analysis was done using a paired t-test. Results: A total of 30 postnatal mothers were enrolled in the study. The mean volume of breast milk expressed by the mother in the mother’s room was 9.9 ± 2.5ml and the mean volume of breast milk obtained when expressed close to her baby in the newborn care unit was 11.2 ± 2.7ml. The volume of milk expressed near the baby was significantly higher when compared to milk expressed away from the newborn (p<0.001). Conclusions: This study showed that mothers who expressed their feed near their admitted newborns in the newborn care unit had a significant increase in the volume of expressed breastmilk in comparison to expressing the milk away from their babies.