{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:06Z","timestamp":1792787766365,"version":"4.5.0"},"reference-count":8,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"School of Medicine, Stanford University","award":["Department of Pediatrics Fellow Scholarship Award"],"award-info":[{"award-number":["Department of Pediatrics Fellow Scholarship Award"]}],"id":[{"id":"https:\/\/ror.org\/00f54p054","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Mother\u2019s own milk (MOM) remains the optimal nutrition for preterm infants, yet disparities persist in its provision. Building on institutional findings identifying human milk feeding disparities among preterm infants in the neonatal intensive care unit (NICU), we identified facilitators and barriers to MOM provision during NICU hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>As part of a quality improvement initiative at a California Level IV NICU, an open-ended survey was administered (August\u2013October 2025) in English or Spanish to mothers of preterm infants born at \u226432 weeks\u2019 gestational age. Questions included attitudes toward MOM, feeding practices, facilitators, and barriers to MOM provision. Emergent themes were identified through thematic analysis. This project received a Not Human Subjects Research determination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirty surveys were completed (80% English, 20% Spanish). Mean maternal age was 33 years, 73% had private insurance, and 43% were Hispanic or Latina. Facilitators of MOM provision included the following: positive attitudes toward its nutritional and immunologic benefits (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 24); lactation consultant and team-based support fostering confidence and emotional reassurance (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 19); and access to pumps and supplies in the NICU (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 16). Key barriers included the following: maternal stress spanning emotional, physical, and logistical burdens from recovery and visitation (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17); pumping challenges encompassing pain, fatigue, and equipment-related frustrations (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17); and low milk supply leading to discouragement and cessation (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 13).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite strong motivation, emotional, physical, and structural barriers limited sustained MOM provision. These findings identify actionable opportunities to strengthen NICU lactation support through earlier and more accessible services, reduced logistical barriers, and individualized psychosocial support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261490300","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:53:31Z","timestamp":1789674811000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cIt\u2019s Hard but Worth It\u201d: Facilitators and Barriers to Providing Mother\u2019s Own Milk in the NI CU"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4184-4723","authenticated-orcid":false,"given":"Igbagbosanmi","family":"Olatunji","sequence":"first","affiliation":[{"name":"Division of Neonatal and Developmental Medicine, Lucile Packard Children\u2019s Hospital, Stanford University School of Medicine, Palo Alto, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey J.","family":"Buckland","sequence":"additional","affiliation":[{"name":"Division of Neonatal and Developmental Medicine, Lucile Packard Children\u2019s Hospital, Stanford University School of Medicine, Palo Alto, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia L.","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"Division of Neonatal and Developmental Medicine, Lucile Packard Children\u2019s Hospital, Stanford University School of Medicine, Palo Alto, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Scala","sequence":"additional","affiliation":[{"name":"Division of Neonatal and Developmental Medicine, Lucile Packard Children\u2019s Hospital, Stanford University School of Medicine, Palo Alto, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.11.020"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-01263-y"},{"key":"e_1_3_2_4_1","article-title":"Socioeconomic disparities in human milk nutrition patterns among preterm infants","author":"Oredein I","year":"2025","unstructured":"3.Oredein I, , Lazarus M, , Land R, et al. Socioeconomic disparities in human milk nutrition patterns among preterm infants. Am J Perinatology 2025; doi: 10.21203\/rs.3.rs-7634913\/v1PREPRINT (Version 1) available at Research Square","journal-title":"Am J Perinatology"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semperi.2020.151381"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/00981389.2019.1629152"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2026-078282"},{"key":"e_1_3_2_8_1","unstructured":"7.United States Census Bureau. QuickFacts California 2025. Available from: https:\/\/www.census.gov\/quickfacts\/fact\/table\/CA\/PST045225 [Last accessed: Aug5 2026]."},{"key":"e_1_3_2_9_1","unstructured":"8.California Department of Health Care Access and Information. Preferred languages spoken in California Healthcare Facilities Available from: https:\/\/hcai.ca.gov\/visualizations\/preferred-languages-spoken-in-california-healthcare-facilities\/#key-findings [Last accessed: Aug5 2026]."}],"container-title":["Breastfeeding Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15568253261490300","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15568253261490300","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15568253261490300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T09:46:25Z","timestamp":1789897585000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15568253261490300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":8,"alternative-id":["10.1177\/15568253261490300"],"URL":"https:\/\/doi.org\/10.1177\/15568253261490300","relation":{},"ISSN":["1556-8253","1556-8342"],"issn-type":[{"value":"1556-8253","type":"print"},{"value":"1556-8342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"15568253261490300"}}