Neonatal hyperoxia leads to cardiac mitochondria abnormalitis

Methods Used: A multidisciplinary quality improvement group was formed to improve rates of VLBW infants discharged from the NICU with a continued supply of MOM.Multiple interventions were implemented, and infant discharge diet was measured before (October 2021-February 2022) and after intervention (March 2022-August 2022).Secondary outcome measures included pumping within six hours postpartum, overall coming to volume (CTV) at 14 days postpartum (goal of greater than or equal to 500 ml per day of expressed breast milk), and CTV based on insurance.Summary of Results: Milk expression initiation times decreased from baseline mean (7.9 hours) to intervention period (6.4 hours; p = 0.109).Mothers who initiated pumping at or before six hours postpartum produced more MOM at 14 days (447 ml) compared to mothers who initiated pumping after 6 hours (328 ml; p = 0.038).Overall CTV at 14 days improved from baseline (331 ml) to intervention period (446 ml; p = 0.062).Medicaid patient CTV increased slightly without statistically significant change while patients with non-Medicaid payer sources improved from baseline (263 ml) to intervention period (596 ml; p = 0.003).A chi-square test of independence was performed to examine the relation between the infants' discharge diet with any MOM before and after intervention.The relation between these variables was significant, X 2 (1, N = 114) = 4.232, p = 0.04.Conclusions: Implementation of antenatal lactation consults and discussions with NICU providers resulted in an improvement of mothers who pump within six hours postpartum.CTV based on pumping initiation time was statistically significant though it is not a sole indicator that a mother will achieve goal CTV at 14 days postpartum.Medicaid insurance status was associated with fewer gains in CTV indicating that future efforts may be more effective by addressing perinatal health disparities and social determinants of health.