Maastrup Ragnhild, Walloee Sisse, Kronborg Hanne, Sandfeld Helle B, Rom Ane L
Department of Neonatology, Knowledge Centre for Breastfeeding Infants with Special Needs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Research Unit Women's and Children's Health, Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
PLoS One. 2025 Jul 18;20(7):e0303224. doi: 10.1371/journal.pone.0303224. eCollection 2025.
The Baby-friendly Hospital Initiative for neonatal wards and the World Health Organization recommend that stable preterm infants initiate breastfeeding regardless of gestational age, postmenstrual age (PMA), or weight. Documented practice, however, is limited. We aimed to describe PMA at first breastfeeding attempt of stable preterm infants, to analyse delaying factors, to detect differences in breastfeeding performance across gestational age groups and use of nasal-CPAP. This Danish multicentre cohort study was based on questionnaires answered by mothers of 992 preterm infants gestational age 23-36 weeks. Differences in PMA between gestational age groups at first breastfeeding attempt were analysed by One-way ANOVA, and associations between PMA and selected factors by linear regression models. The lowest PMA at first breastfeeding attempt was 27.57 weeks. Of the extremely and very preterm infants, 61% and 46%, respectively, had the first breastfeeding attempt before PMA 32 weeks. Mechanical ventilation significantly delayed first breastfeeding attempt by seven days (p < 0.0001). Performance at the preterm infants' first breastfeeding attempt were predominantly without swallowing (78%). During first attempt, 29% were at breast with nasal-CPAP. Performance was in general not affected by nasal-CPAP treatment. In this cohort of preterm infants, we conclude that early initiation of breastfeeding is possible, also at low PMA and while maintained on nasal-CPAP. Hence, nasal-CPAP should not be a barrier for breastfeeding initiation. At first breastfeeding, even preterm infants before PMA 32 weeks demonstrated breastfeeding behaviours, although the majority did not swallow. Preterm infants need time to familiarize with the breast.
新生儿病房的爱婴医院倡议和世界卫生组织建议,病情稳定的早产儿无论其胎龄、月经后年龄(PMA)或体重如何,均应开始母乳喂养。然而,有记录的实践却很有限。我们旨在描述病情稳定的早产儿首次尝试母乳喂养时的PMA,分析延迟因素,检测不同胎龄组和使用鼻持续气道正压通气(nasal-CPAP)情况下母乳喂养表现的差异。这项丹麦多中心队列研究基于992名胎龄为23 - 36周的早产儿母亲所回答的问卷。通过单因素方差分析来分析首次尝试母乳喂养时不同胎龄组之间的PMA差异,并通过线性回归模型分析PMA与选定因素之间的关联。首次尝试母乳喂养时的最低PMA为27.57周。在极早产儿和极早早产儿中,分别有61%和46%在PMA 32周之前进行了首次母乳喂养尝试。机械通气显著延迟首次母乳喂养尝试达7天(p < 0.0001)。早产儿首次母乳喂养尝试时的表现主要是没有吞咽动作(78%)。在首次尝试时,29%的婴儿在使用鼻持续气道正压通气的情况下进行母乳喂养。总体而言,鼻持续气道正压通气治疗对母乳喂养表现没有影响。在这个早产儿队列中,我们得出结论,即使在低PMA且使用鼻持续气道正压通气的情况下,早期开始母乳喂养也是可行的。因此,鼻持续气道正压通气不应成为开始母乳喂养的障碍。在首次母乳喂养时,即使是PMA 32周之前的早产儿也表现出了母乳喂养行为,尽管大多数没有吞咽动作。早产儿需要时间来熟悉乳房。
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