Early Fresh Mother’s Own Milk Feeding in 917 Very-Low-Birth-Weight Infants: Current Status and Nursing Implications

OBJECTIVE: This study aimed to analyze the initiation, intake, proportion, and continuity of fresh mother's own milk (MOM) feeding during the first 14 days of life in hospitalized very-low-birth-weight (VLBW) infants, identify weaknesses in neonatal intensive care unit (NICU) breastfeeding care, and provide evidence for optimizing nursing protocols. METHODS: tests, and repeated measures analysis of variance (ANOVA) were used for data analysis. RESULTS: The fresh MOM feeding rate within 14 days was 55.94%. The median time to first feeding was 24.0 hours, predominantly with donor human milk (92.0%). The median postnatal day of first fresh MOM feeding was 4.0 days, and the median duration was 1.0 day; only 0.11% received fresh MOM continuously through day 14. Feeding rates, intake volumes, and energy contributions peaked on days 4 and 5 and declined sharply thereafter, with mean energy contribution from fresh MOM over 14 days at only 4.24% ± 7.65%. Subgroup analyses showed that infants with gestational age <28 weeks had significantly lower cumulative intake and energy supply; vaginal delivery, uncomplicated pregnancy, and multiparity correlated with earlier first fresh MOM exposure; and cesarean-delivered infants had higher cumulative intake and longer duration, likely attributable to prolonged hospitalization. CONCLUSIONS: Early fresh MOM feeding in VLBW infants is characterized by delayed initiation, short duration, and low intake and energy contribution. The sharp decline after days 4 and 5 suggests fragmentation between in-hospital and postdischarge lactation support. Standardized early initiation protocols, integrated support systems, and stratified care for high-risk infants are urgently needed. CLINICAL IMPLICATIONS: There is an urgent need to establish standardized early initiation protocols, develop integrated in-hospital and postdischarge lactation support systems, and implement stratified care for high-risk infants to improve the timeliness, adequacy, and continuity of fresh MOM feeding in the NICU setting.