None listed
Conditions
Brief summary
A retrospective casenote review of three cohorts following changes to clinical practice, to determine the impact on breastmilk and breastfeeding outcomes. Group A is the historical baseline cohort and covers 6 months 1/1/18-30/6/18. Group B is a 6-month period following the introduction of PDHM into the Neonatal Unit for eligible infants and the employment of an IBCLC in a dedicated role within the Neonatal unit. Group C is a 6-month period following the introduction of an expressing box designed by the IBCLC, containing basic expressing equipment and information (syringes, medicine straws, expressing kit, information booklet), designed to encourage the earlier initiation of expression by making it easier for staff to provide equipment and information simultaneously. Across all cohorts, data assessed included: time of first breastmilk expression, any use of PDHM (where applicable), receipt of the expressing box (where applicable), the timing of the first infant exposure to breastmilk, the timing (corrected gestational age) at the first breastfeed attempt, and feeding outcomes at discharge (exclusive breastfeeding, exclusive breastmilk feeding, mixed feeding (breastmilk and formula), standard formula feeding or specialist formula feeding.
Interventions
Retrospective casenote review of infants from specified groups below.
Group A: Prior to the introduction of pasteurised donor human milk (PDHM) 1/1/2018 - 30/6/2018
Group B: Introduction of PDHM and specific lactation support through the creation of a dedicated International Board-Certified role within the Neonatal Unit. The IBCLC was employed on a 0.5 part-time basis with the primary focus on infants born <32 weeks gestation or < 1500 grams at birth at Flinders Medical Centre, 1/9/2019 - 29/2/
Retrospective casenote review of infants from specified groups below. Group A: Prior to the introduction of pasteurised donor human milk (PDHM) 1/1/2018 - 30/6/2018 Group B: Introduction of PDHM and specific lactation support through the creation of a dedicated International Board-Certified role within the Neonatal Unit. The IBCLC was employed on a 0.5 part-time basis with the primary focus on infants born <32 weeks gestation or < 1500 grams at birth at Flinders Medical Centre, 1/9/2019 - 29/2/2020 and the co-ordination of PDHM use. IBCLC support as provided as needed/desired by the parents during the admission. PDHM was available to eligible infants up until 32-34 weeks corrected gestational age (if born <32 weeks gestation) or 14 days (if born <1500 grams). It could not be utilised outside of the Flinders Medical Centre. Variations in length of use could occur with neonatal consultant discretion. Group C: Introduction of an expressing box containing, syringes, medicine straws, expressing kit, expressing information booklet, milk storage guidelines and expressing kit cleaning guidelines, 1/9/2020 - 28/2/2021. Practical demonstrations may/may not have occurred at the time of the provision of the expressing box, as it could have been provided to the mother or father/partner initially. Demonstrations could have been provided by the IBCLC, bedside nurse or midwife caring for the mother in the birthing/postnatal areas. The expressing information booklet was created by the IBCLC using Flinders Medical Centre guidelines, with instructions on hand expressing and Medela Symphony electric pump use (as per manufacturers recommendations). Cleaning instructions were per manufacturers recommendations. Milk storage guidelines provided as per South Australian and Flinders Medical Centre recommendations. The expressing equipment could be taken home as desired. The duration of observation of each infant varied depending on their clinical condition and actual discharge. Please note that I have inserted '16' as the number of weeks as I was unable to write a comment. The duration of each infant varied depending on their clinical condition and actual discharge.
Sponsors
Jacinta Stone
Eligibility
Sex/Gender
All
Age
No minimum to 35 Weeks
Healthy volunteers
No
Inclusion criteria
Infants born <32 weeks gestation or <1500 grams at birth, born at or retrieved shortly after birth to Flinders Medical Centre Neonatal Unit whose mothers intended to breastfeed/breastmilk feed and who remained in the Neonatal Unit until discharge home/Neonatal Early Discharge program.
Exclusion criteria
Born 32 weeks or greater, or 1500 grams or greater, mother did not intend to provide breastmilk or was transferred to another hospital prior to discharge home. Infants whose mothers were not present during admission or were removed from the maternal care were excluded.
Outcome results
None listed