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.
In the 1970s, Mary Ainsworth introduced three different patterns of mother-child attachment: secure, insecure-avoidant and insecure-ambivalent/resistant attachment. 1 A fourth classification, disorganised attachment was added later and was set in contrast to the organised attachment patterns. Attachment security was associated with important developmental functions such as emotional regulation and social skills competence. 2 Intriguingly, in preterm infants, secure attachment may reduce the risk of behavioural problems and
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