Dataset Information

BLOSSoM: Improving Human Milk Provision in Preterm Infants Through Texting Support.

ABSTRACT: Mother's own milk (MOM) reduces complications of preterm birth. Despite high initiation rates of expression, half of preterm infants do not receive MOM at discharge. Frequent outreach and a short message service (SMS) have improved MOM provision in term dyads. We aimed to improve MOM provision rate from 61% to >80% by implementing standardized lactation education and Breastfeeding & Lactation Outreach via SMS Supporting Mothers (BLOSSoM).

Methods

The baseline period was June 2019 to April 2020. A multidisciplinary team implemented PDSA cycles: education/documentation (standardized lactation education and education documentation, May 2020-April 2021), and BLOSSoM (SMS program providing educational texts/videos, reminders, 2-way communication with neonatal intensive care unit (NICU) lactation, May 2021-December 2021). The primary outcome was MOM provision at NICU discharge/transfer for infants younger than 34 weeks, as analyzed on the SPC chart. BLOSSoM participants evaluated the program using a 5-point Likert scale.

Results

Demographic and clinical characteristics were unchanged among the three periods. However, the monthly MOM provision rate improved from 61% to 81%. Eighty-seven percent of BLOSSoM participants completed the evaluation with 83% rating the program most supportive, 78% rating the videos as the most helpful, followed by team check-ins (54%) and 2-way texting (24%).

Conclusions

Using a multidisciplinary approach, we improved the monthly MOM provision rate at discharge/transfer for preterm infants. SMS providing educational texts/media and 2-way communication supporting lactating NICU mothers was critical to our success. Providing another method of communication through SMS was well accepted and valued by the majority.

SUBMITTER: Hayashi M

PROVIDER: S-EPMC9509171 | biostudies-literature | 2022 Sep-Oct

REPOSITORIES: biostudies-literature

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Publications

BLOSSoM: Improving Human Milk Provision in Preterm Infants Through Texting Support.

Hayashi Madoka M Huber Kelly K Rankin Colette C Boyajian Brittany B Martinez Angelena A Grover Theresa T Roosevelt Genie G

Pediatric quality & safety 20220923 5

Mother's own milk (MOM) reduces complications of preterm birth. Despite high initiation rates of expression, half of preterm infants do not receive MOM at discharge. Frequent outreach and a short message service (SMS) have improved MOM provision in term dyads. We aimed to improve MOM provision rate from 61% to >80% by implementing standardized lactation education and Breastfeeding & Lactation Outreach via SMS Supporting Mothers (BLOSSoM).<h4>Methods</h4>The baseline period was June 2019 to April ...[more]

PMID: 36168514

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Project description:BackgroundPlacental transfusion (by means of delayed cord clamping (DCC), cord milking, or cord stripping) confers benefits for preterm infants. It is not known if providing respiratory support to preterm infants before cord clamping improves outcomes.ObjectivesTo assess the efficacy and safety of respiratory support provided during DCC compared with no respiratory support during placental transfusion (in the form of DCC, milking, or stripping) in preterm infants immediately after delivery.Search methodsWe used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL, 2017, Issue 5), MEDLINE via PubMed (1966 to 19 June 2017), Embase (1980 to 19 June 2017), and CINAHL (1982 to 19 June 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials.Selection criteriaRandomized, cluster randomized, or quasi-randomized controlled trials enrolling preterm infants undergoing DCC, where one of the groups received respiratory support before cord clamping and the control group received no respiratory support before cord clamping.Data collection and analysisAll review authors assisted with data collection, assessment, and extraction. Two review authors assessed the quality of evidence using the GRADE approach. We contacted study authors to request missing information.Main resultsOne study fulfilled the review criteria. In this study, 150 preterm infants of less than 32 weeks' gestation undergoing 60 second DCC were randomized to a group who received respiratory support in the form of continuous positive airway pressure (CPAP) or positive pressure ventilation during DCC and a group that did not receive respiratory support during the procedure. Mortality during hospital admission was not significantly different between groups with wide confidence intervals (CI) for magnitude of effect (risk ratio (RR) 1.67, 95% CI 0.41 to 6.73). The study did not report neurodevelopmental disability and death or disability at two to three years of age. There were no significant differences between groups in condition at birth (Apgar scores or intubation in the delivery room), use of inotropic agents (RR 1.25, CI 0.63 to 2.49), and receipt of blood transfusion (RR 1.03, 95% CI 0.70 to 1.54). In addition, there were no significant differences in the incidences of any intraventricular haemorrhage (RR 1.50, 95% CI 0.65 to 3.46) and severe intraventricular haemorrhage (RR 1.33, 95% CI 0.31 to 5.75). Several continuous variables were reported in subgroups depending on method of delivery. Unpublished data for each group as a whole was made available and showed peak haematocrit in the first 24 hours and duration of phototherapy did not differ significantly. Overall, the quality of evidence for several key neonatal outcomes (e.g. mortality and intraventricular haemorrhage) was low because of lack of precision with wide CIs.Authors' conclusionsThe results from one study with wide CIs for magnitude of effect do not provide evidence either for or against the use of respiratory support before clamping the umbilical cord. A greater body of evidence is required as many of the outcomes of interest to the review occurred infrequently. Similarly, the one included study cannot answer the question of whether the intervention is or is not harmful.

Project description:Background New mothers experience BF challenges but have limited evidence-based technology-enabled support. Objectives 1) Determine if using the Mother’s Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app. Method Randomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded. Results There were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study. Conclusion MMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04976-6.

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Dataset Information

BLOSSoM: Improving Human Milk Provision in Preterm Infants Through Texting Support.

Methods

Results

Conclusions

Publications

BLOSSoM: Improving Human Milk Provision in Preterm Infants Through Texting Support.

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