Prevalence and duration of breast milk feeding in very preterm infants: A 3‐year follow‐up study and a systematic literature review

Rodrigues, Carina; Teixeira, Raquel; Fonseca, Maria João; Zeitlin, Jennifer; Barros, Henrique

doi:10.1111/ppe.12457

Cited by 31 publications

(34 citation statements)

References 52 publications

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“…It is therefore possible to estimate and to compare breastfeeding continuation rates until 6 months using the same methodology across a range of sociocultural contexts in Europe. This is important as previous studies have employed varying definitions, making international comparisons difficult (Rodrigues et al, 2018). The availability of data on many perinatal and socio-FIGURE 2 Distribution of infants by country according to the moment that breastfeeding was stopped economic characteristics allowed us to consider multiple risk factors found to be of importance for breastfeeding initiation in previous studies.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…The availability of data on many perinatal and socio-FIGURE 2 Distribution of infants by country according to the moment that breastfeeding was stopped economic characteristics allowed us to consider multiple risk factors found to be of importance for breastfeeding initiation in previous studies. Finally, the majority of previous studies had smaller, more selected samples, being principally from single centres (Flacking, Wallin, & Ewald, 2007;Morag et al, 2016;Rodrigues et al, 2018).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Bonnet

Blondel

Piedvache

et al. 2018

Maternal & Child Nutrition

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Breastfeeding confers multiple benefits for the health and development of very preterm infants, but there is scarce information on the duration of breastfeeding after discharge from the neonatal intensive care unit (NICU). We used data from the Effective Perinatal Intensive Care in Europe population-based cohort of births below 32 weeks of gestation in 11 European countries in 2011-2012 to investigate breastfeeding continuation until 6 months. Clinical and sociodemographic characteristics were collected from obstetric and neonatal medical records as well as parental questionnaires at 2 years of corrected age. Among 3,217 ever-breastfed infants, 34% were breastfeeding at 6 months of age (range across countries from 25% to 56%); younger and less educated mothers were more likely to stop before 6 months (adjusted relative risk [aRR] <25 years: 0.68, 95% CI [0.53, 0.88], vs. 25-34 years; lower secondary: 0.58, 95% CI [0.45, 0.76] vs. postgraduate education). Multiple birth, bronchopulmonary dysplasia (BPD), and several neonatal transfers reduced the probability of continuation but not low gestational age, fetal growth restriction, congenital anomalies, or severe neonatal morbidities. Among infants breastfeeding at discharge, mixed versus exclusive breast milk feeding at discharge was associated with stopping before 6 months: aRR = 0.60, 95% CI [0.48, 0.74]. Low breastfeeding continuation rates in this high-risk population call for more support to breastfeeding mothers during and after the neonatal hospitalization, especially for families with low socio-economic status, multiples, and infants with BPD. Promotion of exclusive breastfeeding in the NICU may constitute a lever for improving breastfeeding continuation after discharge.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Bonnet

Blondel

Piedvache

et al. 2018

Maternal & Child Nutrition

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“…They include maternal characteristics and health of mothers and infants . However, large variations among neonatal intensive care units (NICUs) are observed in many countries . Professional support, including hospital staffing rates, staff attitudes, and design of neonatal units, is also associated with successful BMF .…”

Section: Introductionmentioning

confidence: 99%

“…2 However, large variations among neonatal intensive care units (NICUs) are observed in many countries. [3][4][5][6][7] Professional support, including hospital staffing rates, staff attitudes, and design of neonatal units, is also associated with successful BMF. 8,9 Consequently, unit policies can overcome the low BMF rate associated with individual factors, including social risk factors.…”

Section: Introductionmentioning

confidence: 99%

Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE‐2 cohort study

Mitha

Piedvache

Glorieux

et al. 2019

Paediatric Perinatal Epid

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Background Facilitating factors and barriers to breast milk feeding (BMF) very preterm (VP) infants have been widely studied at the individual level. We aimed to describe and analyse factors associated with BMF at discharge for VP infants, with a special focus on unit policies aiming to support BMF. Methods We described BMF at discharge in 3108 VP infants enrolled in EPIPAGE‐2, a French national cohort. Variables of interest were kangaroo care during the 1st week of life (KC); unit's policies supporting BMF initiation (BMF information systematically given to mothers hospitalised for threatened preterm delivery and breast milk expression proposed within 6 hours after birth) and BMF maintenance (availability of protocols for BMF and a special room for mothers to pump milk); the presence in units of a professional trained in human lactation and regional BMF initiation rates in the general population. Associations were investigated by multilevel logistic regression analysis, with adjustment on individual factors. Results In total, 47.2% of VP infants received BMF at discharge (range among units 21.1%‐84.0%). Unit policies partly explained this variation, regardless of individual factors. BMF at discharge was associated with KC (adjusted odds ratio (aOR) 2.26 (95% confidence interval (CI) 1.40, 3.65)), with policies supporting BMF initiation (aOR 2.19 (95% CI 1.27, 3.77)) and maintenance (aOR 2.03 (95% CI 1.17, 3.55)), but not with BMF initiation rates in the general population. Conclusion Adopting policies of higher performing units could be an effective strategy for increasing BMF rates at discharge among VP infants.

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“…However, determining the prevalence of a condition is essential to guide health policy and to ensure appropriate resource allocation. Several reviews have been published on the prevalence of drooling, swallowing, and feeding problems in specific populations: for example, the prevalence of drooling in Parkinson disease; swallowing problems in stroke, Alzheimer disease, head injury, Parkinson disease, and multiple sclerosis; and feeding problems in infants born very preterm and patients in intensive care units . For the CP population, data on the prevalence of drooling, swallowing, and feeding problems can be retrieved from individual studies.…”

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confidence: 99%

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

Speyer

Cordier

Kim

et al. 2019

Develop Med Child Neuro

109

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Aim To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta‐analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. Results A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta‐analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non‐significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Interpretation Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper adds Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP.

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Prevalence and duration of breast milk feeding in very preterm infants: A 3‐year follow‐up study and a systematic literature review

Abstract: The duration of breast milk feeding among Portuguese very preterm infants was shorter than recommended. However, this appears to be common globally. Research is needed to inform strategies to promote continued breast milk feeding.

Cited by 31 publications

References 52 publications

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE‐2 cohort study

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

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