A Password-Protected Web Site for Mothers Expressing Milk for Their Preterm Infants.

BACKGROUND: Research has demonstrated that breast milk significantly decreases morbidities that impact length of stay for preterm infants, but there is a need to test interventions to improve breastfeeding outcomes. Since many Americans are using technologies such as the Intranet and smartphones to find health information and manage health, a Web site was developed for mothers who provide breast milk for their preterm hospitalized infants. PURPOSE: This study examined the efficacy of a Web site for mothers to educate them about breast milk expression and assist them in monitoring their breast milk supply. METHODS: Quantitative and qualitative data were collected from mothers whose preterm infants were hospitalized in a level IV neonatal intensive care unit (NICU) or transitional care unit (TCU) in an urban academic medical center in the Midwest. RESULTS: Eighteen mothers participated in evaluation of the Web site. Thirteen mothers consistently logged on to the password-protected Web site (mean [standard deviation] = 13.3 [11.7]) times. Most participants, (69.2%), reported they used the breast milk educational information. Most mothers indicated that using the Web site log helped in tracking their pumping. These findings can be used to direct the design and development of web-based resources for mothers of preterm infants IMPLICATIONS FOR PRACTICE:: NICU and TCU staffs need to examine and establish approaches to actively involve mothers in monitoring the establishment and maintenance of an adequate supply of breast milk to improve neonatal health outcomes. IMPLICATIONS FOR RESEARCH: An electronic health application that incorporates the features identified in this study should be developed and tested.

Cup-feeding for preterm infants: mechanics and safety.

Cup-feeding is recommended for breastfed preterm infants to avoid artificial nipples. However, the oral mechanisms used in cup-feeding, or its safety and efficacy, have not been described. The authors measured sipping, breathing, SaO2, and volume of intake during 15 cup-feeding sessions for 8 infants (mean gestational age at birth was 30.6 weeks). Mean duration of sipping bursts and pauses was 3.6 seconds and 28.1 seconds, respectively. Mean breathing rate during bursts and pauses was similar (46.2 +/- 24.3 vs 45.7 +/- 17.7, respectively), with SaO2 > or = 90% during all bursts. Mean duration of cup-feedings was 15.2 +/- 3.9 minutes (range, 11.0-23.3), whereas mean volume of intake was only 4.6 +/- 2.2 mL (range, 1.5-8). For the 15 sessions, 38.5% of milk taken from the cup was recovered on the bib. Although infants remain physiologically stable, cup-feeding has questionable efficacy and efficiency. Differentiating between actual intake versus spillage of milk merits attention.