First Feed Type Is Associated With Birth/Lactating Parent's Own Milk Use During NICU Stay Among Infants Who Require Surgery.

This was an observational record review, so it cannot show that the first NICU feed caused higher own-milk use or better outcomes. It was a single-center study at a Level IV NICU, and infants were admitted from outside hospitals, so the findings may not apply to other units or hospitals. The sample was small and fixed, and missing data led to exclusions: 4 infants were excluded from the discharge analysis and 17 were excluded from correlational and regression analyses. The study did not know the birth/lactating parent's feeding intentions, so it could not separate parents who intended to provide own milk from those who did not. Feed documentation varied between nurses, and the paper says this made it difficult to distinguish own-milk feeds that were supplemented or fortified with formula. The record review did not capture age at the first enteral feed, which may have affected the feeding pattern results. Pasteurized donor human milk was not used in this sample, so the findings do not address that option. The authors note the analysis may have been underpowered to detect effects of some covariates.

Do not conclude that changing the first NICU feed to the birth/lactating parent's own milk will cause more own-milk feeding or better infant outcomes. This was an observational record review, and the paper states causality cannot be inferred.