Improving Lactation Success in Mothers of Critically Infants

Overview

The purpose of this study is to determine the feasibility and potential benefits of a mHealth intervention to increase BM pumping frequency and BM production in mothers delivering critically ill infants admitted to the neonatal intensive care unit

Full Title of Study: “Improving Lactation Success in Mothers of Critically Infants Using Personalized Real-Time Biomarker Based Text Messages”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: September 3, 2025

Detailed Description

Although compelling evidence exists that breast milk (BM) improves infant health, mothers of critically ill infants frequently produce insufficient amounts BM which is likely due to inadequate daily breast pumping frequency. BM sodium levels are an easy to measure biomarker of pumping frequency and providing this information to mothers via text messaging may increase their pumping frequency and BM production. Therefore, the overall objective of this pilot study is to determine the feasibility and potential benefits of a mHealth intervention to increase BM pumping frequency and BM production in mothers delivering critically ill infants admitted to the neonatal intensive care unit (NICU) at University of Florida Health. Specific aims include (1) evaluate the feasibility of a mHealth intervention to increase BM pumping frequency and BM production and (2) assess whether results indicate a signal of effectiveness supporting a subsequent adequately powered randomized clinical trial (RCT). Following delivery, 50 mothers of critically ill infants admitted to the NICU will be randomized to one of two groups. The Enhanced Intervention Group will receive text messages including both general lactation information and a personalized message consisting of the mother's BM sodium level, pumping frequency and feedback regarding pumping frequency. The Standard Intervention Group will receive only general lactation information. Results will be used to revise the intervention and study processes and to estimate outcome measurement variability and effect sizes needed for sample size calculations for an adequately powered RCT.

Interventions

  • Behavioral: Text message including biomarker of breast pumping adequacy
    • The intervention group will be sent one message that includes general information pertinent to all mothers expressing BM for their infants and one personalized real-time biomarker based message which will include the sodium level contained in the BM since the previous message, the number of times pumped on those days and will either congratulate the participant on how well the participant is pumping BM for the infant or how many more times per day the participant needs to pump to decrease the BM sodium level and increase BM production

Arms, Groups and Cohorts

  • Experimental: Intervention group
    • Will be sent one message that includes general information pertinent to all mothers expressing BM for their infants and one personalized real-time biomarker based message which will include the sodium level contained in the BM since the previous message, the number of times pumped on those days and will either congratulate the participant on how well the is pumping BM for the infant or how many more times per day the participant needs to pump to decrease the BM sodium level and increase BM production
  • No Intervention: Control group
    • Will only be sent text messages that include the same general lactation information sent to the treatment group

Clinical Trial Outcome Measures

Primary Measures

  • Volume of breast milk (BM)
    • Time Frame: Up to 2 weeks
    • All BM will be weighed (1 mg of BM = 1 mL) by a BM technician and the weight recorded in the infant’s medical record. BM will be weighed on a portable digital scale accurate to within 0.1 grams.

Secondary Measures

  • Number of breast pumping episodes
    • Time Frame: Up to 2 weeks
    • Daily number of pumping sessions as recorded in the mother’s log book and verified by examination of the date and time on vials of pumped BM.
  • Breast milk sodium level
    • Time Frame: Up to 2 weeks
    • Daily BM sodium levels beginning when the mother has produced at least 5mL of BM and continuing for the two week study.

Participating in This Clinical Trial

Inclusion Criteria

  • stated intent to provide BM to the infant – infant not expected to be stable enough to bottle/breastfeed for > 14 days – owns a mobile phone with unrestricted SMS capability. – English speaking Exclusion Criteria:

  • known illicit drug use – breast reduction or augmentation – positive HIV status – does not anticipate being able to bring BM to the NICU at least 4X/week – infant not expected to live > 7 days following delivery – COVID-19 positive

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of Florida
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Leslie A Parker, MD, Principal Investigator, University of Florida

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