Predictors of Direct Breastfeeding in Preterm Infants.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Breastfeeding Medicine Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI:10.1089/bfm.2024.0052
Manisha Mills, Laurie Nommsen-Rivers, Heather C Kaplan, Chunyan Liu, Shelley Ehrlich, Laura Ward
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引用次数: 0

Abstract

Objective: Rates of mother's own milk (MOM) provision in the neonatal intensive care unit (NICU) vary widely, despite acceptance as the gold standard for nutrition in preterm infants. Direct breastfeeding (DBF) supports long-term provision of MOM, but factors that support DBF in preterm infants are unknown. The purpose of this study was to identify factors that predict DBF at oral feeding initiation and at NICU discharge. Methods: This was a retrospective cohort study of preterm infants born at ≤ 32 weeks who were receiving MOM at 32 weeks corrected gestational age (cohort 1) and at discharge to home (cohort 2). The primary outcomes were rates of DBF at oral feeding initiation (cohort 1) and at hospital discharge (cohort 2). We examined bivariate associations between infant characteristics, maternal sociodemographic factors, and hospital practices (e.g., lactation visit timing and frequency) with DBF outcomes and then built logistic regression models to determine the adjusted odds ratio and 95% confidence interval ([adjusted odds ratio [aOR] [95%CI]) for independent predictors of the DBF outcomes. Results: Sixty-four percent of eligible infants initiated DBF, and 51% were DBF at discharge. Sociodemographic, NICU, and lactation support factors were associated with both outcomes. Post hoc analysis showed that similar factors also influenced lactation support provision. Conclusions: Lactation support, NICU and sociodemographic variables influence DBF initiation and DBF at discharge. Interventions that optimize efficient use of available lactation support, address bias, and provide ample opportunity for DBF practice could improve rates.

早产儿直接母乳喂养的预测因素。
目的:新生儿重症监护室(NICU)中的母乳喂养率差异很大,尽管母乳喂养已被公认为早产儿营养的黄金标准。直接母乳喂养(DBF)支持长期母乳喂养,但支持早产儿直接母乳喂养的因素尚不清楚。本研究的目的是确定在开始口服喂养和出 NICU 时预测 DBF 的因素。方法:这是一项回顾性队列研究,研究对象是出生不足 32 周的早产儿,他们在 32 周矫正胎龄时(队列 1)和出院回家时(队列 2)接受 MOM。主要结果是开始口服喂养时(队列 1)和出院时(队列 2)的 DBF 率。我们研究了婴儿特征、产妇社会人口学因素和医院实践(如哺乳访视时间和频率)与 DBF 结果之间的二元关联,然后建立了逻辑回归模型,以确定 DBF 结果独立预测因素的调整赔率比和 95% 置信区间([调整赔率比 [aOR] [95%CI])。结果64%的合格婴儿开始了 DBF,51%的婴儿在出院时进行了 DBF。社会人口学、新生儿重症监护室和哺乳支持因素与这两项结果相关。事后分析表明,类似因素也会影响哺乳支持的提供。结论哺乳支持、新生儿重症监护室和社会人口学变量会影响 DBF 的启动和出院时的 DBF。采取干预措施,优化可用哺乳支持的有效利用,解决偏差问题,并为 DBF 实践提供充分机会,可提高比率。
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来源期刊
Breastfeeding Medicine
Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
4.20
自引率
11.10%
发文量
130
审稿时长
6-12 weeks
期刊介绍: Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.
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