Determinants of Successful Direct Breastfeeding at Hospital Discharge in High-Risk Premature Infants
Lara Casey1, Sandra Fucile1, Kimberly E Dow1
1Department of Pediatrics, Kingston Health Sciences Centre, Queen's University , Kingston, Ontario, Canada .
Insights
Older maternal age and initiating direct breastfeeding (DBF) at the first oral feed are key factors for successful breastfeeding in preterm infants. Early support is crucial for improving breastfeeding outcomes.
Area of Science:
- Neonatal Intensive Care
- Pediatrics
- Lactation Science
Background:
- Breastfeeding preterm infants faces significant barriers, impacting established rates.
- Maternal intention to breastfeed does not always translate to successful infant feeding outcomes.
Purpose of the Study:
- To identify factors predicting successful direct breastfeeding (DBF) at hospital discharge for preterm infants.
- To analyze infant, maternal, and feeding-related variables associated with breastfeeding success.
Main Methods:
- Retrospective chart review of 69 preterm infants (<34 weeks gestational age) in NICU.
- Statistical analysis (chi-square, t-test, logistic regression) to determine predictive factors for DBF.
Main Results:
- Successful DBF at discharge was observed in 64% of infants.
- Older maternal age and DBF at the first oral feed were significant predictors of successful breastfeeding.
- Reduced milk supply was a primary reason for breastfeeding failure in 36% of cases.
Conclusions:
- Maternal age and the method of the infant's first oral feed are critical predictors of breastfeeding success.
- Encouraging breastfeeding at the first oral attempt and providing strategic support are vital for preterm infants.
Background:
Despite a mother's intention to breastfeed, there are many barriers to feeding preterm infants that decrease breastfeeding rates.
Objective:
The objective of this research was to determine factors associated with successful direct breastfeeding (DBF) of the preterm infant at hospital discharge.
Materials And Methods:
A retrospective chart review of 69 preterm (<34 weeks' gestational age) infants in the neonatal intensive care unit, whose mothers intended to breastfeed, was conducted. Infant-, mother-, and feeding-related factors were examined by chi-square or t test for their relationship with breastfeeding success, and by multiple logistic regression to identify predictive factors.
Results:
Successful DBF at discharge occurred in 64%. Mothers of infants who were breastfed were older (p < 0.0001); had less psychiatric illness (p = 0.03); and were less likely to smoke (p < 0.0001) and use recreational drugs (p = 0.04). The infants had higher birth weights (p = 0.03) and lower incidence of bronchopulmonary dysplasia (p = 0.04). A higher proportion of infants received DBF at their first oral feed (p < 0.001), and were discharged earlier (p = 0.03). Reduced milk supply was cited for breastfeeding failure in 36%. Older maternal age (odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.02-1.51) and DBF at the first oral feed (OR = 7.72, 95% CI 1.37-43.6) were associated with successful DBF at discharge.
Conclusion:
Maternal age and method of first oral feed are critical predictors of breastfeeding success in preterm infants. Mothers should be encouraged to breastfeed at the infant's first oral attempt and strategic breastfeeding support should be provided before initiation of oral feeding.
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