Development of a Web-based Intervention to Promote Pumping and Breastfeeding in a Neonatal Intensive Care Unit (NICU) Setting Among Mothers of Premature Infants

Introduction: Breastfeeding is recognized as the ideal form of nourishment for infants worldwide. However, for premature infants, the ability to coordinate sucking and swallowing may be underdeveloped, making breastfeeding difficult. In these instances, mothers often turn to mechanically expressing their breastmilk with a breastpump. Motivation to pump is generally higher in the NICU population compared to the general population. Despite positive initiation rates, continuation of pumping and/or breastfeeding until infant discharge falls below recommendations. Through conducting in-depth interviews with mothers of premature infants our aim was to identify facilitators and barriers to continued pumping. Results showed, among mothers who stopped pumping prior to infant discharge, the most commonly cited reason was diminished milk supply. 

Methods: Because self-monitoring has been found to have a positive effect on behaviors in other fields, it is hypothesized that consistent self-monitoring via a web-based platform will lead to increased duration of pumping and/or breastfeeding. Using a web-based platform allows for mothers to log pumping sessions remotely, allowing for timely feedback from IBCLCs when an issue arises.

Discussion/Results: The web-based intervention is being developed using an iterative development process, which allows for assessment of usability (using the Systems Usability Scale) of the website by potential users (mothers of premature infants and IBCLCs) from the target population prior to actual testing. Through a developmental evaluation we will be able to appropriately incorporate changes deemed necessary by potential users. The effectiveness of the web-based intervention will be pilot-tested using an RCT design (control; intervention 1; intervention 2).