Effect of early micro-breastfeeding on growth rate and postpartum depression in preterm infants with low-birth-weight.

Abstract

Background: Premature infant formula is based on milk and contains energy, vitamins, etc. Breast milk is rich in minerals, such as phosphorus and calcium, and proteins. Both can be used for nutritional support in preterm infants with low-birth-weight. However, their effects on the difference in infant growth rate and postpartum depression are still unclear.

Aim: To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.

Methods: Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology, Suzhou Ninth Hospital Affiliated to Soochow University, between January 2022 and December 2024, were retrospectively collected. The infants were divided into two groups according to the different enteral feeding methods in the early stage: Control group (n = 32 cases, premature infant formula feeding) and observation group (n = 36 cases, micro-breastfeeding, i.e., exclusive breastfeeding, no mixed feeding). The baseline data; feeding status; gastrointestinal adverse reactions such as vomiting, gastric retention, and abdominal distension; growth rate (body weight, body length, and head circumference); and adverse events (infection, cholestasis, hyperbilirubinemia, and necrotizing enterocolitis) were compared between the two groups. Moreover, the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale (EPDS) was compared.

Results: No significant difference in baseline data was found between the two groups (P > 0.05). The onset time of weight gain (6.49 ± 0.53 days vs 7.09 ± 0.61 days, P < 0.001), time for complete meconium excretion (6.28 ± 0.92 days vs 8.31 ± 1.17 days, P < 0.001), time for recovery to birth weight (8.81 ± 1.40 days vs 10.95 ± 1.64 days, P < 0.001), and time to reach full enteral feeding (12.29 ± 2.08 days vs 15.48 ± 2.27 days, P < 0.001) were compared between the observation and control groups. The incidence of vomiting, abdominal distension, and gastric retention was significantly lower in the observation group than in the control group, and the difference was significant (P < 0.05). The rates of the weight growth (15.88 ± 1.57 g/day vs 14.84 ± 1.51 g/day, P = 0.007), head circumference (0.63 ± 0.08 cm/week vs 0.59 ± 0.05 cm/week, P = 0.018), and length (0.80 ± 0.12 cm/week vs 0.73 ± 0.14 cm/week, P = 0.029) were compared between the observation and control groups. On hospital admission of preterm infants with low-birth-weight, the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression (P > 0.05). Preterm infants with low-birth-weight were hospitalized for 2 weeks, and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group (8.38 ± 1.47 vs 9.49 ± 2.35, P = 0.021).

Conclusion: Compared with preterm infant formula feeding, early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications, thereby alleviating mothers' concerns about their children and reducing the risk of postpartum depression.