Prevalence and duration of breast milk feeding in very preterm infants: A 3-year follow-up study and a systematic literature review.

Abstract

The World Health Organization recommends exclusive breast milk feeding until 6months and continuing up to 2years of age; little is known about whether very preterm infants are fed in accordance with these recommendations. We aimed to describe the prevalence and duration of breast milk feeding in very preterm children and to systematically review internationally published data. We evaluated breast milk feeding initiation and duration in very preterm children born in 2 Portuguese regions (2011-2012) enrolled in the EPICE cohort and followed-up to the age of 3 (n=466). We searched PubMed® from inception to January 2017 to identify original studies reporting the prevalence and/or duration of breast milk feeding in very preterm children. 91.0% of children received some breast milk feeding and 65.3% were exclusively breast fed with a median duration of 2months for exclusive and 3months for any breast milk; only 9.9% received exclusive breast milk for at least 6months, 10.2% received any breast milk for 12months or more, and 2.0% for up to 24months. The literature review identified few studies on feeding after hospital discharge (n=9); these also reported a low prevalence of exclusive breast milk feeding at 6months (1.0% to 27.0%) and of any breast milk at 12months (8.0% to 12.0%). The duration of breast milk feeding among Portuguese very preterm infants was shorter than recommended. However, this appears to be common globally. Research is needed to inform strategies to promote continued breast milk feeding.