Does Prematurity Moderate the Association Between Breastfeeding Firstborn and Second-Born Children?

Area of Science:

• Maternal and Child Health
• Lactation Science
• Perinatal Epidemiology

Background:

• Preterm infants experience breastfeeding challenges, impacting initiation and duration.
• The influence of prematurity on breastfeeding behavior across subsequent births remains unclear.

Purpose of the Study:

• To investigate how preterm birth of either the first or second child moderates the relationship between prior breastfeeding experience and subsequent breastfeeding outcomes.
• To determine the impact of prematurity on breastfeeding initiation and duration after a second birth.

Main Methods:

• Retrospective cohort study utilizing National Survey of Family Growth data (2011-2019).
• Included 6,031 individuals aged 18-49 with at least two singleton live births.
• Analyzed breastfeeding initiation and duration for second-born children, assessing the interaction between first-child breastfeeding experience and prematurity using multivariable logistic regression.

Main Results:

• First-child breastfeeding experience significantly increased second-child breastfeeding initiation odds (OR=16.98).
• This association was attenuated when the first or second child was born preterm, though interaction terms were not significant.
• Prematurity did not significantly moderate the association between first-child breastfeeding experience and second-child breastfeeding duration.

Conclusions:

• Supporting breastfeeding initiation for first-born children enhances the likelihood of breastfeeding for subsequent children.
• These positive effects on breastfeeding initiation persist irrespective of whether the first or second child was born preterm.
• Addressing barriers for primiparous individuals is key to improving breastfeeding outcomes across multiple births.