Breastfeeding practices among patients managed by a comprehensive cardio-obstetrics program

Area of Science:

• Cardiology
• Obstetrics
• Public Health

Background:

• Maternal cardiac disease presents unique challenges during pregnancy and postpartum.
• Breastfeeding offers significant health benefits to both mother and infant.
• Comprehensive cardio-obstetrics programs aim to optimize care for pregnant individuals with heart conditions.

Purpose of the Study:

• To evaluate breastfeeding intent, discharge rates, and continued breastfeeding at follow-up.
• To stratify these outcomes by the severity of maternal cardiac disease (mWHO functional class).
• To assess the effectiveness of a cardio-obstetrics program in supporting breastfeeding in this high-risk population.

Main Methods:

• Retrospective cohort study of 147 patients managed in a cardio-obstetrics program.
• Inclusion criteria: ≥1 prenatal visit with the Cardio-Obstetrics team and delivery at UAB.
• Outcomes assessed: intent to breastfeed, breastfeeding at discharge, and breastfeeding at postpartum visit, compared between mWHO class I-II and mWHO class III-IV.

Main Results:

• No significant differences in breastfeeding intent or rates at discharge/postpartum visit were found between less severe (mWHO I-II) and more severe (mWHO III-IV) cardiac disease groups.
• Over 85% of patients breastfed upon discharge from the hospital.
• A substantial decline (approx. 40%) in breastfeeding rates was observed by the postpartum visit.

Conclusions:

• Patients with maternal cardiac disease managed in a cardio-obstetrics program demonstrate high breastfeeding rates at hospital discharge.
• Significant challenges exist in maintaining breastfeeding beyond the immediate postpartum period.
• Enhanced postpartum support strategies are essential to sustain breastfeeding in women with cardiac conditions.