38 - Videoconferencing with the Hospitalized Premature Infant While Expressing Milk, a Pilot Randomized Controlled Trial

Poster Number: 38
Publication Number: 38.202

Adrienne E. Hoyt-Austin, University of California Davis Children's Hospital, Sacramento, CA, United States; Kristin R. Hoffman, University of California, Davis, School of Medicine, Sacramento, CA, United States; Iesha Miller, University of California Davis Children's Hospital, Sacramento, CA, United States; Jennifer Rosenthal, University of California Davis Children's Hospital, Sacramento, CA, United States; Daniel J. Tancredi, University of California, Davis, School of Medicine, Sacramento, CA, United States; Caroline J. Chantry, UC Davis School of Medicine, Sacramento, CA, United States; Mark A. Underwood, UC Davis, MEDICAL LAKE, WA, United States; James Marcin, UC Davis Health, Sacramento, CA, United States; Kara Kuhn-Riordon, University of California Davis Children's Hospital, Sacramento, CA, United States; Laura R. Kair, University of California, Davis, School of Medicine, Sacramento, CA, United States

Background: Human milk is key to support optimal health outcomes for infants in the neonatal intensive care unit (NICU); however, expressing milk for one’s hospitalized premature infant is impacted by separation, stress, and time.

Objective: We tested if visualizing one’s infant while pumping through videoconferencing improves volume, efficiency, human milk nutritional content, and the pumping experience.

Design/Methods: In this randomized controlled trial with crossover design (NCT03957941), we enrolled mothers of hospitalized premature infants (< 34 weeks) and randomized participants to pump three times each with and without videoconferencing with their infant. Milk volumes, start, and stop times were self-recorded. Pumping experience was assessed with the Breastmilk Expression Personal Experience subscale (BMEE), a 5-item scale with predictive validity for earlier cessation. Human milk was collected from the final pump per randomization arm session and analyzed using the Miris HMA™. Data were analyzed in SAS using a panel data fixed effects model to estimate within-person mean differences (MD) in human milk volume, pumping efficiency, nutritional content, and BMEE scores with and without videoconferencing.

Results: Thirty-eight women consented to the study. Of those, 28 provided milk volume and efficiency data, 26 completed BMEE scores, and 24 provided milk samples (Table 1). There was no difference in milk volumes (MD -2.5 mL, CI -11.9-6.9; p=0.6) or pumping efficiency (0.3 mL/min, CI -0.4-0.9; p=0.4) with or without videoconferencing. Mean BMEE subscale scores (Figure) were higher with videoconferencing (MD 0.10, 95% CI 0.02-0.18; p=0.01). There were no design effects for volume, efficiency, nor the BMEE. Women endorsed a better experience with videoconferencing, as it “is a reminder of why I pump” and “calms me to see baby at peace.” Human milk nutritional content was affected by the crossover design. Participants randomized to pump with videoconferencing first had milk with less fat, total solids and energy and more carbohydrates when videoconferencing (Table 2).

Conclusion(s):

Videoconferencing with one’s hospitalized premature infant was well received by participants and improved their pumping experience (BMEE). However, use of videoconferencing was not associated with significant effects on human milk expression nor efficiency. The study design did effect several milk nutritional components for those randomized to videoconferencing first with crossover to control second, however, the impact of the variability in the milk warrants future definitive study.