The Association of Low Social Support with Breast Milk Expression in Low-Income Mother-Preterm Infant Dyads.

BACKGROUND: Premature infants benefit from receiving expressed breast milk (BM), but expressing breast milk is difficult for new mothers. Little is known about mothers' social support and BM expression during the premature infant's hospital stay. OBJECTIVE: We examined whether low maternal social support was associated with breast milk expression initiation and low breast milk expression among low-income mothers of premature infants. METHODS: Maternal intake interview data and daily infant data on proportion of nutrition from BM during hospitalization were analyzed from a larger randomized trial testing a developmental intervention on 181 mother-premature infant dyads with at least 2 of 10 social-environmental risks. Multivariable modified Poisson regression was used to examine the relationship between social support (Personal Resources Questionnaire 2000; dichotomized as low for lowest quartile), initiation (any breast milk expressed vs none), and low breast milk expression (if BM was < 30% of infant total milk/formula intake during hospitalization). RESULTS: Breast milk expression was initiated by 70.2% of mothers, and 32.3% of those mothers had low breast milk expression. In adjusted multivariable analyses, social support did not relate to the initiation of breast milk expression but was significantly associated with low breast milk expression among mothers who initiated (adjusted relative risk = 1.57; 95% confidence interval, 1.00-2.47). CONCLUSION: Low social support was not associated with initiation but was associated with low breast milk expression during hospitalization. Interventions to enhance social support for mothers of premature infants, especially those reporting low social support from family and friends, may increase in-hospital expression and long-term breastfeeding.

Concurrent validity of the TIMP and the Bayley III scales at 6 weeks corrected age.

PURPOSE: Examine agreement between the Test of Infant Motor Performance (TIMP) and the Bayley III. METHODS: One hundred forty-five infants born at 29 to 34 weeks gestation with socioenvironmental risk factors were tested on the TIMP and Bayley III at 6 weeks corrected age (CA). Scores were correlated to assess convergence/divergence of content. Decision analysis using a cutoff of the mean on the Bayley Motor Composite and -0.5 and -1 SD from the mean on the TIMP assessed agreement on delay/nondelay. RESULTS: The TIMP-Bayley Motor Composite correlation was 0.546, with Cognitive was 0.310, and with Language was 0.281. Nine percent of infants scored less than -1.0 SD on the TIMP, while no child scored less than -1 SD on the Bayley Motor scale (sensitivity, 31%). CONCLUSIONS: Convergent validity between the TIMP and the Bayley Motor scale was demonstrated, but no infant showed delay on any Bayley scale. The TIMP is preferred for early assessment of infants.