The Exclusively Breastfeeding Rate and Related Factors Among Preterm Infants at Discharge and Postnatal 6th Months of
Nursu Kara1, Didem Arman1, Kudret Ebru Erol1
1Department of Pediatrics, Division of Neonatology, Health Sciences University, Istanbul Training and Research Hospital, Istanbul, Türkiye.
Insights
Exclusive breastfeeding rates for preterm infants were 57.8% at discharge and 45.6% at six months. Promoting mother's own milk and providing consistent maternal support in the NICU are crucial for improving these rates and reducing complications.
Area of Science:
- Neonatal Nutrition and Feeding Practices
- Perinatal Health Outcomes
- Maternal-Infant Health
Background:
- Breastfeeding is recognized as optimal nutrition for both term and preterm newborns.
- Preterm infants, particularly those born before 34 weeks of gestation, often face challenges in achieving exclusive breastfeeding.
Purpose of the Study:
- To investigate exclusive breastfeeding (EBF) rates at discharge among preterm infants (<34 weeks gestation) from the neonatal intensive care unit (NICU).
- To analyze factors influencing EBF practices at discharge and at six months postpartum.
- To explore the association between EBF and outcomes like extrauterine growth retardation (EUGR).
Main Methods:
- Retrospective evaluation of medical records for 114 neonates (<34 weeks gestation) admitted to the NICU.
- Data collection included maternal/neonatal demographics, medical factors, morbidities, and breastfeeding duration from follow-up records.
- Statistical analysis of breastfeeding rates at discharge and six months, and influencing factors.
Main Results:
- Exclusive breastfeeding rate was 57.8% at discharge, declining to 45.6% at six months.
- Maternal ethnicity and language barriers were associated with lower EBF at discharge.
- Higher gestational age, shorter hospital stay, and reduced EUGR incidence were linked to EBF at six months.
Conclusions:
- Actively promoting mother's own milk from birth and providing consistent maternal support in the NICU are essential for improving EBF rates.
- These interventions can help reduce EUGR and enhance overall health outcomes for preterm infants.
- Targeted support is needed to overcome barriers such as ethnicity and language.
Objectives:
Breastfeeding is accepted to be the optimum nutrition for term and preterm newborns. The objective of our study was to investigate the rates of exclusive breastfeeding (EBF) at discharge among infants less than 34 weeks of gestation (GWs), followed up in neonatal intensive care unit (NICU) and to analyze the factors influencing EBF practices at discharge and 6th months of age.
Methods:
In this study, we retrospectively evaluated the medical records of neonates <34 GWs admitted to NICU within the first postnatal 24 hours of life between January 2022 and June 2023. The maternal and neonatal demographic data and the related medical and nutritional factors, morbidities were recorded. Data regarding the duration of exclusive breastfeeding, and the maintenance of breastfeeding were retrieved from the follow-up records of the high-risk newborn outpatient clinic post-discharge. The rate of breastfeeding at discharge and the factors influencing breastfeeding practices were analyzed.
Results:
The study cohort comprised 114 neonates, of whom 44.8% were female and 55.2% were male. The mean gestational age was 29.8±2.6 weeks and the mean birth weight was 1365±474 grams. The exclusive breastfeeding rate was 57.8% at discharge and declined to 45.6% at six months. The mean duration of breastfeeding was 15.7±6.5 months. Maternal ethnicity and the language barrier were found to be statistically significantly associated with exclusive breastfeeding at discharge, respectively (p=0.04, p=0.05). Infants who were exclusively breastfed at six months had significantly higher gestational age and shorter duration of hospital stay, respectively (p=0.029, p=0.02). Exclusive breastfeeding at six months was statistically significantly associated with a reduced incidence of extrauterine growth retardation (EUGR) (p=0.04). Among exclusively breastfed infants at discharge, 96.9% (n=64) received breast milk as their first feed, significantly more than mixed-fed infants (p=0.005). Time to reach full enteral feeding was also statistically significantly shorter in the exclusively breastfed group (p=0.017). Infants with a shorter duration of feeding via orogastric/nasogastric tube had a significantly higher rate of exclusive breastfeeding at six months compared to the mixed-fed group (p=0.043).
Conclusion:
To improve exclusive breastfeeding rates at discharge and six months postnatally, and to reduce the incidence of EUGR, feeding preterm infants with their mother's own milk from birth should be actively promoted. In addition, comprehensive and consistent maternal support should be provided in the NICU to facilitate both the initiation and continuation of breastfeeding under all circumstances from birth.
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