Factors and survival of exclusive breastfeeding in preterm infants upon discharge at six months of age

Abstract

Introduction and objective: Reducing the neonatal mortality rate in half is an objective proposed by WHO for the year 2025 through coverage strategies from the prenatal stage, delivery, birth, and hospitalization, one of these low-cost strategies is exclusive breastfeeding (EBF) in preterm infants, that contributes to the prevention of neonatal mortality, a population that contributes in the first place to neonatal mortality. The objective of this study was to identify the frequency and survival of exclusive breastfeeding and related factors in premature infants of two referral hospitals, one of them certified as Baby-Friendly Hospital Initiative (BFHI).Methods: Follow-up study of 111 premature infants after hospital discharge with equivalent corrected age among hospitals: BFHI 36.1 ± 1.6; non-BFHI (nBFHI) 36.4 ± 1.8 weeks (p ≥ .05). Data collection carried out from February 2016 to March 2017, through records in clinical files and surveys of mothers upon hospital discharge and by telephone during follow-up after 15 days post-discharge, 3, and 6 months of extrauterine life. Kaplan-Meier analysis to determine breastfeeding survival over time, and with Pearson’s r with significance p ≤ .05, the relation was established between EBF with sociodemographic, perinatal, and clinical status factors of the child.Results: Urban maternal origin (68.1%), maternal age (25.7 ± 7.9 years), schooling < 12 years (56.6%). EBF upon discharge on 45/111 dyads (40.5%), 15 days post-discharge 35/73 (47.9%), third month 23/61 (37.7%) and sixth month 7/44 (15.9%). EBF survival was 15 days post-discharge, at this cut-off point, among the correlated factors are: “having received guidance to use Exclusive Breastfeeding until the sixth month of extrauterine life of the premature child” positively correlated with EBF (r = 0.294, p ≤ .05), “the maternal perception that her milk dried” correlated negatively with EBF (r = -0.313, p ≤ .01), if “breastfeeding caused anxiety to the mother” it positively correlated with artificial feeding (AF) (r = 0.237, p ≤ .05).Conclusions: Exclusive breastfeeding in premature infants is below WHO standard, it is favorably related to maternal orientation, and barriers are maternal perceptions of non-milk supply and anxiety. It could be encouraged through actions carried out in hospitals certified with the Baby-Friendly Hospital Initiative and follow up with post-discharge breastfeeding at least to the sixth month of life of premature infants. Similar studies should establish better monitoring mechanisms to avoid losses during the follow-up.

Breastfeeding in adolescent mothers-premature infant dyads

“…This difference was also seen in another Exclusive Breastfeeding survival study in Mexican preterm infant of mothers of all ages. [10] While in Ethiopia the probability of survival of Exclusive Breastfeeding was 64.5% at sixth month because the counseling received on Exclusive Breastfeeding, was the successful factor. The Baby-Friendly Hospital Initiative could improve the prevalence of Exclusive Breastfeeding in preterm infant, specifically the neo-Baby-Friendly Hospital Initiative that include the revised 10 steps of the original Baby-Friendly Hospital Initiative proposal, staff's attitude focusing on the mother as an individual, and the continuity of care.…”

“…Published by Sciedu Press constructed based on a literature review and the validation and cultural adjustment were carried out through application to 12 mothers with premature children in the neonatal unit of a hospital/maternity ward in a previous study. [10] 2.5 Analysis Kaplan-Meier analysis was used to determine the Exclusive Breastfeeding survival curve over time, and Pearson's r with significance p ≤ .05 to establish the relation between Exclusive Breastfeeding with sociodemographic, perinatal, and clinical status factors of the preterm infants.…”

“…[9] 4.6 Difficulties and support for adolescent mothers and exclusive breastfeeding In our study the adolescent mothers who reported difficulties with Exclusive Breastfeeding since hospitalization ended Exclusive Breastfeeding before the third month, cause of early abandonment of Exclusive Breastfeeding of adolescent mothers' children. [8,10] The adolescent mothers received guidance on breastfeeding upon discharge, especially from the baby-friendly hospital, the decrease in prevalence in the first six months of life seems to indicate that they lack support to maintain it, in this regard, they suggested that accompaniment be provided from discharge to continue on Exclusive Breastfeeding, as well as improving the capabilities of human resources or health providers to support and guide in Exclusive Breastfeeding. It has been reported that health professionals may have insufficient skills to advise and assist in establishing and maintaining Exclusive Breastfeeding in Neonatal Units.…”

“…[9] In two reference hospitals in México Exclusive Breastfeeding survival curve was of 15 days and the prevalence was 47.9%, but at six months of life was only 15.9%. [10] In the context of few health and financial resources available for the best possible breeding, nutrition, and health of the preterm infant, there are barriers, limitations, or problems to the beginning, continuity, and maintenance of Exclusive Breastfeeding in the first six months of life, [5] therefore, there exists the highest risk of low Exclusive Breastfeeding rates in adolescent mothers. [5,11] One of the main problems is that Exclusive Breastfeeding is not started early, [12] the WHO recommends that newborns be exclusively breastfed because of the great advantages it confers, and, for successful breastfeeding to begin immediately at birth or within the first hour of life, the problem is that this recommendation is rarely carried out in hospitals and especially with premature infants.…”

The effect of breast massage training on self-efficacy and perceived stress of prim parous women: A clinical trial study

“…Another benefit of breast massage is the increased prolactin secretion, which starts the milk flow from the breast and relieves lobe congestion and breast inflammation. [ 11 , 12 ]…”