Breastfeeding in Preterm and Term Twins—Maternal Factors Associated With Early Cessation: A Population-Based Study

Abstract

To investigate the duration of breastfeeding and the impact of maternal factors for cessation of breastfeeding in twin infants, the authors undertook a population-based cohort study. Breastfeeding data obtained from Child Health Centres were matched with data on infant and maternal demographics from Swedish national registers. A total of 1.657 twins were included, of whom 695 were born preterm. Breastfeeding frequencies in preterm twins were 79% at 2 months, 58% at 4 months, 39% at 6 months, 14% at 9 months, and 6% at 12 months. In term twins, the corresponding frequencies were 84%, 63%, 45%, 18%, and 6%, respectively. In both preterm and term mothers, mothers who had a lower educational level or smoked at first antenatal care visit were subject to earlier cessation of breastfeeding by 6 months of age. In addition, in mothers of term infants, mothers who were < 23 years old or primiparous had a higher risk for cessation of breastfeeding before 6 months. Thus, mothers of twins have a good potential to breastfeed, but additional support is needed for those more susceptible to early cessation of breastfeeding.

Donor human milk largely replaces formula-feeding of preterm infants in two urban hospitals

“…In general, key factors influencing breastfeeding include maternal comfort with breastfeeding combined with lack of comfort with formula feeding. 16,17 Personal intentions, medical, social and cultural support for breastfeeding vary among mothers depending on race/ethnicity and socioeconomic status, 17–19 education 20 and age. 18,20 In the preterm infant population, additional issues include maternal and infant health complications, 18,21 particular concerns about breast milk insufficiency, 22 poor infant latch and weak sucking behavior 23 and lack of effective pumping.…”

Fatores associados à interrupção do aleitamento materno exclusivo de lactentes nascidos com baixo peso assistidos na atenção básica

“…A explicação para esse achado parece estar ligada ao fato de se tratar de lactentes de baixo peso ao nascer e prematuros, quando as dificuldades maternas no estabelecimento e manutenção prolongada do AME podem ser mais intensas. Nesse sentido, estudos com gemelares, inclusive os prematuros 31 , têm evidenciado maior vulnerabilidade para interrupção da amamentação nessa população, e que a sua superação está relacionada com a existência de um suporte extra ou com os conhecimentos prévios da mãe sobre o tema 32 . Isso sugere que a manutenção do aleitamento sofre influência positiva de um suporte profissional no pré-natal e puerpério.…”

The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial

“…A number of studies show a significant relationship between socioeconomic status (SES) and breastfeeding duration; disadvantaged mothers discontinue breastfeeding much earlier than mothers with more advantageous positions [14,20-22]. The best proxy for SES is suggested to be educational level [23].…”