Breastfeeding of Very Preterm Infants in the Neonatal Intensive Care Unit: A Retrospective Cohort Study
1Department of Pediatrics, The First Affiliated Hospital of Air Force Medical University, Xi'an.
Insights
Breastfeeding is crucial for very preterm infants (VPIs). However, many VPIs in the NICU do not receive breast milk, especially those born via C-section, highlighting a need for improved feeding support.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Public Health
Background:
- Breast milk is vital for neonatal growth and development, particularly for premature infants.
- Premature neonates are susceptible to various diseases, making breast milk's protective benefits essential.
- Optimizing nutrition for very preterm infants (VPIs) is critical for their short- and long-term health outcomes.
Purpose of the Study:
- To determine the prevalence and duration of breastfeeding in very preterm infants (VPIs) admitted to the neonatal intensive care unit (NICU).
- To analyze feeding practices, including breast milk and formula, among VPIs.
- To identify factors influencing breastfeeding rates in this vulnerable population.
Main Methods:
- A retrospective review of medical records for 235 VPIs (gestational age <32 weeks) admitted to XiJing Hospital's NICU between January 2017 and December 2023.
- Data collected included clinical characteristics and feeding methods (breast milk, formula, or combination).
- Statistical analysis compared breastfeeding rates and intake between vaginal delivery and cesarean section groups.
Main Results:
- Only 56.6% of VPIs received any breast milk, with 43.4% receiving none during hospitalization.
- Vaginal delivery was associated with significantly higher breastfeeding rates (12% vs. 0.3%) and greater median daily breast milk intake compared to cesarean section.
- Cesarean section delivery was common (75.3%), and these infants were less likely to breastfeed.
Conclusions:
- Breastfeeding rates among VPIs in the NICU are suboptimal, necessitating targeted interventions.
- Infants born via cesarean section require specific support to promote and facilitate breastfeeding.
- Enhancing breastfeeding practices in the NICU is crucial for improving outcomes in very preterm infants.
Background:
Breast milk is the preferred source of enteral nutrition for neonates and is particularly important for premature neonates because it promotes growth and development, and reduces the incidence of many diseases to which premature neonates are susceptible.
Objectives:
To assess the prevalence and duration of breastfeeding among very preterm infants (VPIs) with a gestational age <32 weeks admitted to the neonatal intensive care unit (NICU) of XiJing Hospital.
Methods:
A retrospective record review was conducted to collect data on clinical characteristics and feeding methods of 235 VPIs born in XiJing Hospital from January 2017 to December 2023 and admitted to the NICU within 24 hours of birth.
Results:
Of the 235 eligible VPIs, 177 (75.3%) were delivered by cesarean section, 102 (43.4%) did not receive any breast milk during their hospitalization, and 133 (56.6%) received a mixture of breast milk and formula. Compared with the cesarean-section group, the vaginal-delivery group was significantly more likely to breastfeed (12% vs. 0.3%; P=.004) and had a significantly higher median daily breast milk intake (5.81 vs. 0.17 mL/kg; P=.003) during hospitalization; however, the duration of parenteral nutrition did not differ significantly between groups.
Discussion:
Overall, these results indicate that measures are required to increase breastfeeding among VPIs, particularly those born by cesarean section.
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