Factors associated with the interruption of exclusive breastfeeding and weaning in premature infants after hospital discharge: a prospective cohort study.
Mariana Lamante Bueno, Júlia Carneiro Godoy de Sousa, Vinícius de Sousa Monteiro and 6 others
PMID 41919825WHAT IT FOUND
Preterm infants' exclusive breastfeeding fell from 71.7% at discharge to 64.6% by 15-30 days.
Not being exclusively breastfed at discharge was associated with 6.13 times higher later weaning risk. Nurses can prioritise support before discharge.
Key findings
01Exclusive breastfeeding among preterm infants was 71.7% at hospital discharge and 64.6% 15-30 days after discharge.
02Not being exclusively breastfed at hospital discharge was associated with 3.64 times higher adjusted risk of exclusive breastfeeding discontinuation and 6.13 times higher adjusted risk of weaning 15-30 days after discharge.
03Adjusted risk of exclusive breastfeeding discontinuation was higher with maternal education up to elementary school (1.68 times), up to high school (1.79 times), first breast stimulation after 6 hours (1.88 times), no stimulation until the fifth day (1.69 times), first feeding after 6 hours (1.61 times), no feeding until the fifth day (1.66 times), and length of hospitalization (1.85 times).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Convenience sampling was used, and mothers needed a smartphone with internet access, so families without these resources may be underrepresented. Loss during follow-up was 18%, with difficulty contacting mothers as the leading cause, so mothers with harder breastfeeding experiences may be missing. The study was done in two public Baby-Friendly hospitals in two regions of Brazil during the pandemic period, limiting generalizability. It was an observational cohort, so the reported relative risks are associations, not proof that any single factor caused interruption or weaning. Only two distal variables, maternal education and maternal age, were investigated.
Declared interests
Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Grant # 421873/2021-3; no other funding or conflict is described in the supplied text.
The easy way to misread this
Do not treat the 6.13 times higher risk as proof that not being exclusively breastfed at discharge causes early weaning. This was an observational cohort, so other unmeasured factors may explain both discharge feeding status and later weaning.