Evaluating Readiness for Human Milk Banking and Use of Donor Human Milk for Achieving Exclusive Human Milk Diets for Low Birthweight Infants

Optimizing feeding of small and sick newborns (SSNBs), those born low birthweight (LBW) or preterm, is a critical component to improve quality of care. Donor human milk (DHM) from a human milk bank (HMB) is recommended by the World Health Organization (WHO) when the mother's own milk is unavailable, yet evidence and implementation strategies for low- and middle-income country (LMIC) settings are lacking. The Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand feeding of LBW infants in LMIC settings. We conducted DHM readiness assessments at hospitals in India, Malawi, and Tanzania to determine implementation readiness and feasibility of HMB integration and/or use of DHM for LBW infants as a systems-level infant and young child feeding (IYCF) intervention.

Establishing an Integrated Human Milk Banking Model for Feeding Preterm, Small, and Sick Newborns: The Kenya Experience 

The World Health Organization (WHO) recommends donor human milk (DHM) from a human milk bank (HMB) for small and sick newborns (SSNBs) when the mother's own milk is not available. Global implementation guidelines, especially for low- and middle-income country (LMIC) settings, do not exist, making HMB expansion a challenge. The Kenya Ministry of Health (MOH) sought PATH's technical assistance to pilot the Mother Baby Friendly Initiative Plus (MBFI+) integrated HMB model with the objective of developing an LMIC-appropriate model for providing DHM and enhanced lactation support to improve exclusive human milk diets for SSNBs and reduce neonatal mortality.

Complementary Feeding and Growth among Low Birthweight Infants in the Second Half of Infancy: Results from a Multisite Observational Cohort 

This study was designed to address the high prevalence of infant undernutrition among low birthweight (LBW, 2.5kg) infants in the second half of infancy, and the dearth of evidence on the optimal transition and provision of complementary feeding and growth of LBW infants. We aimed to understand the complementary feeding profile and growth outcomes in the second half of infancy.

Provider Communication and Coaching for Parents of Hospitalized Newborns and Sick Young Infants in Kenya: Provider and Caregiver Perspectives 

The relationship between health care providers and caregivers in the management of hospitalized newborns and sick young infants (SYIs) is an essential element of quality care. Meaningful participation in caring for infants during hospitalization has demonstrated improved caregiver-infant bonding, reduced parental stress, and better confidence in caring for their children once at home. We developed a provider behavior change (PBC) approach to improve experiences of care for caregivers of hospitalized newborns in Kenya. The intervention oriented providers on communication skills and how to coach caregivers on nurturing care: optimizing nutrition, safeguarding sleep, protecting skin, minimizing stress and pain, positioning, and handling.