Factors associated with initiation and exclusive breastfeeding at hospital discharge: late preterm compared to 37 week gestation mother and infant cohort

Abstract

BackgroundTo investigate and examine the factors associated with initiation of, and exclusive breastfeeding at hospital discharge of, late preterm (34 0/7 - 36 6/7 weeks) compared to 37 week gestation (37 0/7 - 37 6/7 week) mother and baby pairs.MethodsA retrospective population-based cohort study using a Perinatal National Minimum Data Set and clinical medical records review, at the Royal Hobart Hospital, Tasmania, Australia in 2006.ResultsLate preterm and 37 week gestation infants had low rates of initiation of breastfeeding within one hour of birth, 31 (21.1%) and 61 (41.5%) respectively. After multiple regression analysis, late preterm infants were less likely to initiate breastfeeding within one hour of birth (OR 0.3 95% CI 0.1, 0.7 p = 0.009) and were less likely to be discharged exclusively breastfeeding from hospital (OR 0.4 95% CI 0.1, 1.0 p = 0.04) compared to 37 week gestation infants.ConclusionA late preterm birth is predictive of breastfeeding failure, with late preterm infants at greater risk of not initiating breastfeeding and/or exclusively breastfeeding at hospital discharge, compared with those infants born at 37 weeks gestation. Stratifying breastfeeding outcomes by gestational age groups may help to identify those sub-populations at greatest risk of premature cessation of breastfeeding.

Facilitators and barriers of breastfeeding late preterm infants according to mothers’ experiences

“…The majority of mothers felt they were adequately supported by the breastfeeding consultant and/or by the health care providers during their hospital stay, stated they were satisfied with their experience of breastfeeding and felt comfortable in communicating with health care professionals about breastfeeding. Accordingly, the percentage of infants who were breastfed at discharge in the present study was 94 %, which is higher than previous data published in the literature [2, 4, 5]. This finding could be explained by the fact that, according to the inclusion criteria of the study, all enrolled mothers intended to breastfeed.…”

“…Despite the potential beneficial effects of breastfeeding in the late preterm population, late preterm infants are at a higher risk of lower initiation of breastfeeding than term infants [2, 4, 5]. Breastfeeding initiation in the U.S. has been reported by Radtke et al [1] to range around 59–70 %.…”

“…In addition, long-term negative health outcomes, such as neurodevelopmental delays, have also been reported [2]. …”

“…Although a growing body of evidence exists on the factors that have been identified to be negatively associated with successful breastfeeding in term infants, the factors affecting the feeding of late preterm infants appear to be complex but still relatively understudied [2, 5]. Within this context, a closer examination of breastfeeding outcomes accounting for neonatal factors, such as infants’ health status and the different degrees of their developmental maturity, physiological and psychological maternal factors and social and system factors has been advocated to develop a customized breastfeeding support strategy for the late preterm population [1, 6].…”

Breastfeeding Practices as Observed in Those Attending a Teaching Hospital for Perinatal Care

“…Bar ngton et al 10 reported other factors such as a planned pregnancy, a endance at antenatal classes, vaginal delivery, being accompanied at delivery, and a post-partum hospital stay of >24 hr which were independently associated with mely ini a on of breast feeding in their study. In another study, Ayton et al 11 reported that preterm birth is predic ve of breas eeding failure, with late preterm infants at greater risk of not ini a ng breas eeding and/or exclusively breas eeding at hospital discharge. Certain factors iden fi ed by Agbo et al 12 would serve as mo vators to the working mother to prac ce EBF; these were good family support and longer maternity leave (25.5%).…”