(38) Characteristics of Mother’s Milk Donation to a Human Milk Bank During Bereavement

Mahati Pidaparti, Indiana University, United States; Grace Knowles, Lurie Children's Hospital, Chicago, IL, United States; Natalia Henner, Ann & Robert H. Lurie Children’s Hospital of Chicago, United States; Jessica T. Fry, Lurie Children's Hospital of Chicago/Northwestern University, Chicago, IL, United States; Summer G. Kelly, Mothers' Milk Bank of the Western Great Lakes, Elk Grove Village, IL, United States; Jinnene Hoggarth, Mothers' Milk Bank of the Western Great Lakes, Elk Grove Village, IL, United States; Daniel Robinson, Northwestern University The Feinberg School of Medicine, United States

Background: Bereaved mothers express positive experiences donating their breast milk and negative feedback when not informed of opportunities to donate. Predictors of whether these mothers donate milk are unknown, impairing efforts to optimize support in completing donation.

Objectives: To define clinical circumstances associated with completion of mother’s milk (MM) donation during bereavement.

Design/Methods: A retrospective cohort study enrolled dyads of bereaved mothers and their deceased children if a child’s death occurred on site at Lurie Children’s Hospital in 2016–2020, the child was receiving MM and age at death was < 24 months. Indicators of MM exposure included either condition of: 1. during the admission in which death occurred, child’s electronic health record (EHR) showed orders for label for bottles of MM; 2. the Illinois milk bank accredited by the Human Milk Banking Association of North America (MB) documented a mother initiating donation. Details abstracted from the MB database and EHR were: donation status (not initiated after child’s death; initiated/not completed; completed); milk volumes obtained by MB; dyad clinical characteristics. The primary outcome was completed milk donation to the MB. Multivariate logistic regression measured associations between clinical variables and completed status. Values reported are median (IQR) or odds ratio (95% CI).

Results: Of 124 deceased children with MM exposure, 34 mothers (28%) completed MM donation and each mother donated a median 7,212 (2,007-22,068) mL (Tables 1, 2). Of the 35 children, a parent’s self-reported race/ethnicity in the child’s EHR was most commonly Caucasian as compared to African American (AA) or Asian (Table 1). Most deaths occurred in the neonatal intensive care unit (Table 1). Referenced to mothers of Caucasian children, being a mother of an AA or Asian child was independently associated with lower odds of completing donation (Table 3). There was no difference in odds of donating milk based on inpatient unit where death occurred or primigravid status of mothers. Referenced to mothers delivering full-term infants, mothers delivering early preterm infant (birth prior to 34 weeks, n=20) showed higher odds of completing MM donation (Table 3).

Conclusion: Relatively few bereaved mothers of children with indicators of MM exposure completed donation after their child’s death within an acute care setting. Distinct circumstances associated with completing donation suggest opportunity to ensure bereaved mothers are uniformly informed and supported in donating.