The Pump Matters: An Educational Bundle to Promote a Predominant Mother’s-Own-Milk Diet in Very Low Birthweight Infants

Introduction: Mothers of very low birthweight (VLBW) infants rely on frequent, effective pumping for breast milk production. While hospital-grade breast pumps aid in mother's-own-milk (MOM) provision, accessing them after maternal discharge can be difficult. Methods: This quasi-experimental study assessed the impact of a bundled intervention on percentages of MOM and oral immune therapy (OIT) intake in the first 28 days of life (DOL) of VLBW infants admitted to a tertiary neonatal intensive care unit. The bundle included breastfeeding education, neonatal provider support, and a free 1-month hospital-grade breast pump rental for home use. Results: There were 102 infants enrolled, split into retrospective (n = 50) and prospective (n = 52) groups. While median %OIT intake was significantly higher in the prospective group (71.9% [interquartile range-IQR: 56, 78.2] versus 41.1% [IQR: 9.1, 60.7]; p ≤ 0.001), %MOM was not significantly increased after adjusting for race. More prospective infants received higher doses (≥90%) of MOM (71% versus 50%; p = 0.042), while more retrospective infants received lower doses (<5%) of MOM (18% versus 4%; p = 0.027). Black infants in the retrospective group received a lower median %MOM (69.1% [IQR: 3, 98.2] versus 93.9% [IQR: 68, 98.8] in non-Black infants; p = 0.388), but a significantly higher median %MOM in the prospective group (99.1% [IQR: 98, 100] versus 97.5% [IQR: 51, 99.5] in non-Black infants; p = 0.041). Conclusion: Bundled interventions including providing free hospital-grade breast pumps for home use may result in increased %OIT received and more VLBW infants receiving higher doses of MOM in the first 28 DOL. It may also help diminish existing racial disparities in %MOM intake.