Breastfeeding Medicine最新文献

{"title":"Impact of Gestational Hypothyroidism on Exclusive Breastfeeding in the Early Postnatal Period.","authors":"Timucin Imdadoglu, Bulent Guzel, Asli Okbay Gunes, Senay Coskun, Emel Altuncu, Sirin Guven","doi":"10.1177/15568253261457856","DOIUrl":"10.1177/15568253261457856","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding (EBF) provides health benefits, yet its continuation remains limited. Maternal endocrine disorders, including gestational hypothyroidism, may impair lactogenesis through hormonal dysregulation; however, evidence regarding the association between gestational hypothyroidism and breastfeeding outcomes remains limited.</p><p><strong>Objective: </strong>To investigate the association between maternal gestational hypothyroidism and breastfeeding outcomes in term infants, with a focus on EBF at the end of the first month and formula-free breast milk feeding at 6 months.</p><p><strong>Methods: </strong>This retrospective matched case-control study compared term infants of mothers with gestational hypothyroidism treated with levothyroxine (<i>n</i> = 103) and matched controls (<i>n</i> = 103). Feeding data were obtained from medical records and 6-month telephone follow-up, and factors associated with early formula supplementation were analyzed using multivariable logistic regression.</p><p><strong>Results: </strong>EBF rates were significantly lower in the case group at 1 month (58.3% versus 81.6%, <i>p</i> < 0.001). Formula supplementation within the first postnatal day was more frequent in the case group than in controls (46.6% versus 21.4%; χ² = 14.63, <i>p</i> < 0.001). At 6 months, formula feeding-either alone or combined with breastfeeding and/or complementary foods-was significantly more frequent in the case group (45.6% versus 25.2%, <i>p</i> = 0.003). Among infants who ever received formula (<i>n</i> = 84), formula was initiated during the first postnatal month more frequently in the case group (82.7% versus 59.4%, <i>p</i> = 0.018), with earlier mean age at formula initiation (1.4 ± 0.97 versus 2.3 ± 1.51 months, <i>p</i> = 0.003). Multivariable logistic regression showed that higher maternal gravidity was independently associated with early formula supplementation (odds ratio = 3.16; 95% confidence interval: 1.09-9.10; <i>p</i> = 0.033).</p><p><strong>Conclusions: </strong>Gestational hypothyroidism was associated with lower EBF rates at 1 month and increased early formula supplementation. These findings underscore the need for targeted lactation support and careful postpartum follow-up in mothers with gestational hypothyroidism.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"496-503"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Saito and Colleagues.","authors":"Benay Oğuz, Nursen Bolsoy","doi":"10.1177/15568253261463542","DOIUrl":"10.1177/15568253261463542","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"527-528"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Practices and Institutional Support for Breastfeeding During Maternal Hospitalization in Adult Wards: A Multicenter Survey in Turkiye.","authors":"Dilara Lahut, Mine Başıbüyük, Övgü Büke, Kübra Yılmaz, Nalan Karabayır","doi":"10.1177/15568253261455185","DOIUrl":"10.1177/15568253261455185","url":null,"abstract":"<p><strong>Introduction: </strong>Breastfeeding support in adult wards is often overlooked. We examined physician practices, institutional support, lactation resources, and educational needs during maternal hospitalization in Turkiye.</p><p><strong>Materials and methods: </strong>We conducted an anonymous, web-based cross-sectional survey of physicians working in adult medical and surgical wards in Turkiye between July and August 2025. The 32-item questionnaire assessed clinician characteristics, breastfeeding support practices, institutional support and lactation resources, breastfeeding-related clinical decisions, educational needs, and Baby-Friendly Hospital (BFH) status. Logistic regression was used to estimate adjusted odds ratios for selected outcomes.</p><p><strong>Results: </strong>Among 419 participants (52.5% female; mean age, 39 ± 10 years; 50.8% medical and 49.2% surgical), 72.3% reported working in a BFH. Female physicians and surgeons were more likely to routinely inquire about breastfeeding (adjusted odds ratio [aOR] = 3.44, 95% confidence interval [CI]: 2.06-5.75 and aOR = 2.11, 95% CI: 1.28-3.49, respectively). Institutional support and lactation resources were reported more often in private and BFH settings. Physicians working in private hospitals were less likely to use lactation-specific resources (aOR = 0.30, 95% CI: 0.12-0.78), whereas female physicians were more likely to use them (aOR = 3.07, 95% CI: 1.81-5.21). Recommendations to interrupt breastfeeding after contrast-enhanced imaging was associated with female sex and private hospital setting (aOR = 2.39, 95% CI: 1.28-4.45, and aOR = 6.10, 95% CI: 1.86-20.01, respectively). Perceived adequacy of prior breastfeeding education increased with experience, whereas interest in further training was higher among less experienced physicians.</p><p><strong>Conclusions: </strong>Breastfeeding support during maternal hospitalization varied across physician and institutional contexts. Gaps were identified in breastfeeding support practices, lactation support and resources, imaging-related counseling, and training needs. Routine documentation, clearer ward policies, reliable lactation support, and targeted education may help standardize care in adult inpatient settings.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"477-486"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Couple Counseling on Maternal Distraction and Attention Levels During Breastfeeding and Nonfeeding Childcare: A Randomized Controlled Trial in Western Iran.","authors":"Ensiyeh Jenabi, Sima Fazli, Mahsa Bashiri Amani, Erfan Ayubi","doi":"10.1177/15568253261457849","DOIUrl":"10.1177/15568253261457849","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the current study was to assess the effect of couple counseling on maternal distraction and attention levels during breastfeeding and nonfeeding childcare in mothers experiencing distractions in Hamadan, western Iran.</p><p><strong>Methods: </strong>In this randomized controlled trial, mothers attending comprehensive health centers for routine postpartum care who reported distraction during breastfeeding were enrolled. Participants were assigned via block randomization to an intervention group (standard care plus couple-centered counseling) or a control group (standard care alone). The maternal distraction was measured using the maternal distraction questionnaire at baseline, immediately post-intervention, and at two-, three-, and 4-month follow-ups.</p><p><strong>Results: </strong>The analysis included 64 participants in each group. At 4 months, 40.6% more mothers in the intervention group than in the control group reported not being at all distracted during breastfeeding, with a 36% difference in favor of the intervention group for very high attention. Corresponding figures during childcare were 42.2% and 37.5%, respectively. A significant interaction between time and group was observed for both maternal distraction during breastfeeding and during childcare (<i>p</i> < 0.001). In the intervention group, maternal distraction during breastfeeding decreased from 17.89 ± 2.53 at baseline to 8.31 ± 1.27 at 4 months, and during childcare from 18.03 ± 1.94 to 8.98 ± 2.06. In the control group, these scores decreased only slightly, from 16.84 ± 2.50 to 15.52 ± 2.37 for breastfeeding and from 17.84 ± 2.44 to 15.19 ± 2.29 for childcare.</p><p><strong>Conclusion: </strong>Our study showed that a couple-centered counseling intervention significantly reduced maternal distraction and improved attention during breastfeeding and childcare.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"504-512"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Peer Counseling Interventions on Breastfeeding Outcomes: A Systematic Review and Meta-Analysis.","authors":"Sümeyye Köse, Enzel Köksaldı, Handan Özcan","doi":"10.1177/15568253261480490","DOIUrl":"https://doi.org/10.1177/15568253261480490","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to determine the effects of peer counseling on breastfeeding outcomes.</p><p><strong>Materials and methods: </strong>In this systematic review and meta-analysis study, PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases were searched. The literature search was conducted between January 2025 and February 2026, and no restrictions were applied regarding the year of publication during the search process. Data were combined using meta-analysis and narrative synthesis methods.</p><p><strong>Findings: </strong>A total of 7 studies involving 684 women were included in this systematic review and meta-analysis. The analysis results showed that peer counseling had a statistically significant effect on improving breastfeeding outcomes in mothers (standardized mean difference: -0.951; 95% CI: -1.358 to -0.545; <i>Z</i> = -4.585; <i>p</i> = 0.000; <i>I² =</i> 83.59).</p><p><strong>Conclusion: </strong>The findings indicate that peer counseling interventions may improve breastfeeding outcomes. These findings support the integration of peer counseling into breastfeeding support programs and may inform clinical practice and future breastfeeding promotion strategies.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261480490"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial and Physiological Determinants of Continued Exclusive Breastfeeding at 6 Months' Corrected Age in Late Preterm Infants.","authors":"Jinxiu Chen, Qinghua Li, Honghui Wen, Qiuxia Liang, Weiqiang Zhang, Xiujuan Liao, Yanqing Tang","doi":"10.1177/15568253261483401","DOIUrl":"https://doi.org/10.1177/15568253261483401","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Exclusive breastfeeding (EBF) is essential for neonatal survival and long-term development; however, late preterm infants (34&lt;sup&gt;+0&lt;/sup&gt;-36&lt;sup&gt;+6&lt;/sup&gt; weeks of gestation) consistently exhibit lower breastfeeding persistence than term infants. Breastfeeding sustainability in this population is influenced by both psychosocial conditions and physiological readiness. This study aimed to identify modifiable psychosocial and physiological determinants-including prenatal breastfeeding intention, family caregiving support, skin-to-skin contact, workplace breastfeeding support, and the timing of the early secretory activation-associated with continued EBF at 6 months among late preterm infants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study reviewed late preterm infants admitted to a tertiary perinatal center between January 2020 and December 2022. Demographic, perinatal, and feeding-related variables were extracted from electronic medical records using the REDCap platform. Key exposures included prenatal breastfeeding intention, postnatal caregiving modality, daily duration of skin-to-skin contact, workplace breastfeeding support, and early secretory activation timing. The primary outcome was EBF duration, assessed at corrected ages of 6, 12, and 24 weeks. Propensity score matching (PSM) (1:1) was performed to balance baseline maternal and neonatal characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After PSM, 124 mother-infant dyads were included in the final analysis. The mean maternal age was 29.7 years, and 54% of mothers reported an intention to breastfeed for more than 6 months. Breastfeeding duration was strongly associated with prenatal intention, with over 80% of mothers who planned continued EBF at 6 months achieving this goal (&lt;i&gt;p&lt;/i&gt; = 0.004). Shared family caregiving was associated with significantly longer breastfeeding duration compared with exclusive maternal care (odds ratio [OR] = 3.144, &lt;i&gt;p&lt;/i&gt; = 0.001). Longer daily skin-to-skin contact demonstrated a dose-response relationship with breastfeeding persistence (OR = 3.038, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Workplace breastfeeding support was independently associated with prolonged EBF, particularly among mothers with established prenatal intention (OR = 2.142, 95% confidence interval [CI]: 1.105-4.334, &lt;i&gt;p&lt;/i&gt; = 0.007). Additionally, an earlier secretory activation (≤2 days postpartum) was a strong predictor of continued EBF at 6 months, independent of maternal intention (OR = 3.227, 95% CI: 1.014-5.610, &lt;i&gt;p&lt;/i&gt; = 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both psychosocial support and physiological factors play critical roles in sustaining breastfeeding among late preterm infants. Prenatal breastfeeding intention, family caregiving support, skin-to-skin contact, workplace breastfeeding accommodations, and early secretory activation independently and jointly contribute to continued EBF at 6 months duration. Targeted interventions addr","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261483401"},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Nipple Length and Early Breastfeeding Success in Postpartum Women: A Descriptive Correlational Study.","authors":"Zeynem Yildirim Balkan, Serap Özdemir, Serap Balci","doi":"10.1177/15568253261483409","DOIUrl":"https://doi.org/10.1177/15568253261483409","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is essential for improving newborn health and maternal-infant bonding.</p><p><strong>Objectives: </strong>To examine the association between nipple length and early breastfeeding success assessed using the LATCH score in postpartum women.</p><p><strong>Methods: </strong>This descriptive correlational study was conducted in the delivery room and obstetric clinic of a university hospital. The researchers aimed to include the entire eligible population without performing sample size calculations. A total of 335 mother-infant pairs were enrolled. The pre-lactation nipple lengths of primiparous mothers were measured, and early breastfeeding success was assessed twice using the LATCH Breastfeeding Assessment Tool. Data were collected using an information form, a follow-up form, and the LATCH assessment scale.</p><p><strong>Results: </strong>The mean nipple length of the mothers was 5.56 ± 3.51 mm, the mean nipple diameter was 17.60 ± 3.09 mm, the mean areola diameter was 6.50 ± 1.35 cm, and the mean time required for newborns to latch onto the breast was 194.77 ± 218.82 seconds. Regression analysis demonstrated that the models explained 60% and 63% of the variance in the LATCH-1 and LATCH-2 scores, respectively. Early breastfeeding success was significantly associated with several maternal nipple characteristics.</p><p><strong>Conclusion: </strong>Early breastfeeding success in primiparous mothers is associated with maternal nipple characteristics, particularly nipple morphology.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261483409"},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fentanyl and Sufentanil in Labor Analgesia and Lactational Mastitis Risk: Evidence from a Retrospective Cohort Combined with Network Pharmacology.","authors":"Qing Song, Mengjuan Li, Qi Wang, Qing Zhao, Jiayan Luo, Wei-Yi Wu, Shih-Pin Lee","doi":"10.1177/15568253261483388","DOIUrl":"https://doi.org/10.1177/15568253261483388","url":null,"abstract":"<p><strong>Background: </strong>Lactational mastitis (LM) is a common postpartum inflammatory disorder. Fentanyl and sufentanil are widely used for labor analgesia; however, their association with postpartum LM and the underlying molecular mechanisms remain unclear.</p><p><strong>Methods: </strong>A single-center retrospective cohort study including 201 women was conducted to evaluate the association between sufentanil-based neuraxial labor analgesia and the occurrence of postpartum LM using logistic regression. In parallel, network pharmacology, protein-protein interaction analysis, Gene Ontology/Kyoto Encyclopedia of Genes and Genomes enrichment, and molecular docking were performed to explore fentanyl- and sufentanil-related molecular targets and potential mechanisms.</p><p><strong>Results: </strong>Women receiving sufentanil-based neuraxial labor analgesia had a higher incidence of LM than women without labor analgesia, and logistic regression showed increased odds of LM in the exposed group (odds ratio = 8.758). Network pharmacology identified 20 shared targets between the drugs and LM, with core nodes including tumor necrosis factor (TNF), IL6, epidermal growth factor receptor (EGFR), ESR1, and NR3C1, which were mainly enriched in inflammation- and stress-related pathways such as NF-κB, mitogen-activated protein kinase (MAPK) and HIF-1. Molecular docking indicated that both opioids could form stable interactions with multiple targets involved in inflammation, endocrine regulation, and cell survival.</p><p><strong>Discussion: </strong>The clinical findings suggest a potential association between sufentanil-based neuraxial labor analgesia and postpartum LM, while the network pharmacology and molecular docking analyses provide hypothesis-generating evidence for opioid-related inflammatory, immune, endocrine, and tissue-repair pathways. Prospective studies are needed to validate these findings and clarify causality.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261483388"},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Everolimus Breast Milk Transfer After Liver Transplantation.","authors":"Nozomi Yoshimoto, Hinata Ueda, Masaki Kobayashi, Katsuya Narumi, Keisuke Okamoto, Satoshi Matsuzawa, Kayo Tomimori, Michika Yamaguchi, Naoki Yoshikawa, Ryuji Ikeda, Shinji Katsuragi","doi":"10.1177/15568253261483396","DOIUrl":"https://doi.org/10.1177/15568253261483396","url":null,"abstract":"<p><strong>Background: </strong>Improving survival after liver transplantation has increased pregnancy rates among women of reproductive age, raising critical questions about breastfeeding safety with maintenance immunosuppressants. Quantitative human data on everolimus transfer into breast milk remain extremely limited.</p><p><strong>Methods: </strong>Pharmacokinetic assessment of everolimus (0.25 mg/day once daily) was performed in a woman postpartum day 5 after cesarean delivery. Maternal whole-blood and breast milk samples were collected under steady-state conditions. Whole-blood concentrations were measured by automated immunoassay; breast milk concentrations were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS).</p><p><strong>Results: </strong>Maternal whole-blood concentrations peaked at 4 hours (1.98 ng/mL). Breast milk concentrations showed a delayed peak at 9 hours (0.117 ng/mL). Using the linear trapezoidal method, the milk-to-whole-blood AUC0-24 ratio was 0.078, and the estimated relative infant dose (RID) was 0.30%.</p><p><strong>Conclusion: </strong>This first liver transplant case demonstrates minimal transfer of everolimus into breast milk, with an estimated RID of 0.30% and delayed mammary peak kinetics. High-sensitivity LC-MS/MS enabled reliable quantification even at minimal maternal doses. Although limited to a single case, these findings provide clinically relevant human pharmacokinetic data to support individualized breastfeeding counseling in everolimus-treated liver transplant recipients.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261483396"},"PeriodicalIF":2.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding-Supportive Cue-Based Feeding and Clinical Outcomes in Preterm Infants: A Retrospective Cohort Study.","authors":"Iris Morag, Michal Amar, Rasha Zoabi Safadi, Mazal Shemer, Hadas Tal, Tatiana Vaiser, Michal Yackobovitch-Gavan","doi":"10.1177/15568253261480488","DOIUrl":"https://doi.org/10.1177/15568253261480488","url":null,"abstract":"<p><strong>Background: </strong>Establishing direct breastfeeding in preterm infants remains challenging in neonatal intensive care units (NICUs). While cue-based feeding (CBF) is considered a developmentally supportive approach, its impact on direct breastfeeding remains uncertain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of preterm infants born at 27 + 0 to 33 + 6 weeks' gestation and admitted to a single tertiary NICU. Infants were assigned to two distinct study epochs reflecting different feeding approaches: traditional feeding (TF) and a breastfeeding-supportive CBF approach. A washout period was applied to minimize contamination between epochs. The primary outcome was direct breastfeeding at discharge (at least once daily). Secondary outcomes included PMA at discharge, length of hospitalization, and growth parameters. Multivariable logistic regression was used to evaluate factors associated with direct breastfeeding at discharge.</p><p><strong>Results: </strong>A total of 135 preterm infants were included (CBF <i>n</i> = 66, TF <i>n</i> = 69). Direct breastfeeding at discharge was more frequent in the CBF group than in the TF group (48.5% versus 23.2%, <i>p</i> = 0.002). CBF was independently associated with any direct breastfeeding at discharge (odds ratio [OR] 5.09; 95% confidence interval [CI] 2.02-12.82), after adjustment for maternal age and mode of delivery. Infants in the CBF group were discharged at a lower PMA and had a shorter hospitalization. Weight and head circumference <i>z</i>-scores at discharge were similar between groups, despite greater declines in <i>z</i>-scores during hospitalization in the CBF group.</p><p><strong>Conclusions: </strong>In this cohort of preterm infants, implementation of a breastfeeding-supportive CBF approach was associated with higher rates of any direct breastfeeding at discharge and shorter length of hospitalization, without differences in weight or head circumference <i>z</i>-scores at discharge. These findings suggest that a breastfeeding-supportive CBF approach may facilitate the establishment of direct breastfeeding in the NICU.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261480488"},"PeriodicalIF":2.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}