Longitudinal Follow-up of Preterm Breastfeeding to 12 Weeks Corrected Gestational Age

Abstract

Background: Preterm infants have shorter breastfeeding duration than that of term infants. Details of postdischarge feeding methods and difficulties are needed to inform the care of preterm breastfeeding dyads. Purpose: To describe postdischarge breastfeeding characteristics of mother-preterm infant dyads up to 12 weeks corrected gestational age (CGA). Methods: A prospective observational study of preterm dyads (birth 24-33 weeks' gestation) that fed their mother's own milk (MOM) at discharge from a neonatal unit in Perth, Western Australia. Feeding method and frequency, breastfeeding duration, difficulties, and nipple shield use were recorded at 2, 6, and 12 weeks CGA. Results: Data were obtained for 49 mothers (singleton infant n = 39, twins n = 10). At 12 weeks CGA, 59% fed any MOM with 47% exclusively fed MOM and 31% fully breastfed. Nipple shield use reduced from 42% at 2 weeks CGA to 11% at 12 weeks CGA. Compared with mothers who exclusively fed MOM at discharge (n = 41) those who fed both MOM and infant formula (n = 8) were more likely to wean before 12 weeks CGA (P < .001). Weaning occurred before 2 weeks CGA in 12/19 (63%), with low milk supply the most frequently cited reason. Implications for Practice: Most mothers with a full milk supply at discharge successfully transition to predominant breastfeeding. Frequent milk removal needs to be prioritized throughout the preterm infant's hospital stay. Implications for Research: Examination of facilitators and barriers to early and continued frequent milk removal across the postpartum period is required to identify strategies to optimize lactation after preterm birth.

Leveraging mHealth and a milk expression frequency biomarker during postpartum to prolong lactation among parents of critically ill infants: a pilot study

“…Similar to many studies, [7,8,20,21] the reason for weaning to formula among our sample was largely attributed to low milk supply. This sample may also have experienced greater contextual challenges to meeting their lactation goals as prevalence of MOM feeding at discharge among pump-dependent parents of critically ill infants is known to be lowest among Medicaid recipients, infants residing in the South, and non-Hispanic Black parents [2].…”

“…There are few published studies investigating MOM feeding beyond discharge from the NICU with which to directly compare our results. One recent study of 49 mothers of preterm infants in Western Australia found that those who were supplementing with formula at discharge were more likely to stop feeding MOM before 12 weeks corrected gestational age [20]. However, no demographic description was provided, and the contextual challenges for lactation may vary within and outside of the U.S. Our exclusive MOM feeding rate in this study was 24-31% at month 3, compared to their rate of 47% at month 4 and the U.S. rate of 25.6% at month 6 [1].…”

Leveraging mHealth and a Milk Expression Frequency Biomarker During Postpartum to Prolong Lactation Among Parents of Critically Ill Infants: A Pilot Study

“…15 Including incentives in a large RCT would likely strengthen follow up rates, as one intervention among WIC recipients reported a 92.4% follow up rate at 2 weeks postpartum with a monetary completion incentive. 16 Similar to many studies, 8,9,21,24 the reason for weaning to formula among our sample was largely attributed to low milk supply. This sample may also have experienced greater contextual challenges to meeting their lactation goals as prevalence of MOM feeding at discharge among pump-dependent parents of critically ill infants is known to be lowest among Medicaid recipients, infants residing in the South, and non-Hispanic Black parents.…”

“…One recent study of 49 mothers of preterm infants in Western Australia found that those who were supplementing with formula at discharge were more likely to stop feeding MOM before 12 weeks corrected gestational age. 21 However, no demographic description was provided, and the contextual challenges for lactation may vary within and outside of the U.S. Our exclusive MOM feeding rate in this study was 24-31% at month 3, compared to their rate of 47% at month 4 and the U.S. rate of 25.6% at month 6. 1 These discrepancies emphasize the urgent need for strategies to support parents of critically ill infants to prolong lactation.…”

Effect of Prefeeding Oromotor Stimulation on Oral Feeding Performance of Preterm Neonates during Hospitalization and at Corrected One Month of Age at a Tertiary Neonatal Care Unit of India: A Randomized Controlled Trial

“…Early breastfeeding discontinuation occurs typically at 15, 40, and 90 days of life. 14–15 WHO prescribed standard of 6 months of exclusive breastfeeding 16 is achieved by only 10.4% to 49% of the preterm mother–infant dyad. 17–18 There is paucity in data from Indian context on post hospitalization exclusive breastfeeding rate among preterms.…”