Factors Associated With Lactation Outcomes Among Mothers of Infants With Congenital Heart Disease

Background: The prevalence of mother’s own milk (MOM) feeding among infants with congenital heart defects (CHD) is low. Purpose: To examine associations between maternal, infant, and clinical practice factors and lactation outcomes among mothers of infants with CHD during the first 14 days postpartum. Methods: Dyads were eligible if the infant was born at the institution and the mother provided MOM for feeding. Bivariate analyses, linear regression, and logistic regression analyses were performed. Results: Of the 93 mothers enrolled, 90 (96.8%) achieved secretory activation (SA), 45 (50%) achieved coming to volume (CTV), and 31 (34.4%) achieved full lactation. Mean time to SA was 92.17 ± 44.95 hours. Multiparity was associated with reduced time to SA by 32.93 hours (95% CI, −49.16 to 16.69; P < .001). A cubic increase in pumping frequency on days 3 to 5 inversely affected time to SA ( P = .002). Multiparity was associated with a 3.35 (95% CI, 1.1201-9.366) higher odds of achieving CTV ( P = .021) and diabetes with a 0.126 (95% CI, 0.032-0.492) lower odds ( P = .003). Odds of reaching full lactation were lower in women with Medicaid insurance (0.333, 95% CI, 0.125-0.0886; P = 0.28) and those with diabetes (0.182, 95% CI, 0.307-0.905; P = .037) and higher in multiparous women (5.437, 95% CI, 1.538-19.217; P = .009). Implications for Practice and Research: Mothers of infants with CHD, especially primiparous or those with diabetes, should receive prenatal lactation education, prenatal access to breast pumps, and postnatal lactation support. Research should explore interventions to improve lactation outcomes among this group.