A structured programme to promote breastfeeding improved the rates in very preterm infants at discharge
Silvia Perugi1, Martina Ciarcià1, Caterina Coviello1
1Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
Insights
The Promotion of Breastfeeding (PROBREAST) program significantly increased breastfeeding rates in very preterm infants. Exclusive breastfeeding at discharge improved neurodevelopment without hindering growth in this vulnerable population.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Public health interventions
Background:
- Very preterm infants (born <32 weeks gestation or ≤1500g) have unique feeding challenges.
- Breastfeeding is associated with improved infant health outcomes.
- Structured programs may enhance breastfeeding initiation and duration in high-risk neonates.
Purpose of the Study:
- To evaluate the impact of the Promotion of Breastfeeding (PROBREAST) program on breastfeeding rates in very preterm infants.
- To assess the relationship between feeding type at discharge and post-discharge breastfeeding.
- To examine the correlation between exclusive breastfeeding, postnatal growth, and neurodevelopment.
Main Methods:
- Comparative cohort study comparing infants before and after PROBREAST implementation.
- Data collected on breastfeeding rates at discharge and post-discharge.
- Analysis of correlations between exclusive breastfeeding, growth (weight z-score), and neurodevelopmental outcomes (cognitive score) at corrected ages.
Main Results:
- The PROBREAST group showed a significantly higher exclusive breastfeeding rate at discharge (42% vs. 16%, p<0.001).
- Exclusive breastfeeding at discharge was negatively correlated with weight z-score at discharge, but not at 12 or 24 months corrected age.
- A positive correlation was observed between exclusive breastfeeding and cognitive scores at 24 months corrected age.
Conclusions:
- A structured breastfeeding promotion program effectively improved breastfeeding rates in very preterm infants.
- Exclusive breastfeeding at discharge supports neurodevelopmental improvements in very preterm infants.
- The PROBREAST program demonstrated that exclusive breastfeeding can be achieved without compromising growth in this population.
Aim:
We developed the Promotion of Breastfeeding (PROBREAST) programme and evaluated what effect it had on the breastfeeding rate in infants born at less than 32 weeks of gestation or weighing ≤1500 grams.
Methods:
We compared the breastfeeding rate in two cohorts of patients who were born before (n = 72; January 2017 to June 2018) and after (n = 80; July 2018 to December 2019) the application of the programme. Moreover, we compared the correlation between type of feeding at discharge and post-discharge breastfeeding rate, between exclusive breastfeeding, postnatal growth and neurodevelopment.
Results:
Infants in the PROBREAST group had an exclusive breastfeeding rate at discharge higher (42 vs. 16%, p < 0.001) than that in the historical control group. Exclusive breastfeeding was negatively correlated with weight z-score at discharge, but not at 12 and 24 months corrected age, and was positively correlated with cognitive score at 24 months corrected age.
Conclusion:
The application of a structured programme for the promotion of breastfeeding improved the breastfeeding rate in very preterm infants. We demonstrated that exclusive breastfeeding at discharge improved their neurodevelopment without impairing growth.
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