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Acta Paediatr. 1999 Nov;88(11):1194-203.

Infant and maternal factors in the development of breastfeeding behaviour and breastfeeding outcome in preterm infants.

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Department of Women's and Children's Health, Uppsala University, Sweden.


A wide range in incidence of breastfeeding has been reported in preterm infants. The aim of this study was to explore the influence of infant and maternal factors on the development of preterm infants' breastfeeding behaviour and breastfeeding outcome. The sample consisted of 71 preterm infants born after a gestation of 26-35 wk. A descriptive, prospective design was used, with direct behavioural observation as data collection method, based on mothers' assessments according to the Preterm Infant Breastfeeding Behavior Scale (PIBBS), in which higher scores indicate higher competence. Multiple regression analyses revealed that variables associated with efficient infant performance included higher birthweight, less need of ventilator and oxygen treatment, higher haemoglobin level, absence of bottle-feeding, no need of apnoea treatment with Theophylline, and no suspicion of infection. A short gestation was associated with high PIBBS scores during weeks 32-37. Maternal characteristics associated with higher infant competence were breastfeeding experience and low educational level. Fifty-seven infants were discharged with full breastfeeding and 10 infants with partial breastfeeding. Infants with a short gestation period achieved full breastfeeding at low postmenstrual and high postnatal age. Infants with Theophylline treatment, low haemoglobin level, and a longer period of separation from their mothers established full breastfeeding at higher postmenstrual and postnatal age. In conclusion, low gestational age at birth was associated with early emergence of efficient breastfeeding behaviour and a high incidence of full breastfeeding.

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