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CompletedNCT04540575ReDiMOMUpdated Feb 20, 2026

Reducing Disparity in Receipt of Mother's Own Milk in Very Low Birth Weight Infants

An interventional study of NICU Acquires MOM and Mother Provides MOM in Pumping, Breast, Milk, Human and Infant, Very Low Birth Weight, sponsored by Rush University Medical Center. Completed at 1 site in United States. Per ClinicalTrials.gov, last updated 2026-02-20.

Sponsored by Rush University Medical Center · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
362
Allocation
Randomized
Sex
All
01

Study summary

In the US, the burden of very low birth weight (VLBW; \<1500 g) birth is borne disproportionately by black (non-Hispanic black/African American) mothers who are 2.2-2.6 times more likely than nonblack mothers to deliver VLBW infants. This disparity is amplified because black VLBW infants are significantly less likely to receive mother's own milk (MOM) feedings from birth until neonatal intensive care unit (NICU) discharge than nonblack infants, which adds to the lifelong burden of VLBW birth with increased risk of morbidities and greater costs. Pumping is associated with out-of-pocket and opportunity costs that are borne by mothers, unlike donor human milk and formula, which are paid for by NICUs.

This innovative trial will determine the effectiveness of the intervention in reducing the disparity in MOM feedings and provide an economic analysis of the interventions, yielding critical data impacting generalizability and likelihood of implementation of results. The investigators hypothesize that mothers who receive intervention will have greater pumping volume and duration and their infants will be more likely to receive MOM at NICU discharge compared to mothers who receive standard of care lactation care and their infants.

Read the detailed description

In the US, the burden of very low birth weight (VLBW; \<1500 g) birth is borne disproportionately by black (non-Hispanic black/African American) mothers who are 2.2-2.6 times more likely than nonblack mothers to deliver VLBW infants. This disparity is amplified because black VLBW infants are significantly less likely to receive mother's own milk (MOM) feedings from birth until neonatal intensive care unit (NICU) discharge than nonblack infants, which adds to the lifelong burden of VLBW birth with increased risk of morbidities and greater costs. Even though black mothers of VLBW infants initiate MOM provision at rates similar to nonblack mothers and have similar goals to sustain MOM provision through to NICU discharge, there is a significant disparity in MOM feedings at NICU discharge. Only the mother can mitigate the disparity in MOM feedings at NICU discharge for the VLBW infant by: 1) sustaining breast pump use (6-8 times/day) for the entire NICU hospitalization (average = 73 days), and 2) transporting the MOM that is pumped in the home to the NICU for infant feedings. Pumping is associated with out-of-pocket and opportunity costs that are borne by mothers, unlike donor human milk and formula, which are paid for by NICUs.

The ReDiMOM randomized controlled trial will implement and evaluate an intervention (NICU acquires MOM) developed to offset the aforementioned costs that serve as barriers to sustaining MOM feedings. The intervention includes free hospital-grade electric breast pump, pickup of MOM, and payment for opportunity costs. The intervention will be evaluated in comparison to the current standard of care (mother provides MOM). Data will be collected from several sources including REDCap surveys, data extraction from the electronic medical record and hospital decision support/financial cost accounting system, smart breast pump data and measurement of pumped MOM volume.

This innovative trial will determine the effectiveness of the intervention in reducing the disparity in MOM feedings and provide an economic analysis of the interventions, yielding critical data impacting generalizability and likelihood of implementation of results. The investigators hypothesize that mothers who receive intervention will have greater pumping volume and duration and their infants will be more likely to receive MOM at NICU discharge compared to mothers who receive standard of care lactation care and their infants.

02

Conditions studied

  • Pumping, Breast
  • Milk, Human
  • Infant, Very Low Birth Weight
  • Preterm Birth

Keywords

  • Race/ethnicity
  • Mother's Own Milk
  • Disparity
  • Economic
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • MATERNAL: Delivery, or anticipated delivery, of infant with gestational age \< 32 0/7 weeks at Rush, age ≥18 years, US citizen or legal resident, fluent in English or Spanish
  • INFANT: Birth gestational age (GA)\< 32 0/7 weeks, no significant congenital anomalies or chromosomal defects, \<144 hours of age at enrollment, multiples may be included

Exclusion criteria

Exclusion Criteria:

  • Mothers with health conditions that are incompatible with milk provision per the clinical judgment of the NICU attending caring for the infant, mother is less than 18 years of age, mother has participated in this study with a previous pregnancy, mother is enrolled in another study that impacts lactation, in the neonatologist's opinion the infant is unlikely to survive, or mother is coronavirus (COVID-19) positive and unable to visit the NICU due to quarantine or infection-control requirements during the 144-hour post-delivery randomization window.
04

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
362 participants (actual)

Study arms

  • Active comparator
    Mother Provides MOM

    Receive Rush NICU standard of care lactation support

    Behavioral: Mother Provides MOM

  • Experimental
    NICU Acquires MOM

    Receive economic interventions in addition to Rush NICU standard of care lactation support

    Behavioral: NICU Acquires MOM · Behavioral: Mother Provides MOM

Interventions

  • BehavioralNICU Acquires MOM

    Mother receives 1) hospital-grade electric smart breast pump for home use at no charge to the mother while the infant is in the NICU and the mother continues to pump; 2) free pickup of expressed MOM from home to transport to NICU 2-3 times per week during weekdays as needed; 3) receives payment for opportunity costs of pumping and handling milk at $24.00/day for each day that the mother pumps during her infant's NICU stay

  • BehavioralMother Provides MOM

    Mother receives standard Rush NICU lactation care

05

What researchers measure

Primary outcomes

  1. Receipt of MOM at NICU Discharge

    Determined from the last full day of hospitalization and categorized as "Yes" if the infant received any or exclusive MOM and "No" if the infant received only formula.

    Time frame: Through study completion, an average of 10 weeks

Secondary outcomes

  1. Receipt of any MOM

    Determined from the entire hospitalization and categorized as "Yes" if the infant received any or exclusive MOM and "No" if the never received MOM during the hospitalization.

    Time frame: Through study completion, an average of 10 weeks

  2. Duration of MOM feedings

    Determined from the entire hospitalization and calculated as the number of days infant received any MOM.

    Time frame: Through study completion, an average of 10 weeks

  3. Cumulative dose of MOM feedings

    Determined from the entire hospitalization and calculated as the total volume of MOM received by the infant.

    Time frame: Through study completion, an average of 10 weeks

  4. Duration of MOM pumped

    Determined from the entire hospitalization and calculated as the number of days mother pumped MOM.

    Time frame: Through study completion, an average of 10 weeks

  5. Volume of MOM pumped

    Determined from the entire hospitalization and calculated as the total volume of MOM pumped by the mother.

    Time frame: Through study completion, an average of 10 weeks

  6. Healthcare system costs

    Costs borne by healthcare providers or third-party payers, including the cost of the hospital stay and donor human milk and formula costs.

    Time frame: Through study completion, an average of 10 weeks

  7. Participant costs in US Dollars

    Participant costs will be measured in dollars and will be the sum of opportunity costs (i.e., mother's time spent pumping (mothers in control group only), time off work to visit NICU), caregiving costs for other children or adults when mother or partner visits the NICU, transportation costs, lodging costs, and other out-of-pocket costs

    Time frame: Through study completion, an average of 10 weeks

  8. ReDiMOM Intervention Costs in US Dollars

    The costs of the intervention including milk pick-up, free provision of pumps, and opportunity costs payments for the intervention arm.

    Time frame: Through study completion, an average of 10 weeks

06

Study locations

1 site
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
07

References and documents

Publications

  • Johnson TJ, Patel AL, Bigger HR, Engstrom JL, Meier PP. Economic benefits and costs of human milk feedings: a strategy to reduce the risk of prematurity-related morbidities in very-low-birth-weight infants. Adv Nutr. 2014 Mar 1;5(2):207-12. doi: 10.3945/an.113.004788. PubMed 24618763 ↗
  • Patel AL, Schoeny ME, Hoban R, Johnson TJ, Bigger H, Engstrom JL, Fleurant E, Riley B, Meier PP. Mediators of racial and ethnic disparity in mother's own milk feeding in very low birth weight infants. Pediatr Res. 2019 Apr;85(5):662-670. doi: 10.1038/s41390-019-0290-2. Epub 2019 Jan 18. PubMed 30679795 ↗
  • Patra K, Hamilton M, Johnson TJ, Greene M, Dabrowski E, Meier PP, Patel AL. NICU Human Milk Dose and 20-Month Neurodevelopmental Outcome in Very Low Birth Weight Infants. Neonatology. 2017;112(4):330-336. doi: 10.1159/000475834. Epub 2017 Aug 3. PubMed 28768286 ↗
  • Jegier BJ, Johnson TJ, Engstrom JL, Patel AL, Loera F, Meier P. The institutional cost of acquiring 100 mL of human milk for very low birth weight infants in the neonatal intensive care unit. J Hum Lact. 2013 Aug;29(3):390-9. doi: 10.1177/0890334413491629. Epub 2013 Jun 17. PubMed 23776080 ↗
  • Profit J, Gould JB, Bennett M, Goldstein BA, Draper D, Phibbs CS, Lee HC. Racial/Ethnic Disparity in NICU Quality of Care Delivery. Pediatrics. 2017 Sep;140(3):e20170918. doi: 10.1542/peds.2017-0918. PubMed 28847984 ↗
  • Trang S, Zupancic JAF, Unger S, Kiss A, Bando N, Wong S, Gibbins S, O'Connor DL; GTA DoMINO Feeding Group. Cost-Effectiveness of Supplemental Donor Milk Versus Formula for Very Low Birth Weight Infants. Pediatrics. 2018 Mar;141(3):e20170737. doi: 10.1542/peds.2017-0737. PubMed 29490909 ↗
  • Krubiner CB, Merritt MW. Which strings attached: ethical considerations for selecting appropriate conditionalities in conditional cash transfer programmes. J Med Ethics. 2017 Mar;43(3):167-176. doi: 10.1136/medethics-2016-103386. Epub 2016 Oct 5. PubMed 27707877 ↗
  • Belfort MB, Anderson PJ, Nowak VA, Lee KJ, Molesworth C, Thompson DK, Doyle LW, Inder TE. Breast Milk Feeding, Brain Development, and Neurocognitive Outcomes: A 7-Year Longitudinal Study in Infants Born at Less Than 30 Weeks' Gestation. J Pediatr. 2016 Oct;177:133-139.e1. doi: 10.1016/j.jpeds.2016.06.045. Epub 2016 Jul 29. PubMed 27480198 ↗
  • Relton C, Strong M, Thomas KJ, Whelan B, Walters SJ, Burrows J, Scott E, Viksveen P, Johnson M, Baston H, Fox-Rushby J, Anokye N, Umney D, Renfrew MJ. Effect of Financial Incentives on Breastfeeding: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2018 Feb 5;172(2):e174523. doi: 10.1001/jamapediatrics.2017.4523. Epub 2018 Feb 5. PubMed 29228160 ↗
  • Washio Y, Humphreys M, Colchado E, Sierra-Ortiz M, Zhang Z, Collins BN, Kilby LM, Chapman DJ, Higgins ST, Kirby KC. Incentive-based Intervention to Maintain Breastfeeding Among Low-income Puerto Rican Mothers. Pediatrics. 2017 Mar;139(3):e20163119. doi: 10.1542/peds.2016-3119. Epub 2017 Feb 6. PubMed 28167511 ↗
  • Johnson TJ, Meier PP, Schoeny ME, Bucek A, Janes JE, Kwiek JJ, Zupancic JAF, Keim SA, Patel AL. Study protocol for reducing disparity in receipt of mother's own milk in very low birth weight infants (ReDiMOM): a randomized trial to improve adherence to sustained maternal breast pump use. BMC Pediatr. 2022 Jan 7;22(1):27. doi: 10.1186/s12887-021-03088-y. PubMed 34996401 ↗

Study documents

  • Informed consent form · Oct 6, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Individual participant data that underlie the results reported in this article, after deidentification

Supporting information: Study protocol, Icf

08

Registry details

Key details

Study ID
NCT04540575
Lead sponsor
Rush University Medical Center
Collaborators
National Institute on Minority Health and Health Disparities (NIMHD), Ohio State University
Responsible party
Sponsor
First posted
Sep 7, 2020
Start date
Dec 3, 2020
Primary completion
Dec 31, 2025
Completion
Dec 31, 2025
Last update
Feb 20, 2026

Study contacts

Aloka L Patel, MD
principal investigator · Rush University Medical Center, Department of Pediatrics
Tricia J Johnson, PhD
principal investigator · Rush University Medical Center, Department of Health Systems Management

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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