156417 Neonatal Intensive Care Unit, Hospital Moinhos de Vento, RS, Brazil.
Federal University of Health Sciences of Porto Alegre, RS, Brazil.
J Hum Lact. 2021 Nov;37(4):775-783. doi: 10.1177/0890334420981929. Epub 2020 Dec 22.
The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays.
The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil.
We conducted a prospective longitudinal cohort study of infants ( = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother's own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding).
Most (93.4%; = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% ( = 54) were receiving exclusive mother's milk and 77.3% ( = 259) mixed feeding (mother's milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], < .05).
In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.
极低出生体重儿的母亲在出院时面临着许多挑战，尤其是在长时间住院的情况下，要实现母乳喂养。
本研究旨在描述巴西南部一家私立新生儿重症监护病房极低出生体重儿（VLBWI）出院时母乳喂养（纯母乳喂养或混合喂养）的发生率及相关因素。
我们进行了一项前瞻性纵向队列研究，纳入了存活至出院且无母乳喂养禁忌证的极低出生体重儿和/或胎龄小于 30 周的婴儿（n = 335）。根据出院时的喂养方式，将参与者最初分为三组（纯母乳喂养、部分母乳喂养和无母乳喂养）；但后来，我们分析了两组（母乳喂养、无母乳喂养）。
大多数（93.4%；n = 313）婴儿在出院时至少每日直接进行母乳喂养，其中 16.1%（n = 54）接受纯母乳喂养，77.3%（n = 259）混合喂养（母乳喂养和配方奶）。出院时母乳喂养与胎龄≥28 周、出生体重较高、住院期间无新生儿败血症或支气管肺发育不良、住院时间较短以及出院时体重较低有关。经泊松回归分析，仅住院时间较短与出院时母乳喂养相关（RR 0.98；95%CI [0.95, 0.99]，<0.05）。
在我们巴西的单一单位经验中，大多数婴儿在出院时进行母乳喂养。新生儿重症监护病房工作人员可能会针对住院时间延长的婴儿的母亲采取特定策略。可以早期识别有风险的母亲和婴儿，并制定个性化干预措施，以提高出院时的母乳喂养率。
