Feeding practices with human milk in newborns less than 1500g or less than 32 weeks

Abstract

Abstract Introduction There is currently no unified policy on either breastfeeding support or enteral nutrition practices, as regards human milk (HM) in pre-term newborns. The aim of this study was to describe breastfeeding support measures, as well as the use of HM in very preterm infants in Spanish public hospitals. Method A questionnaire on enteral feeding practices was distributed. Data were analysed from units caring for newborns less than 32 weeks or 1500 g. A univariate analysis was performed comparing level II and III care units. Results There was a 91% response rate. A total of 93 units cared for infants less than 32 weeks or 1500 g (17 level II and 76 level III), and 49% of the units recorded the breastfeeding rate on discharge. Around 75% (70/93) had a guideline on managing HM (level III 81 vs. level II 47%, P = .002), and 25% had access to donor human milk. Just under half (46%) started trophic feeding in the first 6 h. Target enteral feeding volume in stable preterm infants was ≥180 ml/kg/day in 89% of the units (level III 93% vs. level II 70%, P = .017). HM fortifier was used in 96% of the units. In 92%, it was added when the required enteral volume was tolerated. In 59% of the units, adjustments in the quantity of fortifier were made according to weight, and in 36%, it depended on analytical criteria. Some units (9%) used pure protein fortifier. Conclusions There is a marked variability in breastfeeding support measures and in feeding practices of preterm infants in Spanish neonatal units.