Telemedicine for Breastfeeding Support in the NICU during the COVID-19 Pandemic and Beyond

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ESPR397
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Background: Telemedicine has emerged as an essential medical tool during the COVID19 pandemic, affording uninterrupted services while ensuring the safety of both patients and providers. Its effectiveness in breastfeeding support especially for NICU mothers has not been studied. Lactation support plays an essential role in empowering mothers to successfully breastfeed. Mothers face tremendous barriers for initiation and sustaining breastfeeding in the NICU and post discharge. The pandemic has further exacerbated many of these obstacles. Our lactation service transitioned to telemedicine on March 18, 2020. We utilized all approved platforms to provide ongoing support to mother in the comfort of their own homes, while facilitating access to continued care with flexibility. Objective: The goal of this study was to assess the effectiveness of telemedicine lactation support for NICU mothers by comparing breastfeeding outcomes before and after its implementation. Methods: This is a case control study of mothers whose infants were admitted to our NICU from 1/1/2020 to 6/30/2020. Mothers in the Pre-Telemedicine (Pre-TM) group (1/1/2020-3/17/2020) received in-house lactation support while visiting their babies; mothers in the Telemedicine (TM) group (3/18/2020-6/30/2020) received telemedicine consults. Maternal and infant demographics, type of feeds in the first 24 hours and at discharge were analyzed. Follow-up survey will assess ongoing breastfeeding rates, including current type of feed, maternal preference of type of consult and satisfaction with each different type of consultations. Results: There were 130 mothers in the Pre-TM and 161 in TM periods with 303 infants who survived to discharge (136 in Pre-TM and 167 in TM). There were 6 sets of twins in each cohort. We found no significant difference in maternal and infant demographics in the two groups (Table 1). More infants in the TM group received their mothers' own milk (MOM) in the first 24 hours of life (39% vs 26%, p < 0.03); with infants not eligible for donor milk (DM) experiencing the greatest benefit (17% vs 7%, p <0.01). Exclusive breastfeeding at discharge increased during TM although not reaching statistical significance (18% vs 11%, p=0.1). During TM, mothers who were not successful in providing MOM in the first 24 hours of life, experienced the greatest improvement in exclusive breastfeeding at discharge (13% vs 3%, p <0.03) (Table 2, 3). Conclusions: During the TM period, more mothers were able to provide their own milk in the first 24 hour of life and the overall rates of exclusive breastfeeding were sustained. In our experience, telemedicine lactation support was easy to implement and proved to be an invaluable alternative to in-person consultations. Telemedicine should be incorporated to optimize breastfeeding support for all mothers even after the pandemic.


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The Regional Neonatal ICU Maria Fareri Children’s Hospital at Westchester Medical Center-NYMC Valhalla, NY, White Plains, NY, US
New York Medical College
New York Medical College
The Regional Neonatal ICU Maria Fareri Children’s Hospital at Westchester Medical Center - New York Medical College
The Regional Neonatal ICU Maria Fareri Children’s Hospital at Westchester Medical Center - New York Medical College
The Regional Neonatal ICU Maria Fareri Children’s Hospital at Westchester Medical Center - New York Medical College
The Regional Neonatal ICU Maria Fareri Children’s Hospital at Westchester Medical Center - New York Medical College
Westchester Medical Center

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