Changes in the prevalence of breast feeding in preterm infants discharged from neonatal units: a register study over
Jenny Ericson1,2,3, Renée Flacking4, Lena Hellström-Westas1
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Insights
Exclusive breastfeeding rates for preterm infants in Sweden have significantly declined, particularly for extremely preterm babies. This trend raises concerns for neonatal units aiming to support breastfeeding practices.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Public health
Background:
- Exclusive breastfeeding is crucial for infant health.
- Preterm infants have unique nutritional needs.
- Declining breastfeeding rates in preterm infants pose a public health concern.
Purpose of the Study:
- To investigate trends in exclusive breastfeeding at discharge among preterm infants in Sweden.
- To identify associated factors contributing to these trends.
Main Methods:
- Retrospective register study using data from the Swedish Neonatal Quality Register.
- Analysis of 29,445 preterm infants (gestational age <37 weeks) born between 2004-2013.
- Stratified analysis by gestational age groups (extremely, very, and moderately preterm).
Main Results:
- A statistically significant decline in exclusive breastfeeding at discharge was observed across all preterm groups from 2004-2013.
- The most pronounced decrease was seen in extremely preterm infants (55% to 16%).
- Factors such as small for gestational age and maternal mental illness were associated with the decline but did not fully explain it.
Conclusions:
- Sweden has seen a substantial decrease in exclusive breastfeeding rates for preterm infants over the past decade.
- The identified factors account for only a small portion of this decline.
- The declining trend necessitates a focus on strategies for neonatal units to better support and promote breastfeeding for preterm infants.
Objective:
There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants.
Design, Setting And Participants:
This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004-2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups.
Results:
From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22-27 weeks) from 55% to 16%, in very preterm (GA 28-31 weeks) from 41% to 34% and in moderately preterm infants (GA 32-36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding and which became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants).
Conclusions:
In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding.
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