544 Neonatal intensive care admission is associated with lower breastfeeding in late preterm infants

Abstract

Breastfeeding is associated with improved maternal and infant outcomes. Infants who deliver during the late preterm period (34-0 to 36-6 weeks) represent over 70% of preterm births and have increased morbidity as compared to term infants. Whether NICU admission is associated with the likelihood of breastfeeding among late preterm infants is unknown. This is a secondary analysis of live births < 37 weeks in a Maternal Fetal Medicine Unit study of steroid use in the late preterm period. Prevalence of any breastfeeding in hospital was compared by infant NICU admission status. Chi square tests were used for bivariable analyses, and logistic regression was used to adjust for confounders. Median hours to first feed of any type (breast or bottle) was compared using Wilcoxon rank sum by NICU admission. Rate of breastfeeding was compared among infants who were fed within the first hour of life. Incidence of feeding problems, or inability to take all feeds by mouth, was compared by NICU admission among those breastfeeding. A total of 2329 subjects were included. The prevalence of any breastfeeding was 74.3% in infants not admitted to NICU and 65.8% in those admitted to the NICU (Table 1, p<0.001). NICU admission was independently associated with lower odds of any breastfeeding (adjusted odds ratio (aOR) 0.61, 95% CI 0.49, 0.77, p <0.001). NICU admission was associated with a significant delay to any first feed (Figure, p < 0.001). Analysis restricted to those with first feed within an hour revealed no difference in breastfeeding (70.6% admitted to NICU vs 77.4% not admitted to NICU p=0.08, aOR 0.62 95% CI 0.37- 1.02). Among breastfed infants, NICU admission was associated with higher odds of feeding problems (aOR 1.65, 95% CI 1.30 – 2.11, p<0.001). NICU admission is independently associated with decreased odds of any breastfeeding during delivery hospitalization in the late preterm infant. NICU admission is associated with longer time to any first feed. Among those infants who are fed in the first hour, there is no difference in breastfeeding rates by NICU admission.View Large Image Figure ViewerDownload Hi-res image Download (PPT)