Preterm Multiples Getting Less Breast Milk than Optimal, According to New Study
A new study shows that preterm multiples, who often face life-threatening illnesses and could benefit from breast milk, get it far less often than term multiples and singletons.
"Breast milk is universally acknowledged as the optimal source of nutrition for infants due to its immunologic, psychological and economic benefits," says Sheela Geraghty, MD, MS, a pediatrician at Cincinnati Children's Hospital Medical Center and the study's lead author. "Mothers of term multiples have figured out how to feed their infants breast milk, but mothers of preterm multiples are struggling. The medical community must support mothers of multiples during pregnancy and immediately after birth so the infants have the best chance for getting breast milk."
Dr. Geraghty and her colleagues examined the feeding practices of 346 mothers of full-term singletons, preterm singletons, full-term multiples (twins and triplets) and preterm multiples. By three days postpartum, only 57 percent of mothers of preterm multiples provided some breast milk to their children. This compares to 66 percent of mothers of preterm singletons, 69 percent of term singletons, and 73 percent of term multiples.
By six months, only 14 percent of preterm multiples received some breast milk, compared to 29 percent of preterm singletons, 35 percent of term singletons and 38 percent of term multiples.
"We were pleasantly surprised when we discovered that full-term multiples were fed breast milk at least to the same extent than either group of singletons," says Dr. Geraghty. "The difference for mothers of preterm multiples, however, is multi-factorial. Even if mothers are highly motivated and want to breastfeed, issues such as infant illness, maternal poor milk supply, mother-infant separation, and lack of time can result in lower breast milk feeding rates in these mothers. Obstetricians, pediatricians, neonatologists and family practitioners tell me, 'We don't know what to say to these moms. They have a short office visit; we tell them to do whatever they can.'"
Dr. Geraghty believes in greater "anticipatory guidance." For example, physicians involved with prenatal care can lay the groundwork for what mothers will need and ask mothers of multiples if they have a breastfeeding plan, according to Dr. Geraghty. In addition, physicians can work with lactation consultants and be more involved with breastfeeding management.
For mothers who are unable to breastfeed at hospital discharge or who go home while their infants remain hospitalized, it is essential that they have an electric breast pump to increase their milk supply and be able to bring breast milk to the hospital to feed to their infants, says Dr. Geraghty.
Multiple gestation infants make up 3 percent of the population. More than 120,000 preterm multiples are born each year, a number that has risen each year for the last two decades. The United States government, in its Healthy People 2010 agenda, has set a goal of having at least 75 percent of mothers breastfeed after their infants are born and 50 percent continuing to breastfeed until six months. No national goals have been set specifically for mothers of multiples.
"Mothers of preterm multiple gestation infants are as motivated as any other mothers," says Dr. Geraghty. "It is the obligation of the health care community to support these mothers so they can provide the optimal nutrition of breast milk to their infants as well."
The study is published in the May / June issue of Ambulatory Pediatrics.
Contact Information
Jim Feuer, 513-636-4656,
jim.feuer@cchmc.org
