A Prospective Study on Lactation Status and Breastfeeding Challenges of Mothers Giving Birth to Preterm Infants

Abstract BackgroundMothers of preterm infants face challenges in breastfeeding. The aim of the study was to investigate lactation status and challenges in breastfeeding faced by mothers of preterm infants. MethodsMothers giving birth to preterm infants between May 26th 2018 and October 31st 2018 were enrolled. Lactation status and challenges in breastfeeding on day 7 postpartum, at discharge of infants, 2 weeks post-discharge, and 3 months of corrected age (CA 3m) were collected by questionnaires. ResultsSeventy mothers were enrolled, and 51.4% had delayed lactogenesis II. Multivariate logistic regression analysis revealed that cesarean section (OR=3.368, p=0.032), older maternal age (OR=1.189, p=0.008), and primiparity (OR=5.091, p=0.012) were significant independent predictors of delayed lactogenesis II. Mothers with delayed lactogenesis II had significantly lower milk output (day 7 postpartum: 160.0mL vs. 300.0mL, p=0.001; at discharge: 425.0mL vs. 612.5mL, p=0.005) and lower proportion of exclusive breastfeeding (at discharge: 38.9% vs. 70.6%, p=0.008; CA 3m: 12.5% vs. 33.3%, p=0.050). The ROC showed that milk output >190mL/d and >245mL/d on day 7 postpartum significantly predict milk output ≥300mL/d at discharge and exclusive breastfeeding at post-discharge two weeks, respectively. Insufficient human milk was the top reason for breastfeeding discontinuation at CA 3m, and mother’s own milk ≥50% of total milk uptake at postpartum two weeks (OR=5.303, p=0.007) was an independent predictor of continuous breastfeeding at CA 3m. Feeding complications in infants, poor breastfeeding techniques, and low milk output were the top challenges in breastfeeding. ConclusionInterventions to improve early postpartum lactation and breastfeeding techniques may increase breastfeeding adoption in mothers of preterm infants.