Trend over 25 years of risk factors of mother's own milk provision to very low birth weight infants at discharge

Abstract

BackgroundFeeding mother's own milk (MOM) is associated with reduced morbidity of very low birth weight (VLBW) infants (<1500 g), but not all mothers are able to provide pumped breast milk or breastfeed until discharge. AimsTo investigate the duration of MOM feeding and identify risk factors for cessation. Study designSingle-center retrospective cohort study. Subjects307 VLBW infants born 2012 and 2019 surviving beyond 7 days of life. Outcome measuresAnalysis of MOM feeding at discharge, including comparison with a historical cohort of infants born 1992–1994. ResultsMOM feeding was initiated in 178/180 infants (98.9 %) born in 2012 and in 123/127 infants (96.9 %) born in 2019 (p = 0.132), as compared to 73/89 (82 %) infants born 1992–1994 (p < 0.001). Median [range] duration of MOM feeding was similar for infants born in 2012 (45 [0–170] days) and 2019 (50 [0–190] days) (p = 0.396), but much longer than in the historical cohort (36 [0–152] days) (p < 0.001). The overall breastfeeding rate increased up to 69.2 % and 77.2 %. Factors associated with cessation of MOM feeding were smoking during pregnancy, single-mother status, short (<12 years) duration of maternal or paternal school education (all p ≤ 0.001), natural conception, birth weight ≥ 1000 g, and gestational age ≥ 29 weeks (p < 0.05). In Cox proportional hazard multivariate analysis, smoking during pregnancy and single-mother status remained independent risk factors. ConclusionsDuration of MOM feeding and breastfeeding rates of VLBW infants during hospital stay have increased significantly during the last 30 years, while smoking and indicators of low socioeconomic status remain dominant predictors of cessation of MOM feeding.