Advertisement

Canadian Journal of Public Health

, Volume 104, Issue 4, pp e351–e356 | Cite as

Breastfeeding Difficulties and Exclusivity Among Late Preterm and Term Infants: Results From the All Our Babies Study

  • Tharsiya Nagulesapillai
  • Sheila W. McDonald
  • Tanis R. Fenton
  • Hannah Faye G. Mercader
  • Suzanne C. ToughEmail author
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVE: To compare breastfeeding difficulties attributable to the baby and mother/milk and exclusive breastfeeding between a group of late preterm (LP) infants and term infants.

METHODS: We utilized data from a prospective community-based cohort (n=2977) in Calgary, Alberta, and performed bivariate and multivariable analyses to identify demographic, obstetric, maternal and infant health indicators that were independently associated with term status and breastfeeding outcomes.

RESULTS: Multivariable analyses found that LP status was an independent risk factor for breastfeeding difficulties attributable to the baby (OR 1.72, 95% CI 1.24–2.38), but not for difficulties due to mother/milk (defined as not producing enough milk or having flat or inverted nipples). Among women who were breastfeeding at hospital discharge, mothers of LP infants were less likely to report exclusive breastfeeding at 4 months (OR 0.67, 95% CI 0.46–0.97), after controlling for household income level, mode of delivery and postpartum maternal physical health.

CONCLUSIONS: Mothers of LP infants need increased support to establish successful breastfeeding outcomes and to ensure that these infants receive the full benefits of breast milk.

Key Words

Breastfeeding infant preterm epidemiology 

Résumé

OBJECTIF: Comparer les difficultés à allaiter imputables au bébé et celles imputables à la mère/au lait et la pratique de l’allaitement maternel exclusif entre un groupe de nourrissons peu prématurés (PP) et de nourrissons nés à terme.

MÉTHODE: Nous nous sommes servis des données d’une cohorte communautaire prospective (n=2 977) à Calgary, en Alberta, pour effectuer des analyses bivariées et multivariées afin de cerner les indicateurs de santé démographiques, obstétriques, maternels et du nourrisson indépendamment associés à la naissance à terme et aux résultats de l’allaitement maternel.

RÉSULTATS: Selon nos analyses multivariées, le statut PP était un facteur de risque indépendant pour les difficultés d’allaitement imputables au bébé (RC 1,72, IC de 95 % 1,24-2,38), mais pas pour les difficultés imputables à la mère/au lait (définies comme ne produisant pas assez de lait ou ayant des mamelons plats ou invertis). Chez les femmes qui allaitaient à leur sortie de l’hôpital, les mères de nourrissons PP étaient moins susceptibles de déclarer pratiquer l’allaitement maternel exclusif à 4 mois (RC 0,67, IC de 95 % 0,46-0,97), après prise en compte du revenu du ménage, du mode d’accouchement et de la santé physique maternelle post-partum.

CONCLUSIONS: Les mères de nourrissons PP ont besoin de soutien supplémentaire pour allaiter avec succès et pour que leurs nourrissons profitent entièrement des avantages du lait maternel.

Mots Clés

allaitement maternel nourrisson prématuré épidémiologie 

References

  1. 1.
    March of Dimes, The Partnership for Maternal, Newborn & Child Health, Save the Children, WHO. Born Too Soon: The Global Action Report on Preterm Birth. Geneva, Switzerland: WHO, 2012.Google Scholar
  2. 2.
    Engle WA, Tomashek KM, Wallman C. “Late-preterm” infants: A population at risk. Pediatrics 2007;120(6):1390–401.CrossRefGoogle Scholar
  3. 3.
    Joseph KS, Allen AC, Dodds L, Vincer MJ, Armson, BA. Causes and consequences of recent increases in preterm birth among twins. Obstet Gynecol 2001;98(1):57–64.PubMedGoogle Scholar
  4. 4.
    Canadian Institute for Health Information. Too Early, Too Small: A Profile of Small Babies Across Canada. Ottawa, ON: CIHI, 2009. Available at: https://secure.cihi.ca/free_products/too_early_too_small_en.pdf (Accessed May 13, 2013).Google Scholar
  5. 5.
    McCormick MC, Litt JS, Smith VC, Zupancic, JA. Prematurity: An overview and public health implications. Annu Rev Public Health 2011;32:367–79.CrossRefGoogle Scholar
  6. 6.
    Quigley MA, Poulsen G, Boyle E, Wolke D, Field D, Alfirevic Z, Kurinczuk, JJ. Early term and late preterm birth are associated with poorer school performance at age 5 years: A cohort study. Arch Dis Child Fetal Neonatal Ed 2012;97(3):F167-F173.Google Scholar
  7. 7.
    Talge NM, Holzman C, Wang J, Lucia V, Gardiner J, Breslau N. Late-preterm birth and its association with cognitive and socioemotional outcomes at 6 years of age. Pediatrics 2010;126(6):1124–31.CrossRefGoogle Scholar
  8. 8.
    McDonald SW, Benzies KM, Gallant JE, McNeil DA, Dolan SM, Tough, SC. A comparison between late preterm and term infants on breastfeeding and maternal mental health. Matern Child Health J 2012 Oct 7 [Epub ahead of print].Google Scholar
  9. 9.
    Brandon DH, Tully KP, Silva SG, Malcolm WF, Murtha AP, Turner BS, Holditch-Davis D. Emotional responses of mothers of late-preterm and term infants. J Obstet Gynecol Neonatal Nurs 2011;40(6):719–31.CrossRefGoogle Scholar
  10. 10.
    Saigal S, Doyle, LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 2008;371(9608):261–69.CrossRefGoogle Scholar
  11. 11.
    Stephens BE, Vohr, BR. Neurodevelopmental outcome of the premature infant. Pediatr Clin North Am 2009;56(3):631–46, Table of Contents.CrossRefGoogle Scholar
  12. 12.
    Doyle LW, Anderson, PJ. Adult outcome of extremely preterm infants. Pediatrics 2010;126(2):342–51.CrossRefGoogle Scholar
  13. 13.
    ESPGHAN Committee on Nutrition, Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, Michaelsen KF, et al. Breast-feeding: A commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2009;49(1):112–25.CrossRefGoogle Scholar
  14. 14.
    Cai X, Wardlaw T, Brown, DW. Global trends in exclusive breastfeeding. Int Breastfeed J 2012;7(1):12.CrossRefGoogle Scholar
  15. 15.
    Public Health Agency of Canada. What Mothers Say: The Canadian Maternity Experiences Survey. Ottawa: PHAC, 2009.Google Scholar
  16. 16.
    World Health Organization. Global Strategy for Infant and Young Child Feeding. Geneva, Switzerland: WHO, 2003.Google Scholar
  17. 17.
    Kehler HL, Chaput KH, Tough, SC. Risk factors for cessation of breastfeeding prior to six months postpartum among a community sample of women in Calgary, Alberta. Can J Public Health 2009;100(5):376–80.Google Scholar
  18. 18.
    Dennis, CL. Breastfeeding initiation and duration: A 1990-2000 literature review. J Obstet Gynecol Neonatal Nurs 2002;31(1):12–32.CrossRefGoogle Scholar
  19. 19.
    Lande B, Andersen LF, Baerug A, Trygg KU, Lund-Larsen K, Veierød MB, Bjørneboe, GE. Infant feeding practices and associated factors in the first six months of life: The Norwegian infant nutrition survey. Acta Paediatr 2003;92(2):152–61.CrossRefGoogle Scholar
  20. 20.
    Coulibaly R, Seguin L, Zunzunegui MV, Gauvin L. Links between maternal breast-feeding duration and Quebec infants’ health: A population-based study. Are the effects different for poor children? Matern Child Health J 2006;10(6):537–43.CrossRefGoogle Scholar
  21. 21.
    Adamkin, DH. Feeding problems in the late preterm infant. Clin Perinatol 2006;33(4):831–37; abstract, ix.CrossRefGoogle Scholar
  22. 22.
    Meier PP, Furman LM, Degenhardt M. Increased lactation risk for late preterm infants and mothers: Evidence and management strategies to protect breastfeeding. J Midwifery Womens Health 2007;52(6):579–87.CrossRefGoogle Scholar
  23. 23.
    Radtke, JV. The paradox of breastfeeding-associated morbidity among late preterm infants. J Obstet Gynecol Neonatal Nurs 2011;40(1):9–24.CrossRefGoogle Scholar
  24. 24.
    Walker M. Breastfeeding the late preterm infant. J Obstet Gynecol Neonatal Nurs 2008;37(6):692–701.CrossRefGoogle Scholar
  25. 25.
    Kirchner L, Jeitler V, Waldhor T, Pollak A, Wald M. Long hospitalization is the most important risk factor for early weaning from breast milk in premature babies. Acta Paediatr 2009;98(6):981–84.CrossRefGoogle Scholar
  26. 26.
    Maia C, Brandao R, Roncalli A, Maranhao H. Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants. J Matern Fetal Neonatal Med 2011;24(6):774–77.CrossRefGoogle Scholar
  27. 27.
    Colaizy TT, Morriss, FH. Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003. J Perinatol 2008;28(7):505–10.CrossRefGoogle Scholar
  28. 28.
    McDonald SW, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SM, et al. The All Our Babies pregnancy cohort: Design, methods, and participant characteristics. BMC Pregnancy Childbirth 2013;13(Suppl 1):S2.Google Scholar
  29. 29.
    Sherbourne CD, Stewart, AL. The MOS social support survey. Soc Sci Med 1991;32(6):705–14.CrossRefGoogle Scholar
  30. 30.
    Lubow JM, How HY, Habli M, Maxwell R, Sibai, BM. Indications for delivery and short-term neonatal outcomes in late preterm as compared with term births. Am J Obstet Gynecol 2009;200(5):e30-e33.Google Scholar
  31. 31.
    Donath SM, Amir, LH. Effect of gestation on initiation and duration of breastfeeding. Arch Dis Child Fetal Neonatal Ed 2008;93(6):F448-F450.Google Scholar
  32. 32.
    Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Weiss J, Evans S. Risk factors for neonatal morbidity and mortality among “healthy,” late preterm newborns. Semin Perinatol 2006;30(2):54–60.CrossRefGoogle Scholar
  33. 33.
    Pound CM, Gaboury I. The impact of jaundice in newborn infants on the length of breastfeeding. Paediatr Child Health 2009;14(7):445–49.Google Scholar
  34. 34.
    Allen EC, Manuel JC, Legault C, Naughton MJ, Pivor C, O’Shea TM. Perception of child vulnerability among mothers of former premature infants. Pediatrics 2004;113(2):267–73.CrossRefGoogle Scholar
  35. 35.
    Oates RK, Forrest D. Reliability of mothers’ reports of birth data. Aust Paediatr J 1984;20(3):185–86.PubMedGoogle Scholar
  36. 36.
    Bat-Erdene U, Metcalfe A, McDonald SW, Tough SC. Validation of Canadian mothers’ recall of events in labour and delivery with electronic health records. BMC Pregnancy Childbirth 2013;13(Suppl 1):S3.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2013

Authors and Affiliations

  • Tharsiya Nagulesapillai
    • 1
  • Sheila W. McDonald
    • 2
  • Tanis R. Fenton
    • 1
    • 3
  • Hannah Faye G. Mercader
    • 2
  • Suzanne C. Tough
    • 1
    • 2
    Email author
  1. 1.Department of Community Health Sciences, Alberta Children’s Hospital Research Institute, Faculty of MedicineUniversity of CalgaryCalgaryCanada
  2. 2.Department of Pediatrics, Faculty of MedicineUniversity of CalgaryCalgaryCanada
  3. 3.Department of Nutrition ServicesAlberta Health ServicesCalgaryCanada

Personalised recommendations