Effect of structured breastfeeding early intervention package for babies born at less than 34 weeks gestation on exclusive breastfeeding at 6 months-a quasi-experimental study

Human milk is the optimal source of nutrition for preterm infants, significantly reducing neonatal morbidities and enhancing neurodevelopmental outcomes. However, preterm neonates face challenges in direct breastfeeding due to immaturity, maternal-infant separation, and inadequate milk production. The aim of this study is to compare the impact of a structured early intervention package on exclusive breastfeeding rate and compare that to a control group that had no structured early intervention package regarding exclusive breastfeeding at 6 months of chronological age in neonates born at less than 34 weeks. Eligible mother-infant dyads were divided into the control and intervention groups. While both the groups received breastfeeding counseling, the control group received routine counseling as per WHO guidelines during antenatal visits, hospital stay, and follow-up immunization visits. In contrast, the intervention group received structured, frequent counseling using specially developed education materials, including intrapartum counseling in the pre-labor area, early initiation of expression facilitated by designated personnel, and scheduled postnatal sessions. Breast milk output was measured at days 3, 7, and 14 or discharge. Exclusive breastfeeding rates were assessed at 6 months. Among 90 enrolled dyads, the exclusive breastfeeding rate at 6 months was significantly higher in the intervention group (75.0%) compared to the control group (47.3%) (P value = .015). Breast milk output on day 3 was also significantly higher in the intervention group (P value = .008). The findings indicate that integrating structured lactation support into neonatal care can improve breastfeeding outcomes, and larger studies are needed to validate these results.