Factors Influencing Fresh Mother's Own Milk Feeding Frequency in Very Low Birth Weight Infants: A Retrospective Study.

Abstract

Objective: This study aimed to identify factors influencing the frequency of fresh mother's own milk feeding during the first 7 days of life in very low birth weight infants (VLBWIs), in order to inform evidence-based nursing interventions.

Methods: A retrospective case-control study was conducted. A total of 917 VLBWIs admitted to the neonatal intensive care unit of a tertiary maternity hospital in Zhejiang Province, China, between January 2020 and December 2023, were enrolled using convenience sampling. Based on the number of adequate fresh mother's own milk feedings, infants were categorized into three ordinal groups: 0 times, 1-13 times, and ≥14 times. Univariate ordinal logistic regression was used to screen for statistically significant variables, which were subsequently included in a multivariate ordinal logistic regression model to adjust for confounders and identify independent factors.

Results: Multivariate analysis identified multiple gestation (odds ratio [OR] = 0.66, 95% confidence interval [CI]: 0.50-0.87) and higher CRIB-II score (OR = 0.90, 95% CI: 0.81-0.99) as significant risk factors for reduced feeding frequency. In contrast, several protective factors were confirmed: two or more telephone follow-ups (OR = 1.68, 95% CI: 1.27-2.23), parental participation in offline professional educational sessions (OR = 2.78, 95% CI: 1.63-4.77), father as primary milk transporter (OR = 1.96, 95% CI: 1.25-3.09), higher paternal education level (OR = 3.03, 95% CI: 1.30-10.58), and cesarean delivery (OR = 1.96, 95% CI: 1.44-2.68).

Conclusion: The frequency of early fresh mother's own milk feeding in VLBWIs is influenced by a constellation of neonatal, interventional, and familial factors. To effectively promote feeding practices, clinical care should implement an integrated model that encompasses risk assessment (e.g., for multiples and infants with high illness severity), systematic nursing interventions (including structured follow-up and parent education), and enhanced family support, with a particular emphasis on paternal engagement.