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August 07, 2017

CHOP study finds new mothers see wider connotation for 'breastfeeding'

Mothers in newborn/infant intensive care units (N/IICU) have varying views on what the term "breastfeeding" really conveys, according to a new study out of The Children's Hospital of Philadelphia.

In order to better understand how new mothers regard both the nourishment and bonding aspects of breastfeeding, the CHOP team worked with 11 mothers of infants with congenital diaphragmatic hernia (CDH), a condition that affects one in every 2,000 to 4,000 live births.

In infants with CDH, the diaphragm muscle fails to close during prenatal development, allowing contents from the abdomen to pass through to the chest and thus preventing mothers from breastfeeding directly.

"We found early on that 'breastfeeding' didn't necessarily mean holding the baby to the breast," said Elizabeth Froh, clinical supervisor of the Lactation Team at CHOP and lead author of the study. "For the most part, mothers felt happy as long as their baby was getting their milk, whether by pumping or traditional breastfeeding."

At least one mother said getting her newborn son to drink human milk in any form would constitute breastfeeding.

"I think [breastfeeding and bottle feeding are] the same, right? Because he's getting potentially…the exact same thing. He's getting breast milk, still. I feel like if he can take a bottle before we go home, then that's fine," the woman said. "My goal is to get home with a feeding tube and with something else; I want him to be able to either take a bottle or breastfeed – whichever one. That's my goal before we go home."

Based on their findings and interviews with the 11 mothers, the CHOP team believes the terminology surrounding "breastfeeding" should be expanded beyond direct feeding at the breast. This not only helps mothers of infants with CDH prepare for when their child can be fed directly, but educates them in the hospital setting about what needs to be done and helps them feel connected to their newborn, motivating them to pump milk.

"If a mother in the N/IICU wants to one day breastfeed her child in the traditional sense, they need to be taught the importance of pumping early and pumping often with a hospital-grade electric pump," said Diane Spatz, director of the Lactation Program at CHOP and study co-author. "The benefit is two-fold: the mother's body is learning how to produce milk, and the baby is able to get all the benefits of human milk although being fed through a feeding tube."

The full study, published in the Journal of Human Lactation, can be accessed here.