This retrospective study comprised all newborns discharged between April 1, 2013 and March 31, 2015, from the Department for Neonatology and Paediatric Intensive Care Medicine, Technical University of Dresden, Germany, which is a level III neonatal centre. Included were infants born at the Department for Obstetrics and Gynaecology, Technical University of Dresden, and requiring admission to the nursery or the neonatal intensive care unit or transferred to the nursery or NICU within 48 hours after delivery from a community hospital. Excluded were all infants being re-admitted after discharge. Data were collected from the electronic patient charts (Integrated Care Manager®, Draeger, Luebeck, Germany and ORBIS, Agfa HealthCare, Bonn, Germany).
The primary outcome was the nutrition during the last 48 hours prior to discharge: Infants in the MOM group received their own mother’s breast milk exclusively. Neonates which received formula at least once in that time frame were included in the non-MOM group (NMOM). We did not discriminate between breastfeeding or bottle feeding.
It is hospital policy to encourage mothers to use electrical milk pumps which are available in hospital and are prescribed for use at home after the mother is discharged. Extracted breast milk is stored in a central hospital facility and thawed for each use. For preterm infants, breast milk was fortified after reaching full enteral nutrition using Nestle Beba FM85 (Nestle Nutrition GmbH, Frankfurt, Germany) and/or medium chain triglycerides (Ceres oil) and/or protein powder.
Neonatal variables include birth weight (BW), completed weeks of gestation (GA), intubation in the delivery room, skin-to-skin contact in the delivery room, first day of breast feeding (≤ two weeks of life / > two weeks of life), kangarooing, days of nutrition per gastric tube, respiratory support without notice of the duration (none/Continuous Positive Airway Pressure (CPAP) or mechanical ventilation for newborns below 37 weeks and none or CPAP/intubation for newborns ≥ 37 weeks), abdominal surgery, length of stay in hospital (LOS), length of stay on NICU, corrected gestational age at discharge and type of discharge (home or into a different hospital/rehabilitation centre).
Maternal variables included maternal age, professional degree (academic or non-academic), marital status, mode of delivery (vaginal birth or caesarean section), number of previous deliveries, number of antenatal consultations, length of hospital stay before delivery, multiple births, gestational diabetes, nicotine abuse and mode of conception.
Data was collected using Microsoft Excel 2010® (Microsoft Corporation, Redmond, Washington, USA) and statistical analyses were performed with SPSS 23.0 (IBM®, Chicago, IL, USA).
Categorical data is presented as absolute and relative frequency. Continuous data was not normally distributed and presented as median and IQR (25th percentile; 75th percentile). All variables potentially influencing the primary outcome were analysed using the chi-square test or the Mann-Whitney U test. p < 0.05 was judged as statistically significant. All analyses were performed separately for infants born < 32, infants born 32—37 and infants ≥ 37 weeks of gestation.
Independent variables identified in the bivariate analysis (p<0.05) were included in a multifactorial logistic regression analysis. Results are expressed as odds ratios with 95% confidence intervals for infants receiving MOM exclusively at discharge.