Early Hospital Practices Were Associated With Exclusive Breastfeeding Among Late Preterm and Early Term Infants

To assess how maternal/infant characteristics and early hospital practices influenced exclusive breastfeeding at 2-3 weeks postpartum among mothers intending to breastfeed their late preterm and early term infants.

This secondary analysis used data from a randomised controlled trial of 72 mothers of late preterm (34 + 0-36 + 6) and early term infants (37 + 0-38 + 6), assigned to either a breastfeeding intervention or control group. Information on hospital practices and infant feeding was collected prior to intervention start.

Overall, 62% of infants were exclusively breastfed (57% of late preterm, 75% of early term infants) at 2-3 weeks postpartum. In-hospital formula supplementation was highly prevalent (76%), and particularly larger volumes (30-60 mL per feed) were strongly associated with reduced exclusive breastfeeding (p < 0.001). Being offered support for breastfeeding problems at hospital was also associated with reduced odds of exclusive breastfeeding (OR 0.17, 95% CI 0.04-0.84). Early hospital practices, such as skin-to-skin contact and early breastfeeding initiation, differed between early term and late preterm infants.

The findings highlight the potential impact of modifiable hospital practices, particularly formula supplementation, on exclusive breastfeeding in this group. Strategies to improve these practices warrant further investigation.

ClinicalTrials.gov identifier: NCT03791749.