AUTHOR=Jiang Chengyao , Chu Xue , Yu Zhangbin , Chen Xiaohui , Zhang Jun , Han Shuping 

TITLE=Effects of a WeChat Mini-Program on Human Milk Feeding Rates in a Neonatal Intensive Care Unit During the COVID-19 Pandemic

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.888683

DOI=10.3389/fped.2022.888683

ISSN=2296-2360

ABSTRACT=Objective: We investigated changes in maternal daily milk pumping frequency and milk volume per expression and their derived lactation indicators, as well as human milk (HM) feeding status with focus on amount and rates in preterm infants admitted to the neonatal intensive care unit (NICU) after using a WeChat mini-program during the 2019 coronavirus (COVID-19) pandemic.

Methods: The study was conducted with 482 mothers and their 544 babies. We prospectively enrolled mothers and infants with birth weight <1500g or gestational age <32 weeks born in 2020, and retrospectively included the same population in 2019. All study subjects were classified into three subgroups: pre-pandemic (PP, 2019), early pandemic (EP, January to April 2020) and late pandemic (LP, May to December 2020). From January 1 2020, mothers recorded in an online pumping diary using the WeChat mini-program. We obtained the infants’ feeding information from an online database for analysis.

Results: Maternal lactation indicators did not change significantly. However, 56.7% (139/245) of mothers achieved milk volume ≥500 ml/d (CTV) in PP, 58.9% (33/156) in EP, and a slight increase to 60.7% (91/150) in LP. Maternal pumping frequency remained about eight times/d. In LP, daily milk volume was higher than the other two from day 4 and mothers achieved CTV by day 12, which was achieved in the other two groups by 13-14 days. There were several statistical differences in the amount and rates of feeding between groups, especially about HM and donor milk feeding, with the vast majority being decreased during EP, while during LP they returned to PP levels. Pleasingly, median average daily dose of HM at 1-28 days was highest in LP (LP 87.8 vs PP 75.5 or EP 52.6 ml/kg/d, Pcorrected <0.001). In addition, most categorical indicators decreased in EP and recovered in LP.

Conclusions: An education model based on WeChat could aid lactation education and management in mothers of preterm infants to maintain healthy lactation. The model, together with optimized management strategies, can ensure that HM feeding rate is not compromised in vulnerable high-risk infants during NICU hospitalization in a public health emergency, like the COVID-19 pandemic.