Integrative Review of Interventions to Promote Breastfeeding in the Late Preterm Infant.
JoAnna Cartwright, Teresa Atz, Susan Newman and 2 others
PMID 28390223WHAT IT FOUND
For late preterm infants, skin-to-skin care, rooming-in, and targeted education increased breastfeeding duration and exclusivity.
Second-line strategies like nipple shields showed inconsistent results, sometimes reducing exclusivity or increasing weight loss. Cup feeding helped more infants transition to exclusive breastfeeding.
Key findings
01Skin-to-skin care correlated with breastfeeding exclusivity or duration in four of nine studies, with more daily contact linked to longer breastfeeding.
02Cup feeding helped more late preterm infants transition to exclusive breastfeeding compared to bottle feeding, while nipple shields alone failed to improve exclusivity at discharge.
03Educational interventions by nurses or peer counselors regarding infant cues and temperament increased the likelihood of continued breastfeeding at 3, 6, 9, and 12 months.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 13 studies, limiting the strength of conclusions. Gestational age definitions varied across included studies, with some including infants younger than 34 weeks, which complicates comparisons for the specific late preterm population. A single reviewer compiled the literature, which introduces potential selection bias despite checks. The search was limited to English-language articles published between 2005 and 2015.
Declared interests
The authors report no conflict of interest or relevant financial relationships.
The easy way to misread this
Do not assume all feeding aids are equally effective. While cup feeding supported exclusive breastfeeding, nipple shields used alone were associated with decreased exclusivity and increased weight loss in some studies. Evaluate the specific strategy used rather than treating second-line interventions as a single category.