How to provide NICU babies with needed nutrients

After childbirth, the welcome sight of holding a new baby is a cherished moment for loved ones. But soon after birth, making sure an infant is properly nourished with milk becomes a parent’s main priority.

But for some babies whose mothers are unable to breastfeed due to factors such as prematurity or illness, breast pumps provide a much-needed lifeline. However, some researchers believe that milk production for these women could be affected by several factors, which may soon transform the way clinicians work to improve milk production.

Marion M. Bendixen, PhD, MSN, RN, IBCLC

According to University of Florida assistant professor Marion Bendixen, babies who need a longer stay in the hospital, specifically in infants who are critically ill in the neonatal intensive care unit (NICU), are especially in need of the nutrients and proteins provided by a mother’s own milk.

“Premature and critically ill infants are at a higher-than-average risk for complications,” Bendixen said. “In particular, Black women are substantially more likely to deliver premature or critically ill infants, and Black infants receive less of their mother’s own milk during their hospitalization. These babies are also more likely to experience complications, like sepsis, which are often mitigated when infants receive their mother’s own milk.”

To help NICU babies get the nutrients they need, Bendixen and a team of interdisciplinary researchers launched a study to investigate lactation outcomes in mothers who pump to provide their milk to feed NICU babies. Over the course of a three-year, $412,000 grant from the National Institute of Nursing Research, a division of the National Institutes of Health, Bendixen will study a diverse group of mothers of infants admitted to the NICU for their first 14 postpartum days.

According to Bendixen, gestational age, the length of time that an infant remains in the womb, may be a key factor influencing when a mother produces milk. As mothers enter the postpartum period, mammary gland cells that produce milk may have a longer time to mature with each day, resulting in greater volumes of milk.

However, Bendixen and her team also theorize that how often or how long the breast pump is used during this period may affect the amount of milk a mother is able to produce.

“Breast pump usage may be a potential mediator of mammary gland maturation during the critical postpartum window,” Bendixen said. “We hope to observe whether breast pump usage with smart technology by these women has any impact on how these cells develop, providing insight that will help clinicians ensure that these gland cells are fully activated and can produce enough milk for the baby for months to follow.”

After evaluating how milk volumes compare across postpartum days, Bendixen and her team also plan to use biomarkers, molecules that can be used as signs that a process is taking place, to determine if there are biological signs of ‘peak’ or “altered” mammary gland activation. The group also intends to examine how these biomarkers relate to the amount of milk produced by each mother.

Bendixen said her team’s work marks just the “first step” in designing a research program to identify and provide appropriate personalized lactation care to mothers at risk for insufficient milk production or the delayed activation of their mammary glands.

“We look forward to developing a research plan to improve maternal and infant health, as well as advance health equity,” Bendixen said.

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR020537. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health

Dr. Bendixen’s collaborators are internationally recognized scientist: Dr. Paula Meier (co-primary mentor) is a Professor of Pediatrics and Nursing at Rush University, Chicago, and Dr. Geoffrey Dahl (co-primary mentor). Harriet B. Weeks Professor, Department of Animal Sciences at UF, Dr. Martina Mueller, Professor of Biostatistics and Bioinformatics in MUSC’s CON, and Dr. Leslie Parker (co-mentor) Professor of Nursing at UF