180. Introducing the Mother Infant Lactation Questionnaire (MILQ): A Patient-reported Outcome Measure for Breastfeeding and Lactation Success and Challenges

PURPOSE: Breastfeeding offers maternal and infant health benefits. Despite recommendations of exclusive breastfeeding for at least six months postpartum, 75% of mothers in the United States fail to meet this goal. The literature lacks information on the impact of medical, psychosocial, and cultural factors on breastfeeding practices, largely due to limited research methodology. Thus, we developed and report our initial findings from, the Mother Infant Lactation Questionnaire (MILQ, pronounced “milk”), a novel patient-reported outcome measure to assess breastfeeding satisfaction, challenges, and deficit areas for mother and child. METHODS: Women aged 18 to 45 years and between 6 months and 5 years postpartum completed the MILQ. Associations between categorical variables (demographics, method of feeding, breastfeeding duration, physical symptoms, and mental health conditions) were examined using Pearson χ2. Odds ratios (OR), 95% confidence intervals (CI), and P values were also calculated. Breastfeeding duration was dichotomized into >6 months and ≤6 months for analyses. A P value <.05 was considered statistically significant. RESULTS: A total of 323 mothers completed the MILQ, at a mean (standard deviation) age of 34.8 (5.5) years. Most participants self-identified as White (n=222, 68.7%), earned a bachelor’s degree or higher (n=254, 85.2%), and reported an annual household income of $150,000 or greater (n=154, 51.5%). Nearly all women were able to lactate and attempted breastfeeding (n=286/299, 95.7% and n=282/289, 97.6%, respectively). Mothers who breastfed or pumped breast milk for ≤6 months were 1240% more likely to not meet their breastfeeding goals than those who utilized breast milk for >6 months (OR: 13.4, 95% CI: 7.23-25.0; P<0.001). In addition, mothers who breastfed or pumped breast milk for >6 months were nearly 400% more likely to be satisfied with their overall ability to nourish their infant compared to those who breastfed or pumped for ≤6 months (OR: 4.91, 95% CI: 2.73-8.83; P<0.001). Experiencing a physical challenge during breastfeeding or pumping did not significantly impact meeting one’s breastfeeding goals or predict early cessation (P>0.05, all). Although 96.3% of women (n=311) experienced mental health symptoms in the first postpartum year, experiencing these symptoms did not predict breastfeeding or pumping for ≤6 months (P>0.05, all). CONCLUSION: The MILQ offers a means to comprehensively measure and understand breastfeeding and lactation performance. While a longer breastfeeding duration predicted satisfaction with nourishing one’s infant and meeting personal breastfeeding goals, further study is needed to elucidate deficit areas and allow for a more targeted approach to education and intervention to raise breastfeeding rates.