Human Milk Cessation in the NICU in Infants with Bronchopulmonary Dysplasia

Objective The objective of this study was to identify factors associated with the cessation of human milk prior to neonatal intensive care unit (NICU) discharge for infants diagnosed with bronchopulmonary dysplasia (BPD). Study Design Participants were recruited from the Johns Hopkins BPD Clinic between January 2016 and October 2018. Clinical and demographic characteristics were analyzed based on whether participants stopped human milk before or after NICU discharge. Results Of the 224 infants included, 109 (48.7%) infants stopped human milk prior to discharge. The median duration of human milk intake was less for infants who stopped human milk prior to discharge compared with those who continued after discharge (2 vs. 8 months, p <0.001). In multivariate regression analysis, pulmonary hypertension (odds ratio [OR]: 2.90; p =0.016), public insurance (OR: 2.86; p< 0.001), and length of NICU admission (OR: 1.26 per additional month; p =0.002) were associated with human milk cessation prior to NICU discharge. Conclusion Infants with BPD who have severe medical comorbidities and markers of lower socioeconomic status may be at higher risk for earlier human milk discontinuation. Key Points Half of infants in our study with BPD who received human milk stopped human milk prior to NICU discharge. For infants on human milk after discharge, the duration of human milk intake was 8.6 months. Infants with pulmonary hypertension, tracheostomies, and ventilation stopped human milk earlier. Non-White race, lower income, and public insurance were predictors of early human milk cessation.