Factors Influencing Breastfeeding Knowledge and Attitudes Among Parents of Moderate-To-Late Preterm Infants: A Cross-Sectional Study.

Abstract

Background: Prematurity constitutes a major threat to perinatal health, with moderate-to-late preterm infants accounting for over 80% of all preterm births in China. This places significant challenges on breastfeeding for the affected families. As the optimal enteral nutrition for preterm infants, human milk reduces the incidence of necrotizing enterocolitis and fulfills their growth needs.

Purpose: The aim of this study was to explore factors associated with breastfeeding knowledge and attitudes among parents of moderate-to-late preterm infants in the context of mother-infant separation.

Method: A total of 344 parents of moderate-to-late preterm infants were recruited. The infants were hospitalized under a no-rooming-in policy in the neonatal intensive care unit (NICU) of a maternal and child health hospital from March to August 2025. To assess breastfeeding knowledge and attitudes, participants completed a general information questionnaire, a Breastfeeding Knowledge Scale, and the Iowa Infant Feeding Attitude Scale (IIFAS). Univariate and multiple linear regression analyses were used to identify influencing factors.

Results: Gestational age, parental educational levels, and prenatal lactation education were initially associated with correct breastfeeding knowledge and feeding attitude tendencies. Higher paternal education and prenatal lactation education predicted better breastfeeding knowledge, whereas greater gestational age, higher maternal education, and prenatal lactation education predicted more positive breastfeeding attitudes.

Implications for practice and research: Moderate-to-late preterm infants experiencing mother-infant separation face significant feeding challenges and exhibit lower breastfeeding rates, outcomes influenced by multiple factors. To enhance breastfeeding motivation, education should be personalized and evidence-based. This involves considering the family's socioeconomic background, parental education levels, and distribution of caregiving roles.