Lactation Education Study in Mothers of Very Low Birth Weight Infants

• Maternal breast milk proportion of enteral feeding. [ Time Frame: Daily during the initial hospitalization which is an average of 60 days ] [ Designated as safety issue: No ]
  Volume (ml) of maternal breast milk received daily by the infant divided by the total daily volume of all enteral feeding received.
  
  
• Volume of daily maternal milk intake in relation to infant weight. [ Time Frame: Daily during the initial hospitalization which is an average of 60 days ] [ Designated as safety issue: No ]
  Daily maternal milk intake(ml)divided by daily infant weight (kilograms).
  
  

• Maternal lactation and breast milk expression knowledge. [ Time Frame: One month postpartum ] [ Designated as safety issue: No ]
  Prior knowledge will be assessed by administering a self-administered knowledge test on lactation and breast milk expression before providing the instructional DVD or written instructions. The same test will be self-administered approximately one month after delivery.
  
  

Very low birth weight (VLBW; <1500 g) infants who receive maternal breast milk, as opposed to infant formula, are less likely to experience the serious illnesses and poor developmental outcomes associated with VLBW. However, a disparity exists in breast milk feeding. Infants whose mothers have low educational attainment and low income are less likely to receive maternal breast milk than infants whose mothers who do not have low educational attainment and low income. The primary objective of this proposed research is to determine the effect of lactation discharge instructions in an audio-visual format provided to mothers for home viewing on the dose and duration of maternal breast milk received by their VLBW infants during the neonatal intensive care unit hospitalization.

Methods. Forty mothers of VLBW infants will be randomly assigned to receive a breast milk expression instruction digital video disc (DVD) in addition to standard of care lactation education or assigned to receive written instructions in addition to standard of care lactation education. In addition to comparing infant intake of maternal breast milk intake, pre and post intervention lactation and breast milk expression knowledge will be compared between groups and DVD viewing frequency and acceptability will be determined with a log and questionnaire to be completed by the intervention group and collected the first month after delivery.