Subscribe to RSS
DOI: 10.1055/a-1524-3328
Privacy, Early Colostrum, and Gestational Age are Associated with Exclusive Breastfeeding in Preterm and Sick Term Infants
Abstract
Our study was designed to assess the rates of exclusive breastfeeding (defined as direct breastfeeding) and the use of mother’s own milk (MOM) in preterm infants and sick term infants at discharge and to identify potential influencing factors such as gestational age, early colostrum, and privacy. The study was conducted at a German level III neonatal department. All preterm and sick term infants admitted to the neonatal intensive care unit, the pediatric intensive care unit, the intermediate care unit, and the low care ward were included in the study. Infants were recruited between March and October 2015 (phase 1) and April to July 2016 (phase 2). Due to an emergency evacuation, privacy was limited during the first phase. Breastfeeding and the use of MOM were assessed daily using a self-designed score. In total, 482 infants of 452 mothers were included. More than 90% initiated breastfeeding and one-third were exclusively breastfed at discharge. Extremely immature infants and late preterm infants were less likely to be exclusively breastfed at discharge. Privacy (p<0.001) and early colostrum (p=0.002) significantly increased exclusive breastfeeding. Conclusion Extremely immature and late preterm infants were least likely to be exclusively breastfed at discharge and need special support. Interventions such as privacy and early colostrum should be promoted to increase breastfeeding.
Publication History
Received: 23 March 2021
Accepted after revision: 26 May 2021
Article published online:
12 August 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 American Academy of Pediatrics. Section on breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012; 129: e827-e841
- 2 Brettschneider AK, von der Lippe E, Lange C. Breastfeeding behaviour in Germany-News from KiGGS Wave 2. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61: 920-925 DOI: 10.1007/s00103-018-2770-7.
- 3 Sievers E, Weikert C, Weissenborn A. et al. Monitoring breastfeeding in Germany-the current need for action and perspectives. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61: 911-919 DOI: 10.1007/s00103-018-2772-5.
- 4 Koo W, Tank S, Martin S. et al. Human milk and neurodevelopment in children with very low birth weight: a systematic review. Nutr J 2014; 13: 94 DOI: 10.1186/1475-2891-13-94.
- 5 Miller J, Tonkin E, Damarell RA. et al. A systematic review and meta-analysis of human milk feeding and morbidity in very low birth weight infants. Nutrients 2018; 10 DOI: 10.3390/nu10060707.
- 6 Lucas A. Long-term programming effects of early nutrition – implications for the preterm infant. J Perinatol 2005; 25: S2-S6 DOI: 10.1038/sj.jp.7211308.
- 7 Henderson JJ, Evans SF, Straton JA. et al. Impact of postnatal depression on breastfeeding duration. Birth 2003; 30: 175-180 DOI: 10.1046/j.1523-536x.2003.00242.x.
- 8 Callen J, Pinelli J. A review of the literature examining the benefits and challenges, incidence and duration, and barriers to breastfeeding in preterm infants. Adv Neonatal Care 2005; 5: 72-88 quiz 89–92 DOI: 10.1016/j.adnc.2004.12.003.
- 9 Ip S, Chung M, Raman G. et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 2007; 1-186
- 10 Foligno S, Finocchi A, Brindisi G. et al. Evaluation of mother's stress during hospitalization can influence the breastfeeding rate. Experience in intensive and non intensive departments. Int J Environ Res Public Health 2020; 17 DOI: 10.3390/ijerph17041298.
- 11 Rodriguez JM. The origin of human milk bacteria: is there a bacterial entero-mammary pathway during late pregnancy and lactation?. Adv Nutr 2014; 5: 779-784 DOI: 10.3945/an.114.007229.
- 12 Uvnas Moberg K, Ekstrom-Bergstrom A, Buckley S. et al. Maternal plasma levels of oxytocin during breastfeeding – a systematic review. PLoS One 2020; 15: e0235806 DOI: 10.1371/journal.pone.0235806.
- 13 Smith JP, Forrester R. Maternal time use and nurturing: analysis of the association between breastfeeding practice and time spent interacting with baby. Breastfeed Med 2017; 12: 269-278 DOI: 10.1089/bfm.2016.0118.
- 14 Ventura AK. Associations between breastfeeding and maternal responsiveness: a systematic review of the literature. Adv Nutr 2017; 8: 495-510 DOI: 10.3945/an.116.014753.
- 15 Ericson J, Eriksson M, Hoddinott P. et al. Breastfeeding and risk for ceasing in mothers of preterm infants – long-term follow-up. Matern Child Nutr 2018; 14: e12618 DOI: 10.1111/mcn.12618.
- 16 Keim SA, Boone KM, Oza-Frank R. et al. Pumping milk without ever feeding at the breast in the Moms2Moms Study. Breastfeed Med 2017; 12: 422-429 DOI: 10.1089/bfm.2017.0025.
- 17 Maastrup R, Hansen BM, Kronborg H. et al. Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice: the results of a national cohort study with high breastfeeding initiation rates. PLoS One 2014; 9: e108208 DOI: 10.1371/journal.pone.0108208.
- 18 Bonet M, Blondel B, Agostino R. et al. Variations in breastfeeding rates for very preterm infants between regions and neonatal units in Europe: results from the MOSAIC cohort. Arch Dis Child Fetal Neonatal Ed 2011; 96: F450-F452 DOI: 10.1136/adc.2009.179564.
- 19 Fugate K, Hernandez I, Ashmeade T. et al. Improving human milk and breastfeeding practices in the NICU. J Obstet Gynecol Neonatal Nurs 2015; 44: 426-438 quiz E414–425 DOI: 10.1111/1552-6909.12563.
- 20 Hallowell SG, Rogowski JA, Spatz DL. et al. Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data. Int J Nurs Stud 2016; 53: 190-203 DOI: 10.1016/j.ijnurstu.2015.09.016.
- 21 Labbok MH, Starling A. Definitions of breastfeeding: call for the development and use of consistent definitions in research and peer-reviewed literature. Breastfeed Med 2012; 7: 397-402 DOI: 10.1089/bfm.2012.9975.
- 22 Pang WW, Bernard JY, Thavamani G. et al. Direct vs. Expressed breast milk feeding: relation to duration of breastfeeding. Nutrients 2017; 9 DOI: 10.3390/nu9060547.
- 23 Lau C. Breastfeeding challenges and the preterm mother-infant dyad: a conceptual model. Breastfeed Med 2018; 13: 8-17 DOI: 10.1089/bfm.2016.0206.
- 24 Colaizy TT, Morriss FH. Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003. J Perinatol 2008; 28: 505-510 DOI: 10.1038/jp.2008.32.
- 25 Killersreiter B, Grimmer I, Buhrer C. et al. Early cessation of breast milk feeding in very low birthweight infants. Early Hum Dev 2001; 60: 193-205 DOI: 10.1016/s0378-3782(00)00116-x.
- 26 Davanzo R, Monasta L, Ronfani L. et al. Breastfeeding at NICU discharge: a multicenter Italian study. J Hum Lact 2013; 29: 374-380 DOI: 10.1177/0890334412451055.
- 27 Radtke JV. The paradox of breastfeeding-associated morbidity among late preterm infants. J Obstet Gynecol Neonatal Nurs 2011; 40: 9-24 DOI: 10.1111/j.1552-6909.2010.01211.x.
- 28 Gewolb IH, Vice FL. Maturational changes in the rhythms, patterning, and coordination of respiration and swallow during feeding in preterm and term infants. Dev Med Child Neurol 2006; 48: 589-594 DOI: 10.1017/S001216220600123X.
- 29 Lapillonne A, Bronsky J, Campoy C. et al. Feeding the late and moderately preterm infant: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2019; 69: 259-270 DOI: 10.1097/MPG.0000000000002397.
- 30 Parker LA, Sullivan S, Krueger C. et al. Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med 2015; 10: 84-91 DOI: 10.1089/bfm.2014.0089.
- 31 Patil CL, Turab A, Ambikapathi R. et al. Early interruption of exclusive breastfeeding: results from the eight-country MAL-ED study. J Health Popul Nutr 2015; 34: 10 DOI: 10.1186/s41043-015-0004-2.
- 32 Morelius E, Ortenstrand A, Theodorsson E. et al. A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding. Early Hum Dev 2015; 91: 63-70 DOI: 10.1016/j.earlhumdev.2014.12.005.
- 33 Grundt H, Tandberg BS, Flacking R. et al. Associations between single-family room care and breastfeeding rates in preterm infants. J Hum Lact 2020; 890334420962709 DOI: 10.1177/0890334420962709.