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Home care practices for preterm and term infants after hospital discharge in Massachusetts, 2007 to 2010

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Abstract

Objective:

The objective of this study was to compare the prevalence of home care practices in very to moderately preterm (VPT), late preterm (LPT) and term infants born in Massachusetts.

Study Design:

Using 2007 to 2010 Massachusetts Pregnancy Risk Assessment Monitoring System data, births were categorized by gestational age (VPT: 23 to 33 weeks; LPT: 34 to 36 weeks; term: 37 to 42 weeks). Home care practices included breastfeeding initiation and continuation, and infant sleep practices (supine sleep position, sleeping in a crib, cosleeping in an adult bed). We developed multivariate models to examine the association of infant sleep practices and breastfeeding with preterm status, controlling for maternal sociodemographic characteristics.

Results:

Supine sleep position was more prevalent among term infants compared with VPT and LPT infants (77.1%, 71.5%, 64.4%; P=0.02). In the adjusted model, LPT infants were less likely to be placed in supine sleep position compared with term infants (adjusted prevalence ratio=0.86; 95% confidence interval: 0.75 to 0.97). Breastfeeding initiation and continuation did not differ among preterm and term groups. Nearly 16% of VPT and 18% of LPT and term infants were not sleeping in cribs and 14% of LPT and term infants were cosleeping on an adult bed.

Conclusion:

Compared with term infants, LPT infants were less likely to be placed in supine sleep position after hospital discharge. A significant percent of preterm and term infants were cosleeping on an adult bed. Hospitals may consider improving their safe sleep education, particularly to mothers of LPT infants.

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References

  1. Hamilton BE, Martin JA, Ventura SJ . Births: final data for 2012. Natl Vital Stat Rep 2013; 62 (3): 9.

    Google Scholar 

  2. Massachusetts Births 2010. Division of Research and Epidemiology, Bureau of Health Information, Statistics, Research, and Evaluation, Massachusetts Department of Public Health: Boston, MA, October 2012.

  3. Vernacchio L, Corwin MJ, Lesko SM, Vezina RM, Hunt CE, Hoffman HJ et al. Sleep position of low birth weight infants. Pediatrics 2003; 111 (3): 633–640.

    Article  Google Scholar 

  4. Hwang SS, Barfield WD, Smith RA, Morrow B, Shapiro-Mendoza CK, Prince CB et al. Discharge timing, outpatient follow-up, and home care of late-preterm and early-term infants. Pediatrics 2013; 132 (1): 101–108.

    Article  Google Scholar 

  5. Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Wright LL, Langer JC et al. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118 (1): e115–e123.

    Article  Google Scholar 

  6. Lee HC, Gould JB . Factors influencing breast milk versus formula feeding at discharge for very low birth weight infants in California. J Pediatr 2009; 155 (5): 657–662; e1–e2.

    Article  Google Scholar 

  7. Shulman HB, Gilbert BC, Msphbrenda CG, Lansky A . The Pregnancy Risk Assessment Monitoring System (PRAMS): current methods and evaluation of 2001 response rates. Public Health Rep 2006; 121 (1): 74–83.

    Article  Google Scholar 

  8. Tablizo MA, Jacinto P, Parsley D, Chen ML, Ramanathan R, Keens TG . Supine sleeping position does not cause clinical aspiration in neonates in hospital newborn nurseries. Arch Pediatr Adolesc Med 2007; 161 (5): 507–510.

    Article  Google Scholar 

  9. Byard RW, Beal SM . Gastric aspiration and sleeping position in infancy and early childhood. J Paediatr Child Health 2000; 36 (4): 403–405.

    Article  CAS  Google Scholar 

  10. Task Force on SIDS Task Force on SIDS, Moon RY . SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 2011; 128 (5): 1030–1039.

    Article  Google Scholar 

  11. Gelfer P, Cameron R, Masters K, Kennedy KA . Integrating ‘Back to Sleep’ recommendations into neonatal ICU practice. Pediatrics 2013; 131 (4): e1264–e1270.

    Article  Google Scholar 

  12. Smith VC, Hwang SS, Dukhovny D, Young S, Pursley DM . Neonatal intensive care unit discharge preparation, family readiness and infant outcomes: connecting the dots. J Perinatol 2013; 33 (6): 415–421.

    Article  CAS  Google Scholar 

  13. Report of the Secretary's Advisory Committee on Infant Mortality (SACIM): Recommendations for Department of Health and Human Services (HHS) Action and Framework for a National Strategy, January 2013. Available at: http://www.hrsa.gov/advisorycommittees/mchbadvisory/InfantMortality/About/natlstrategyrecommendations.pdf (last accessed 9 July 2014).

  14. Collaborative Improvement and Innovation Network to Reduce Infant Mortality. Available at: http://mchb.hrsa.gov/infantmortality/coiin/index.html (last accessed 9 July 2014).

  15. Sisk PM, Lovelady CA, Dillard RG, Gruber KJ, O'Shea TM . Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. J Perinatol 2007; 27 (7): 428–433.

    Article  CAS  Google Scholar 

  16. Meinzen-Derr J, Poindexter B, Wrage L, Morrow AL, Stoll B, Donovan EF . Role of human milk in extremely low birth weight infants' risk of necrotizing enterocolitis or death. J Perinatol 2009; 29 (1): 57–62.

    Article  CAS  Google Scholar 

  17. Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Higgins RD, Langer JC et al. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007; 120 (4): e953–e959.

    Article  Google Scholar 

  18. Meier PP, Patel AL, Bigger HR, Rossman B, Engstrom JL . Supporting breastfeeding in the neonatal intensive care unit: Rush Mother's Milk Club as a case study of evidence-based care. Pediatr Clin N Am 2013; 60 (1): 209–226.

    Article  Google Scholar 

  19. Husebye ES, Kleven IA, Kroken LK, Torsvik IK, Haaland OA, Markestad T . Targeted program for provision of mother's own milk to very low birth weight infants. Pediatrics 2014; 134 (2): e489–e495.

    Article  Google Scholar 

  20. Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta-Fobes T, Hanson-Timpson TA et al. A quality improvement project to increase breast milk use in very low birth weight infants. Pediatrics 2012; 130 (6): e1679–e1687.

    Article  Google Scholar 

  21. Meier P, Patel AL, Wright K, Engstrom JL . Management of breastfeeding during and after the maternity hospitalization for late preterm infants. Clin Perinatol 2013; 40 (4): 689–705.

    Article  Google Scholar 

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Correspondence to S S Hwang.

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The authors declare no conflict of interest.

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The views presented are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Supplementary Information accompanies the paper on the Journal of Perinatology website .

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Hwang, S., Lu, E., Cui, X. et al. Home care practices for preterm and term infants after hospital discharge in Massachusetts, 2007 to 2010. J Perinatol 35, 880–884 (2015). https://doi.org/10.1038/jp.2015.90

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  • DOI: https://doi.org/10.1038/jp.2015.90

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