Risk factors and short-term consequences of the absence or early cessation of breastfeeding in infants born preterm

Abstract

Breastfeeding (BF) benefits all babies; it also benefits preterm infants, so it is crucial that mothers receive skilled and expanded lactation support. Purpose - to identify factors associated with the absence or early cessation of BF, to evaluate the short-term consequences of the absence of BF in preterm infants and to identify the relationship between feeding practices (BF vs formula feeding - FF) and adherence to preventive measures recommended for preterm children, related with food. Materials and methods. An anonymous online survey of parents (self-reported) of preterm infants was conducted using the Google Forms service. The study involved 390 children divided into two groups. The main group (MG) included 290 children who were on mechanical ventilation, and the control group (CG) included 70 children on BF. Results. Early termination of BF of a preterm baby or start from FF is associated with the following factors: maternal age under 18 or older than 38 years old (OR=3.47; 95% CI: 0.84-2.40), male gender of the child (OR=2.43; 95% CI: 1.41-4.18), birth from a multiple pregnancy (OR=1.94; 95% CI: 1.01-3.73), prolonged (more than 7 days) mechanical lung ventilation (OR=2.52; 95% CI: 1.36-4.66) and prolonged (more than 14 days) tube feeding of the child (OR=1.96; 95% CI: 1.14-3.36). Children of MG aged 6 months of adjusted age were significantly more likely to have delayed psychomotor development. Conclusions. When counseling parents on the nutrition of a child born pretermin the first year of life, it should be taken into account that in the absence of BF, parents start introducing the first complementary foods to the child later (р<0.001), including those rich in iron (р=0.01), and parents of a BF child more often neglect the recommendations for adding iron and vitamin D (OR=2.09 vs OR=1.92). The lack of BF of preterm babies for at least the first 6 months of life is associated with an increased risk of developing atopic dermatitis and acute respiratory diseases in the first year of life (OR=2.14 and OR=2.24, respectively). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. No conflict of interests was declared by the authors.