Study Protocol for Reducing Disparity in Receipt of Mother's Own Milk in Very Low Birth Weight Infants (ReDiMOM): a Randomized Trial to Improve Adherence to Sustained Maternal Breast Pump Use

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2022 Jan 8

PMID 34996401

Citations 5

Authors

Tricia J Johnson

Paula P Meier

Michael E Schoeny

Amelia Bucek

Judy E Janes

Jesse J Kwiek

John A F Zupancic

Sarah A Keim

Aloka L Patel

Affiliations

Soon will be listed here.

Abstract

Background: Black very low birth weight (VLBW; < 1500 g birth weight) and very preterm (VP, < 32 weeks gestational age, inclusive of extremely preterm, < 28 weeks gestational age) infants are significantly less likely than other VLBW and VP infants to receive mother's own milk (MOM) through to discharge from the neonatal intensive care unit (NICU). The costs associated with adhering to pumping maternal breast milk are borne by mothers and contribute to this disparity. This randomized controlled trial tests the effectiveness and cost-effectiveness of an intervention to offset maternal costs associated with pumping.

Methods: This randomized control trial will enroll 284 mothers and their VP infants to test an intervention (NICU acquires MOM) developed to facilitate maternal adherence to breast pump use by offsetting maternal costs that serve as barriers to sustaining MOM feedings and the receipt of MOM at NICU discharge. Compared to current standard of care (mother provides MOM), the intervention bundle includes three components: a) free hospital-grade electric breast pump, b) pickup of MOM, and c) payment for opportunity costs. The primary outcome is infant receipt of MOM at the time of NICU discharge, and secondary outcomes include infant receipt of any MOM during the NICU hospitalization, duration of MOM feedings (days), and cumulative dose of MOM feedings (total mL/kg of MOM) received by the infant during the NICU hospitalization; maternal duration of MOM pumping (days) and volume of MOM pumped (mLs); and total cost of NICU care. Additionally, we will compare the cost of the NICU acquiring MOM versus NICU acquiring donor human milk if MOM is not available and the cost-effectiveness of the intervention (NICU acquires MOM) versus standard of care (mother provides MOM).

Discussion: This trial will determine the effectiveness of an economic intervention that transfers the costs of feeding VLBWand VP infants from mothers to the NICU to address the disparity in the receipt of MOM feedings at NICU discharge by Black infants. The cost-effectiveness analysis will provide data that inform the adoption and scalability of this intervention.

Trial Registration: ClinicalTrials.gov: NCT04540575 , registered September 7, 2020.

Citing Articles

Mother's Own Milk Provision During the First 12 Weeks of Life by Gestational Age.

Patel A, Wilson J, Holmes M, Johnson T JAMA Netw Open. 2025; 8(3):e250024.

PMID: 40042846 PMC: 11883506. DOI: 10.1001/jamanetworkopen.2025.0024.

When a baby is born, so is a parent: Understanding the effects of preterm birth on Black parents through the lens of the NIMHD framework.

Warren K, Dail R, Dawson R, Boghossian N, Felder T Nurs Outlook. 2024; 72(5):102246.

PMID: 39116649 PMC: 11490407. DOI: 10.1016/j.outlook.2024.102246.

Race as social determinant of growth and body composition among infants born very preterm.

Salas A, Chetta K, Lach L, Katikaneni L, Itriago E, Hair A Pediatr Res. 2024; .

PMID: 39034355 DOI: 10.1038/s41390-024-03406-x.

Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors.

Patel A, Tan A, Bucek A, Janes J, McGee K, Mulcahy D Front Nutr. 2024; 11:1278818.

PMID: 38352705 PMC: 10861725. DOI: 10.3389/fnut.2024.1278818.

Milk Biomarkers of Secretory Activation in Breast Pump-Dependent Mothers of Preterm Infants: An Integrative Review.

Parker L, Hoban R, Bendixen M, Medina-Poeliniz C, Johnson T, Meier P Breastfeed Med. 2024; 19(1):3-16.

PMID: 38241129 PMC: 10818056. DOI: 10.1089/bfm.2023.0107.

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