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Birth. 2014 Dec;41(4):330-8. doi: 10.1111/birt.12135. Epub 2014 Oct 8.

Hospital care and early breastfeeding outcomes among late preterm, early-term, and term infants.

Author information

1
Division of Neonatology and Division of Hospital Medicine, Cincinnati Children's Research Foundation and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Abstract

BACKGROUND:

Compared with term infants (39-41 weeks), early-term (37-38 weeks) and late preterm (34-36 weeks) infants have increased breastfeeding difficulties. We evaluated how hospital practices affect breastfeeding by gestational age.

METHODS:

This Listening to Mothers III survey cohort included 1,860 mothers who delivered a 34-41-week singleton from July 2011 to June 2012. High hospital support was defined as at least seven practices consistent with the Baby-Friendly Hospital Initiative's Ten Steps for United States hospitals. Logistic regression tested mediating effects of hospital support on the relationship between gestational age and breastfeeding at 1 week postpartum.

RESULTS:

High hospital support was associated with increased exclusive breastfeeding (AOR 2.21 [95% CI 1.58-3.09]). Just 16.4 percent of late preterm infants experienced such support, compared with early-term (37.9%) and term (30.7%) infants (p = 0.004). Although overall breastfeeding rates among late preterm, early-term, and term infants were 87, 88, and 92 percent, respectively, (p = 0.21), late preterm versus term infants were less likely to exclusively breastfeed (39.8 vs. 62.3%, p = 0.002). Inclusion of hospital support in multivariable modeling did not attenuate the effect of late preterm gestation.

DISCUSSION:

Differences in practices do not account for decreased exclusive breastfeeding among late preterm infants. Hospital supportive practices increase the likelihood of any breastfeeding.

KEYWORDS:

Baby-Friendly Hospital Initiative; breastfeeding; early-term; hospital practices; late preterm

PMID:
25294061
DOI:
10.1111/birt.12135
[Indexed for MEDLINE]

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