Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice: the results of a national cohort study with high breastfeeding initiation rates.

Many preterm infants are not capable of exclusive breastfeeding from birth. To guide mothers in breastfeeding, it is important to know when preterm infants can initiate breastfeeding and progress. The aim was to analyse postmenstrual age (PMA) at breastfeeding milestones in different preterm gestational age (GA) groups, to describe rates of breastfeeding duration at pre-defined times, as well as analyse factors associated with PMA at the establishment of exclusive breastfeeding

Factors associated with exclusive breastfeeding of preterm infants. Results from a prospective national cohort study.

Evidence-based knowledge of how to guide the mothers of preterm infants in breastfeeding establishment is contradictive or sparse. The aim was to investigate the associations between pre-specified clinical practices for facilitating breastfeeding, and exclusive breastfeeding at discharge as well as adequate duration thereof

Breastfeeding milestones for various gestational age groups.

<p>GA  =  gestational age, IQR, interquartile range, PMA  =  postmenstrual age, PNA  =  Postnatal age, pp  =  postpartum</p><p>Breastfeeding milestones for various gestational age groups.</p

Proportions of infant and mother characteristics and clinical practices in exclusive and non-exclusive breastfeeding groups.

<p>*  =  p < 0,05, **  =  p< 0,01, ***  =  p< 0,001, ****  =  p< 0,0001.</p><p>BF  =  breastfeeding, excl.  =  exclusive, n/N  =  number of infants or mothers with the characteristic/number of responses, NS  =  Non-significant, pp  =  postpartum, SGA  =  Small for gestational age.</p

Odds for failure of exclusive breastfeeding at discharge from NICU to home.

<p>*  =  p < 0,05, **  =  p< 0,01, ***  =  p< 0,001, ****  =  p< 0,0001.</p><p>BF  =  breastfeeding, CI  =  confidence interval, GA  =  Gestational age, <b>N</b>  =  Number included in unadjusted analyses, (N  =  1007)  =  Number included in adjusted analysis NICU  =  Neonatal Intensive Care Unit, OR  = odds ratio, pp  = post partum, prev  =  prevalence.</p

Flow chart.

<p>BF  =  breastfeeding, M  =  mothers, NICU  =  Neonatal Intensive Care Unit, PI  =  preterm infants, Q1  =  Questionnaire 1, Q2  =  Questionnaire 2. *The four infants who died after inclusion were all twins, no mothers were lost due to infant death.</p

Postmenstrual age at establishment of exclusive breastfeeding compared to gestational age (GA) at birth.

<p>Postmenstrual age at establishment of exclusive breastfeeding compared to gestational age (GA) at birth.</p

Gestational age groups and drop out.

<p>N  =  total number, n  =  sub group numbers.</p

Flowchart.

<p>BF  =  breastfeeding, M  =  mothers, NICU  =  Neonatal Intensive Care Unit, PI  =  preterm infants, Q  =  Questionnaire. *The four infants who died after inclusion were all twins; no mothers were lost due to infant death.</p