Goose Creek native and new mom Shaneisha McQueen couldn’t wait to bring newborn daughter, Trinity Simmons, home in early July. Born earlier than expected, Trinity is McQueen's second child and was a preemie in the neonatal intensive care unit (NICU) at MUSC Shawn Jenkins Children’s Hospital (SJCH) and Pearl Tourville Women’s Pavilion (PTWP). Prior to Trinity’s discharge, McQueen learned that she could take care of something while still at the hospital – something that would give both mother and child a good start on a successful healthy life.
It’s stressful enough for new mothers of preterm infants who are managing so much in the care of their newborns while still being hospitalized. Yet a statewide mother-child support program that focuses on nutrition and a mother’s breastfeeding efforts has become an easy and convenient solution for new Lowcountry moms, their families and a caring team of neonatal physicians and experts at MUSC Children’s Health.
Starting June 30, South Carolina mothers whose babies are admitted to the NICU or cardiovascular ICU (CVICU) at the SJCH may be eligible to receive personalized nutritional support to help to feed their newborns and children up to age 5 through the South Carolina Department of Health and Environmental Control’s (SC DHEC) Women, Infants and Children (WIC) Nutrition Program. One part of WIC’s services is devoted to helping new mothers by providing them with a personal hospital-grade electric breast pump immediately after discharge to aid in breastfeeding support.
As the state’s regional comprehensive perinatal center, more than 3,000 newborns are delivered at the MUSC SJCH&PTWP, with an additional 12,000 babies born within the referral area. Among these deliveries, more than 1,000 babies are admitted to the MUSC SJCH intensive care nurseries, with 40% of neonatal transport admissions admitted to the NICU.
This collaboration was the brainchild of neonatology-perinatal medicine fellow Neal Boone, M.D., who was involved in a large quality improvement group project that evaluated mother-infant success in multiple areas. The group conducted feeding evaluations and specifically tracked mothers’ breast milk use – especially for preterm newborns in both ICUs. Previously, the breastfeeding rates among moms and their babies up until discharge and up to six months of age, as recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention, remained good, but they saw a decline in the fall of 2021. And with the current formula shortage, mothers are choosing to breastfeed their babies more. Research continues to promote the value of breastfeeding and improved health outcomes that follow, which include a decrease in hospitalizations, costs and other spending related to donated breast milk.
Boone, along with neonatologist Katie Chetta, M.D., lactation consultants and other specialists, looked at ways to improve these rates for breastfeeding mothers. They created a multistep plan to help moms to improve their breastfeeding experiences early on in their hospital stays. The effort focused on reeducation, the distribution of new pamphlets and materials and one-on-one sessions with the hospital lactation consultant team before and after birth. One problem they discovered was that mothers were being discharged with standard hand breast pumps rather than the high-quality Medela Symphony electric pumps that they used while still inpatients with their newborns. The team agreed that continued use of a hospital-grade electric breast pump after discharge improved the chances for a mother and child’s long-term breastfeeding success.
According to Molly Gros, a lactation consultant with the MUSC Women’s Care Lactation Center, the first week for a mom is critical in terms of success in breastfeeding and pumping for her infant. It’s critical for a mother’s body to continue to produce milk as her baby grows. Research has touted the value of human breast milk for newborns and especially preterm infants. Preemies typically are fed mother’s milk or donor milk during their hospital stays. Studies have confirmed the many benefits that are associated with the consumption of breastmilk, compared with formula, for preemies, including: shorter hospital stays; lower lung infection rates in conditions such as bronchopulmonary dysplasia, a breathing disorder that affects an infant’s lungs; lower risk of necrotizing enterocolitis, an intestinal disorder that affects very low-birth-weight infants; plus, breast milk helps babies’ brains to grow, resulting in higher IQs.
“If we don’t establish that brain-breast-body connection in the first two weeks, we risk insufficient milk production forever. It doesn’t get any better. That’s why this program is so important so we can establish this sooner,” said Gros.
“We were back to the basics asking, ‘How do we get electric breast pumps to moms faster?’ That’s when we approached our regional WIC staff, and we were surprised to learn they had the solution,” said Boone, of their initial meetings in 2021 and again this past January and May with Lowcountry WIC administrators.
“They were already using the WIC Service on Wheels (SoW) van across the Lowcountry so it was a no-brainer to park it at the SJCH once a week to conduct initial WIC appointments and be a registration site for mothers and infants, who were admitted in our ICUs. It’s been a huge success so far,” Boone continued.
Between June 23 and June 30, the teams scheduled five mothers, with a 100% show rate. An additional mother, who was discharged the morning of June 30, was seen the same day, thanks to MUSC’s lactation consultants who called the WIC van staff. “This has been a significant improvement, given that some mothers may wait up to two to three weeks to be seen post-delivery in their local regions. It’s definitely a win-win for mothers, WIC and MUSC Children’s Health,” Boone said.
The MUSC team has worked with WIC program manager Kristin Pillion, WIC breastfeeding coordinator Courtney Smith and others to coordinate the logistics for bringing in the WIC SoW van to SJCH. Mothers register with the lactation consultants and receive information and reminders about their visits via email and in-person consultation. Both teams hope to track patient/client outcomes and data about breastfeeding and breast milk rates that will help them to improve the quality of services, education and interventions for better mother-baby outcomes.
A mostly underutilized statewide program, the WIC program faced many challenges during the early part of the COVID-19 pandemic. As offices were short staffed and the program worked to accommodate clients, cautious mothers navigated through transportation issues, work and family challenges that prevented them from visiting their local WIC area offices. To counter this, the regional office ramped up its WIC SoW program featuring a dedicated mobile van equipped to serve as an “offices on wheels” and staffed with WIC coordinators, a nutritionist and support personnel to travel around the region to public gatherings such as Head Start centers, libraries, farmers markets and back-to-school events around their districts.
Nancy Kate Pippin is the WIC van coordinator for the Lowcountry WIC SoW program. She, Smith, a nutritionist and van administrator Alleyah Wilder coordinate the van schedule at MUSC and other Lowcountry locations where it’s used. The Lowcountry WIC SoW team is based with the Colleton County Health Department in Walterboro, but covers the entire Lowcountry region, including Charleston.
“Our main goal was to try and eliminate transportation barriers of our clients and try and meet participants where they are – that’s what we’re doing here at MUSC,” said Pippin.
Wilder drives the van and helps moms and children through the registration process, recording client information, arranging for the mother to meet with a WIC nutritionist and reviewing benefits before issuing a SC WIC card. Smith also talks to mothers about breastfeeding support, responds to questions and issues electric breast pumps.
“You can quickly tell: Mothers, with their babies in the NICU, they’re stressed and having a tough time,” said Wilder. “You can see it on the moms’ faces. Being a mother who’s had a child in the NICU, I know how that felt. It’s nice to bring a smile to a mom’s face by providing good customer service and connecting them with the things they need, like a breast pump and other interventions to help their child."
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August 04, 2022 at 12:29AM
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New partnership connects mothers of preterm babies with breast pumps, nutritional resources - Medical University of South Carolina
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