Maternal and Child Health Journal

, Volume 23, Issue 10, pp 1339–1347 | Cite as

Early Term Delivery and Breastfeeding Outcomes

  • Lauren S. Keenan-DevlinEmail author
  • Yetunde F. Awosemusi
  • William Grobman
  • Hyagriv Simhan
  • Emma Adam
  • Jennifer Culhane
  • Gregory Miller
  • Ann E. B. Borders



Higher rates of adverse outcomes have been reported for early term (37 0 to 38 6 weeks) versus full term (≥ 39 0 weeks) infants, but differences in breastfeeding outcomes have not been systematically evaluated. This study examined breastfeeding initiation and exclusivity in early and full term infants in a large US based sample.


This secondary analysis included 743 geographically- and racially-diverse women from the Measurement of Maternal Stress Study cohort, and 295 women from a quality assessment at a hospital-based clinic in Evanston, IL. Only subjects delivering ≥ 37 weeks were included. Initiation of breastfeeding (IBF) and exclusive breastfeeding (EBF) were assessed via electronic medical record review after discharge. Associations of IBF and EBF with early and full term delivery were assessed via univariate and multivariate logistic regression.


Among 872 women eligible for inclusion, 85.7% IBF and 44.0% EBF. Early term delivery was not associated with any difference in frequency of IBF (p = 0.43), but was associated with significantly lower odds of EBF (unadjusted OR 0.61, 95% CI 0.466, 0.803, p < 0.001). This association remained significant (adjusted OR 0.694, 95% CI 0.515, 0.935, p = 0.016) after adjusting for maternal diabetes, hypertensive disorders of pregnancy, cesarean delivery, maternal age, race/ethnicity, parity, Medicaid status, NICU admission, current smoking, and delivery hospital.

Conclusions for Practice

Despite comparable breastfeeding initiation frequencies, early term infants were significantly less likely to be exclusively breastfed compared to full term infants. These data suggest that women with early term infants may benefit from counseling regarding the potential for breastfeeding difficulties as well as additional breastfeeding support after delivery.


Breastfeeding Breastfeeding initiation Disparities Early term Exclusive breastfeeding 



Financial support for this research provided by the following sources: HHSN275201200007I–HHSN27500005. National Children’s Study: Vanguard Study – Task Order 5: Stress and Cortisol Measurement for the National Children’s Study. Principal Investigator: Ann E.B. Borders, MD, MSc, MPH. We are grateful for the support of the MOMS Study Collaboration including research staff and participants. We also appreciate the important contribution of the MOM-le pilot study collaboration.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Lauren S. Keenan-Devlin
    • 1
    • 2
    Email author
  • Yetunde F. Awosemusi
    • 2
  • William Grobman
    • 3
    • 4
  • Hyagriv Simhan
    • 5
    • 6
  • Emma Adam
    • 7
  • Jennifer Culhane
    • 8
    • 9
  • Gregory Miller
    • 10
  • Ann E. B. Borders
    • 1
    • 2
    • 11
  1. 1.Department of Obstetrics and GynecologyNorthShore University HealthSystemEvanstonUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of Chicago Pritzker School of MedicineChicagoUSA
  3. 3.Division of Maternal–Fetal Medicine, Department of Obstetrics and GynecologyNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Center for Healthcare Studies – Institute for Public Health and MedicineNorthwestern UniversityChicagoUSA
  5. 5.Division of Maternal–Fetal MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA
  6. 6.Division of Obstetrical ServicesMagee Women’s HospitalPittsburghUSA
  7. 7.School of Education and Social Policy, Institute for Policy ResearchNorthwestern UniversityEvanstonUSA
  8. 8.Division of Adolescent MedicineChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  9. 9.Department of PediatricsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  10. 10.Department of Psychology, Institute for Policy ResearchNorthwestern UniversityEvanstonUSA
  11. 11.Center for Healthcare Studies—Institute for Public Health and MedicineNorthwestern UniversityChicagoUSA

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