Study to examine how breastfeeding impacts cost of healthcare for very low birth weight babies

Dec 16 2008

The National Institutes of Health (NIH) has awarded nearly $3 million to support Rush University Medical Center's study analyzing how human breast milk impacts the health outcomes and health care cost savings for very low birth weight infants - babies less than 1500 grams.

The grant will enable researchers at Rush to conduct a five-year study involving the largest prospective cohort of 600 very low birth weight infants born to racially and economically diverse mothers. The study will have a representative number of African American and low income women enrolled in this study.

“Unlike other institutions with the same demographics, the mothers that give birth at Rush elect to provide breast milk because they are encouraged to think of their milk as ‘medicine' for their babies,” said Paula Meier, director of clinical research and lactation in the Rush neonatal intensive care unit (NICU) and principal investigator of the study.

More than 95 percent of very low birth weight infants in Rush's NICU receive their mothers' breast milk and will be enrolled into the study.

The trial will examine the relationship between the amount, the duration, and the timing of human milk feedings and improved health outcomes for very low birth weight babies hospitalized in the NICU.

Past research indicates that human milk protects very low birth weight infants from prematurity-specific complications that predispose these infants to short-and long-term health problems and increase cost of health care.

“However, no one has conclusively linked the amount and length of time these infants need to be fed human milk in order to lower their health risks and tie it back to cost of care,” said Meier.

“For this patient population, human milk is much more important for its therapeutic and medicinal properties rather than nutrition,” said Meier. “While these infants are in the NICU, we have a critical window to decrease morbidity rates and risks of severe complications.”

The study will follow very low birth weight infants in the Rush NICU to see what effect higher doses of human breast milk and longer periods of exposure during critical periods of hospitalization have on length of stay, infant growth, as well as lowering total NICU costs.

Infants enrolled in the study will receive different amounts of human breast milk during their NICU stay. Data on the variables of dose and exposure period of human breast milk feeding will be collected throughout the infant's entire NICU stay. Researchers also will collect data on short-term costs of providing breast milk such as breast pump rental, total number of storage containers needed and access to lactation experts.

“The findings from this study will be easily translated into health policy that we hope will help shape protocol standards for NICUs and providing care for this vulnerable patient population,” said Meier.

About the Neonatal Intensive Care Unit at Rush

The Rush NICU provides the full spectrum of medical and surgical care for infants born at Rush or transferred from other hospitals. The 57-bed NICU is housed adjacent to the labor/delivery services, allowing neonatal medicine specialist immediate access during high-risk deliveries. The NICU provides neonatal specialty care including high frequency ventilation and nitric oxide therapy.

Rush Children's Hospital is one of two hospitals in the area that has a board-certified neonatologist in-house 24-hours-a-day with immediate availability for consultations and referrals.

All high-risk deliveries, including all pregnancies less than 32 weeks gestation, are attended by a board-certified neonatologist. All critical clinical decisions are made at the bedside by the board-certified neonatologist 24 hours a day.

The NICU receives full subspecialty support from pediatric medical subspecialists, pediatric surgery and other surgical subspecialties. In addition, Rush Children's Hospital is the only hospital with complete neonatal nurse practitioner coverage on all extremely low birth weight infants. These two factors have been associated with lower mortality and morbidity rates.

The unit staff includes neonatologists, neonatal nurses, nurse practitioners and respiratory therapists. Also available are pediatric medical subspecialists, pediatric surgeons and other surgical subspecialties as needed to care for infants in the unit.

Rush University Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children's Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,270 students, is home to one of the first medical schools in the Midwest, and one of the nation's top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.