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Breastfeeding among patients with congenital malformations
Mario Enrique Rendón-Macías1, Graciela Castañeda-Muciño, José Jesús Cruz
1Infants Department, Hospital de Pediatría, Centro Médico Nacional Siglo XXI (CMN-SXXI), Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico. enrendon@df1.telmex.net.mx
Insights
Breastfeeding is less common in infants with major congenital malformations. Factors like maternal decisions and prenatal education influence initiation, while separation and low birth weight hinder it.
Area of Science:
- Pediatric Health
- Neonatal Care
- Lactation Studies
Background:
- Major congenital malformations present unique challenges for infant feeding.
- Understanding breastfeeding patterns in this population is crucial for optimizing infant nutrition and health outcomes.
Purpose of the Study:
- To determine the frequency of breastfeeding among infants with major congenital malformations.
- To identify factors associated with the initiation and early cessation of breastfeeding in this vulnerable group.
Main Methods:
- A descriptive cohort study was conducted at a tertiary-care pediatric hospital.
- Infants under 20 days with major congenital malformations were categorized into exclusively breastfed (EB), alternating breast and formula (ABF), or exclusively formula (EF) groups.
- Follow-up interviews were conducted monthly for 6 months to track feeding patterns and reasons for changes.
Main Results:
- At 6 months, only 18.1% of infants were exclusively breastfed, a lower frequency than in healthy infants.
- Maternal prenatal decisions and attendance at breastfeeding sessions were linked to initiation.
- Mother-child separation and low birth weight were associated with reduced breastfeeding, with perceived low milk production being the primary reason for cessation.
Conclusions:
- Breastfeeding frequency and duration are lower in infants with congenital malformations compared to healthy peers.
- Healthcare professionals should actively promote and support breastfeeding in infants with major congenital malformations.
- Addressing factors like mother-child separation and perceived milk insufficiency is vital for improving breastfeeding outcomes.
Background:
This study was undertaken in order to 1) determine the frequency of infants with major congenital malformations who are breastfed and 2) identify factors associated with initiating and early weaning of breastfeeding.
Methods:
We conducted a descriptive cohort study at a tertiary-care pediatric hospital. Subjects included infants <20 days of age with major congenital malformations. According to the feeding pattern, the following three groups were identified: exclusively breastfed (EB); alternating breast and formula (ABF), and exclusively formula (EF).Follow-up interviews were conducted on a monthly basis until the infants were 6 months of age. The feeding pattern was determined during each visit. Reasons for changing the breastfeeding pattern were explored.
Results:
A total of 120 newborns were recruited. At the time of the first interview, 29.2% were EF, 47.5% EB, and 23.3% ABF. By 6 months of age, the feeding patterns were 8.6, 18.1, and 73.3%, respectively. Median length of breastfeeding was 3 months (range: 1-6 months). The maternal prenatal decision to breastfeed (odds ratio [OR] 0.11, 95% confidence interval [95% CI] 0.02-0.52) and attendance at prenatal breastfeeding sessions (OR 0.30, 95% CI 0.17-0.87) were associated with breastfeeding initiation. Conversely, mother-child separation (OR 3.07, 95% CI 1.36-7.01) and low birth weight (OR 2.98, 95% CI 1.36-6.48) were associated with a lack of breastfeeding. The mother's sensation of low milk production was the main reason to change or to stop breastfeeding.
Conclusions:
In this study, breastfeeding frequency and length among infants with congenital malformations during the first 6 months of life were lower than previously published reports of breastfeeding obtained from healthy infants. Healthcare professionals must encourage breastfeeding in these infants.