Oral care with human milk is associated with increased human milk feeding and breastfeeding for newborns with critical congenital heart disease

OBJECTIVE: Describe the prevalence of oral care with human milk (OHM) for infants with critical congenital heart disease (CCHD) and estimate the effect of early OHM (1st postnatal week) on lactation outcomes. STUDY DESIGN: Retrospective cohort including infants with CCHD from 2014-2023. Adjusted regression estimated effects of early OHM frequency (quartiles (Q); Q1 = 0-1 OHM doses, Q2 = 2-6, Q3 = 7-13, Q4 ≥ 14) on human milk intake and breastfeeding (BF) at discharge. RESULT: For 297 infants ≤6 months old, OHM comprised 25.5% of oral care. Early OHM frequency was associated with 42.67-57.03 mL/kg/d higher human milk intake (p < 0.001 for Q2-4 compared to Q1), and 4.7-6.03 greater odds of BF (p < 0.01 for Q2-4) at discharge. CONCLUSION: Increased early OHM frequency was strongly associated with lactation outcomes for newborns with CCHD. OHM may support human milk/BF exposure in this vulnerable population.