Breastfeeding in term and preterm infants with and without growth restriction: A 50-year analysis of incidence and

Achim Fieß1, Alica Hartmann1, Eva Mildenberger2

  • 1Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Insights

Breastfeeding rates have risen over 50 years, but preterm birth and fetal growth restriction remain barriers. Infants born small for gestational age (SGA) face reduced breastfeeding incidence and delayed initiation, highlighting a need for targeted support.

Area of Science:

  • Perinatal Medicine
  • Maternal-Infant Health
  • Public Health Nutrition

Background:

  • Breastfeeding is crucial for infant health and development.
  • Preterm birth and fetal growth restriction are known to impact infant feeding practices.
  • Understanding long-term trends in breastfeeding is essential for public health initiatives.

Purpose of the Study:

  • To analyze trends in breastfeeding rates and duration over five decades.
  • To investigate the association between breastfeeding and preterm birth, fetal growth restriction, and demographics.
  • To identify risk factors for reduced breastfeeding incidence and delayed initiation.

Main Methods:

  • Retrospective cohort study of 1559 individuals and their parents.
  • Categorization by gestational age (extremely preterm to term) and birth weight percentile (SGA, AGA, LGA).
  • Data collected via interviews, questionnaires, and medical records; 940 mothers' data analyzed.

Main Results:

  • Breastfeeding rates and duration significantly increased over 50 years.
  • Low gestational age (≤32 weeks) and being born small for gestational age (SGA) were associated with reduced breastfeeding.
  • Delayed breastfeeding initiation was more common in preterm and SGA infants; higher maternal education correlated positively with breastfeeding.

Conclusions:

  • Despite overall increases, preterm birth and fetal growth restriction are linked to lower breastfeeding rates and delayed initiation.
  • Being born SGA is an independent risk factor for reduced breastfeeding, independent of gestational age.
  • Increased awareness and tailored support are needed for mothers of SGA infants to improve breastfeeding outcomes.
Abstract

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