The Rates of Any Breastfeeding at the Time of Postpartum Hospital Discharge for Early Term (37⁰-38⁶ Weeks) Versus Full Term (39⁰-41⁶ Weeks) Infants

Objective: This study sought to compare the rates of any breastfeeding between early term (37⁰-38⁶ weeks) and full term (39⁰-41⁶ weeks) infants at the time of postpartum hospital discharge.

Methods: A retrospective cohort study of women with live, singleton pregnancies who were delivered in St. John's, Newfoundland and Labrador, between April 2001 and March 2018 was completed. The primary outcome was any breastfeeding at the time of postpartum hospital discharge. Secondary analyses included a comparison of breastfeeding by week of gestational age at term and by maternal and neonatal demographics and outcomes of pregnancy. Univariate and multiple logistic regression analyses were performed.

Results: A total of 34 511 women were included. Early term infants were less likely to be breastfed than were full-term infants (67.9 vs. 70.4%) (adjusted odds ratio [aOR] 0.91; 95% confidence interval [CI] 0.86-0.97). Multiple logistic regression analysis also showed a significant effect of maternal age (aOR 1.07; 95% CI 1.05-1.09), partner status (aOR 1.56; 95% CI 1.20-2.03), smoking (aOR 0.32; 95% CI 0.26-0.41), prenatal education (aOR 2.43; 95% CI 1.99-2.97), pre-pregnancy body mass index (kg/m²) (aOR 0.97; 95% CI 0.96-0.98), and cesarean section (aOR 0.72; 95% CI 0.60-0.88). When compared by week of gestational age at term, the likelihood of breastfeeding significantly increased with each successive week (aOR 1.08; 95% CI 1.007-1.16).

Conclusion: Early term delivery is an independent risk factor for not breastfeeding at the time of postpartum hospital discharge. It is important to target and support these women to increase breastfeeding rates. Additionally, these findings further validate recommendations to avoid non-medically indicated early term deliveries because of the increased risks of adverse outcomes.