Postdischarge Feeding of Very‐low‐birth‐weight Infants

Francis, Jane; Unger, Sharon; Bando, Nicole; Vance, Ashleigh; Gibbins, Sharyn; Kiss, Alex; Church, Paige; Sellen, Daniel; O'Connor, Deborah L

doi:10.1097/mpg.0000000000002041

Cited by 11 publications

(7 citation statements)

References 42 publications

(51 reference statements)

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“…Despite this, the percentage of births that were completed via cesarean was higher than the objectives established by the WHO 44 and therefore, taking into account the risk that this type of birth has with regard to reducing the rates of EBF upon discharge (up to ve times higher), the appropriate indication for cesareans should be assessed. Likewise, although a modest risk, it was observed that newborns with a lower birth weight had an increased risk of not receiving EBF at the time of discharge; ndings that were in line with what is described in the literature 45,46 .…”

Section: Discussionsupporting

confidence: 86%

Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study

Gabriel

Lozoya

Ibarra

et al. 2023

Preprint

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Background There are very few studies assessing the association between a COVID-19 infection and the rates of exclusive breastfeeding (EBF) upon discharge following the first waves of the pandemic and after the initiation of vaccination. The primary objective of this study is to compare the rates of EBF upon discharge in mothers diagnosed with a COVID-19 infection at the time of the birth versus a group of non-infected mothers in maternity hospitals with Baby Friendly Hospital Initiative (BFHI) accreditation. The secondary objectives include determining the rates of BF at 3 and 6 months of life in both groups, as well as determining the possible factors involved in the rates of EBF observed upon discharge.Methods An observational, multi-center, prospective cohort study conducted from April 1, 2021 to March 31, 2022 and with follow-up during the first six months of life. Follow-up was performed via telephone contact with calls performed at three and six months. A multivariate logistic regression analysis model was performed to identify the factors related to a lower probability of EBF upon discharge.Results 308 mother-infant pairs participated in the study, 111 in the cohort of exposed patients and 197 in the cohort of non-exposed patients. Exposure to COVID-19 during the birth (AOR 5.28; 95% CI 2.01, 13.86), not practicing BF previously (AOR 36.3; 95% CI 7.02, 187.74), birth via cesarean section (AOR 5.06; 95% CI 1.62, 15.79) and the weight of the newborn (AOR 1.01; 95% CI 1.01, 1.01) were associated with a greater risk of not performing EBF upon discharge. At three months, 52.4% of exposed patients vs. 57% of non-exposed patients (p = 0.33) were performing EBF, with the rates of EBF at six months being 43% vs. 39.3% (p = 0.45) respectively.Conclusions Mothers with a mild or asymptomatic COVID-19 infection at the time of the birth had a lower probability of feeding their babies with EBF at the time of discharge from hospital in a group of BFHI-accredited hospitals.

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Section: Discussionsupporting

confidence: 86%

Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study

Gabriel

Lozoya

Ibarra

et al. 2023

Preprint

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“…In Studies A and B, infant feeding data were collected prospectively at 2 weeks and 2, 4 and 6 months postpartum using the same standardised and validated interviewer-administered questionnaire used previously by our group. 20 21 In Study B, data were also collected at postpartum months 1, 3 and 5, but only the time points shared with Study A are reported here. At each time point, participants reported the average number of milk feeds provided to their infant per 24 hours, divided into feeds at the breast, expressed HM feeds and formula feeds.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Associations between use of expressed human milk at 2 weeks postpartum and human milk feeding practices to 6 months: a prospective cohort study with vulnerable women in Toronto, Canada

et al. 2022

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ObjectivesTo examine whether use of expressed human milk in the first two weeks postpartum is associated with cessation of human milk feeding and non-exclusive human milk feeding up to 6 months.DesignPooled data from two prospective cohort studiesSettingThree Canada Prenatal Nutrition Program (CPNP) sites serving vulnerable families in Toronto, Canada.Participants337 registered CPNP clients enrolled prenatally from 2017 to 2020; 315 (93%) were retained to 6 months postpartum. Exclusions: pregnancy loss or participation in prior related study; Study B: preterm birth (<34 weeks); plan to move outside Toronto; not intending to feed human milk; hospitalisation of mother or baby at 2 weeks postpartum.Primary and secondary outcome measuresMain exposure variable: any use of expressed human milk at 2 weeks postpartum. Outcomes: cessation of human milk feeding by 6 months; non-exclusive human milk feeding to 4 months and 6 months postpartum.ResultsAll participants initiated human milk feeding and 80% continued for 6 months. Exclusive human milk feeding was practiced postdischarge to 4 months by 28% and to 6 months by 16%. At 2 weeks postpartum, 34% reported use of expressed human milk. Any use of expressed human milk at 2 weeks was associated with cessation of human milk feeding before 6 months postpartum (aOR 2.66; 95% CI 1.41 to 5.05) and with non-exclusive human milk feeding to 4 months (aOR 2.19; 95% CI 1.16 to 4.14) and 6 months (aOR 3.65; 95% CI 1.50 to 8.84).Trial registration numbersNCT03400605, NCT03589963.

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“…By telephone (or in-person during programming), at 2 weeks and 2, 4 and 6 months postpartum (+/− two weeks), the first author administered a standardized and validated infant feeding questionnaire used previously by our group (Supplementary Table 1) [33,34]. During the first telephone call, participants were asked whether their infant received any formula in-hospital.…”

Section: Data Collectionmentioning

confidence: 99%

Breastfeeding rates are high in a prenatal community support program targeting vulnerable women and offering enhanced postnatal lactation support: a prospective cohort study

Francis

Mildon

Stewart

et al. 2021

Int J Equity Health

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Background In Canada, 91% of all mothers initiate breastfeeding, but 40–50% stop by 6 months and only 34% breastfeed exclusively for 6 months, with lower rates among socially and/or economically vulnerable women. The Canada Prenatal Nutrition Program (CPNP) aims to support breastfeeding among vulnerable women, but there is no formal framework or funding for sites to integrate proactive postnatal breastfeeding support. This research aimed to i) describe infant feeding practices among clients of one Toronto CPNP site using charitable funds to offer a lactation support program (in-home lactation consultant visits, breast pumps); ii) determine whether breastfeeding outcomes at 6 months differ based on maternal sociodemographics and food insecurity; and iii) assess utilization of the lactation support program. Methods Infant feeding practices were collected prospectively at 2 weeks, 2, 4 and 6 months postpartum via telephone questionnaires (n = 199). Maternal sociodemographics were collected at 2 weeks and food insecurity data at 6 months postpartum. Program monitoring records were used to determine utilization of the lactation support program. Results Ninety-one percent of participants were born outside of Canada; 55% had incomes below the Low-Income Cut-Off; and 55% reported food insecurity. All participants initiated breastfeeding, 84% continued for 6 months and 16% exclusively breastfed for 6 months. Among breastfed infants, ≥76% received vitamin D supplementation. Approximately 50% of infants were introduced to solids before 6 months. Only high school education or less and food insecurity were associated with lower breastfeeding rates. Overall, 75% of participants received at least one visit with a lactation consultant and 95% of these received a breast pump. Conclusions This study provides initial evidence that postnatal lactation support can be delivered within a CPNP site, with high uptake by clients. While all participants initiated breastfeeding and 84% continued for 6 months, adherence to the recommended 6 months of exclusive breastfeeding was low. Further research is needed to better understand the barriers to exclusive breastfeeding and how to support this practice among vulnerable women. Study registered at clinicaltrials.gov as NCT03400605.

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Postdischarge Feeding of Very‐low‐birth‐weight Infants

Abstract: Low rates of partial and exclusive breast-feeding of VLBW infants to 6 months CA were reported. Overall adherence to iron supplementation was low. Strategies to provide increased support for mothers identified as at-risk should be developed.

Cited by 11 publications

References 42 publications

Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study

Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study

Associations between use of expressed human milk at 2 weeks postpartum and human milk feeding practices to 6 months: a prospective cohort study with vulnerable women in Toronto, Canada

Breastfeeding rates are high in a prenatal community support program targeting vulnerable women and offering enhanced postnatal lactation support: a prospective cohort study

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