Jiang Xin, Ding Lijing, Wu Na, Wan Yue, Xu Yiting, Yao Xiao, Huo Ke Ying, Huang Rong
Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Nursing Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
BMC Pregnancy Childbirth. 2025 Jul 9;25(1):738. doi: 10.1186/s12884-025-07837-0.
This study aims to assess the exclusive breastfeeding rate among preterm infants, examine the factors influencing breastfeeding practices, and identify evidence-based interventions to enhance lactation support.
This scoping review was conducted following Arksey and O'Malley (2005) methodological framework and reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Review and Meta-analyses Extension for Scoping Review) guidelines. We comprehensively searched five English databases and three Chinese databases in September 2023. This systematic review incorporated longitudinal, cohort, and randomized controlled trials (RCTs) published between 2013 and 2023 in English or Chinese. It specifically investigated WHO-compliant exclusive breastfeeding practices (rates and duration) among mother-preterm infant dyads (< 37 weeks gestation), with observational studies requiring documented follow-up protocols for inclusion. Three reviewers independently screened records, selected relevant studies, and performed the data charting. Finally, discrepancies were resolved through consensus-based discussion and final adjudication by a third reviewer to ensure methodological transparency and minimize selection bias.
11 studies met the inclusion criteria and were included in this review. This scoping review observed a progressive decline in exclusive breastfeeding rates among preterm infants within one year postpartum, with challenges in the immediate postpartum period related to breastfeeding techniques and milk supply insufficiency. Factors such as maternal age, infant gestational age and health status, and hospital transfers also influence breastfeeding cessation at 6-12 months postpartum.
This scoping review study provides the complex and evolving breastfeeding challenges faced by preterm infants, shaped by physiological, social, and psychological factors. Key findings underscore the need for longitudinal, adaptive lactation support strategies that align with infants' developmental trajectories and parental psychosocial needs. To address critical gaps, future research should prioritize multicenter trials evaluating stepped-care interventions through standardized CONSORT-compliant protocols, while integrating machine learning models to predict individualized lactation failure risks based on dynamic NICU biometrics.
本研究旨在评估早产儿的纯母乳喂养率，探讨影响母乳喂养行为的因素，并确定基于证据的干预措施以加强泌乳支持。
本范围综述遵循阿克西和奥马利（2005年）的方法框架进行，并按照PRISMA-ScR（系统评价和Meta分析扩展的范围综述的首选报告项目）指南报告。我们于2023年9月全面检索了五个英文数据库和三个中文数据库。本系统综述纳入了2013年至2023年期间以英文或中文发表的纵向、队列和随机对照试验（RCT）。它专门调查了母亲-早产儿二元组（孕周<37周）中符合世界卫生组织标准的纯母乳喂养行为（率和持续时间），观察性研究要求有记录的随访方案才能纳入。三位评审员独立筛选记录、选择相关研究并进行数据图表制作。最后，通过基于共识的讨论和第三位评审员的最终裁决解决分歧，以确保方法的透明度并尽量减少选择偏倚。
11项研究符合纳入标准并被纳入本综述。本范围综述观察到产后一年内早产儿的纯母乳喂养率逐渐下降，产后即刻在母乳喂养技术和乳汁供应不足方面存在挑战。母亲年龄、婴儿孕周和健康状况以及医院转诊等因素也会影响产后6至12个月的母乳喂养中断情况。
本范围综述研究揭示了早产儿面临的复杂且不断变化的母乳喂养挑战，这些挑战受到生理、社会和心理因素的影响。主要研究结果强调需要制定与婴儿发育轨迹和父母心理社会需求相匹配的纵向、适应性泌乳支持策略。为弥补关键差距，未来研究应优先开展多中心试验，通过符合标准化CONSORT的方案评估逐步护理干预措施，同时整合机器学习模型，根据新生儿重症监护病房的动态生物特征预测个体泌乳失败风险。
