Low-birth-weight, high-risk African-American (AA) infants do not receive the best possible nutrition. AA has the lowest rate of the initiation of breastfeeding (provision of mother's milk) when compared to white and Hispanic infants and also the highest rate of preterm and low-birth-weight infants when compared to all other racial and ethnic groups. Consequently, the infants who would benefit the most from the immuniologic and nutritional benefits of mother's milk are the least likely to receive it. The purpose of this study is to reduce this racial disparity by testing the strongest possible intervention, the Mother's Milk Education Program (MMEP). MMEP combines two interventions, which alone have increased initiation of breastfeeding for AA mothers. The first is a specific lactation program (Meier, 2003), which consists of an ongoing program of education, support and involvement of the mother in the infant's care. The second component is Kangaroo Care, where the mother holds her infant skin-to-skin between her breasts for as long as she wishes. In this study Kangaroo Care will be given four times a week.
The specific aims of this pilot study are to: (1) increase the initiation and duration of provision of mother's milk by AA mothers of hospitalized infants; (2) increase the proportion of feedings that are mother's milk in AA hospitalized infants; (3) determine the effect of MMEP on infant growth, and (4) establish the feasibility of the protocol for a more definitive study. The design is a quasi-experimental cohort study with the comparison group (n =30) studied first, followed by the intervention group (n = 30). Purposive sampling will be used insure that the sample is 100% AA. Mothers in the comparison group receive routine care. Mothers in the intervention (MMEP) group receive intensive ongoing education related to the provision of mother's milk, and will meet with a peer counselor and a lactation consultant two times a week. Measurements of initiation and duration of lactation, proportion of feedings that are mother's milk and infant growth will be obtained at 1, 2,3 & 4 weeks post-birth and at 40 weeks corrected age. The significance of this study is the long-term goal of improving health of high-risk infants by increasing the initiation and duration of breastfeeding, as proposed by Healthy People 20 JO for a population where the rates of breastfeeding have been inadequate.
| Dowling, Donna A; Shapiro, Jennifer; Burant, Christopher J et al. (2009) Factors influencing feeding decisions of black and white mothers of preterm infants. J Obstet Gynecol Neonatal Nurs 38:300-9 |
