Factors Associated With Breastfeeding Very Low Birth Weight Infants at Neonatal Intensive Care Unit Discharge: A Single-Center Brazilian Experience

Abstract

Background The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays. Research aim The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil. Methods We conducted a prospective longitudinal cohort study of infants ( N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother’s own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding). Results Most (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% ( n = 54) were receiving exclusive mother’s milk and 77.3% ( n = 259) mixed feeding (mother’s milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05). Conclusions In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.

Effects of a WeChat Mini-Program on Human Milk Feeding Rates in a Neonatal Intensive Care Unit During the COVID-19 Pandemic

“…Most of the existing breastfeeding indicators for preterm infants are based on categorical variables and are usually presented as the percentage to which a certain indicator has been achieved. For example, the percentage of those who had ever received MOM during hospitalization or the percentage of those who still received DM or MOM feeding at discharge is evaluated, among which the latter is widely used (36)(37)(38). In the present study, we compared breastfeeding in three groups using categorical evaluation indicators that are frequently used in the field.…”

Breastfeeding Knowledge, Attitude, Self-Efficacy, and Social Support Among Mother of Macrosomia in China

“…Breastfeeding knowledge scale: using the breastfeeding knowledge scale reported by Abbass-Dick [19]. The scale has two dimensions: the advantages and skills of breastfeeding with 17 items, of which 11 items are the advantages of breastfeeding (4,5,6,7,8,9,10,11,12,14,15), 6 items are breastfeeding skills (1,2,3,16,17), each item is1 point, the total score is 0-17. The score is higher, the better the mother's knowledge of breastfeeding.…”

“…There are 14 items in total, including skills and inner mind. There are 9 questions in the skill dimension (1,4,5,6,8,10,11,13, and 14 questions), which mainly measure the con dence of breastfeeding skills, which of 5 questions in the inner dimension (2,3,7,9,12), mainly measuring attitudes and beliefs about breastfeeding. All items are graded likerts 5 (each item is divided into 5 levels of "no con dence at all", "no con dence", "sometimes con dent", "con dent", and "very con dent").…”

“…In the worldwide, six months of exclusive breastfeeding varies, less than half babies at the age of 6 months were breastfeeding exclusively in India [6]. Currently, research on breastfeeding with special birth weights is mostly focused on low weight infants, but the breastfeeding condition of macrosomia are rare reported [7]. Breastfeeding in the rst six months of life varies depending on complicated factors, especially in macrosomia [8].…”

Experiencias de las madres en el proceso de alimentación con leche humana en recién nacidos en la unidad neonatal

“…En general, se observa baja prevalencia de alimentación con leche humana en los neonatos hospitalizados y principalmente en los pacientes pretérmino (8). Durante la hospitalización del neonato, el binomio madre -hijo se enfrenta a situaciones complejas y desafíos que pueden retrasar y hacer difícil la lactancia del neonato con alguna patología de base (5); comportándose como barreras en el proceso de alimentación por parte de la madre hacia su hijo (9).…”