Study reports reduced maternal breastfeeding in late preterm infants

Study reports reduced maternal breastfeeding in late preterm infants | Image Credit: © Анастасія Стягайло - © Анастасія Стягайло - stock.adobe.com.

Mother’s own milk (MOM) feeding initiation and continuation rates are significantly reduced among late preterm (LPT) infants vs those with other gestational ages (GAs), according to a recent study published in JAMA Network Open.¹

Importance of MOM feeding

Approximately 10% of US infants are born preterm. However, breastfeeding from MOM has been linked to protection for all infants, including those born preterm.² This has made exclusive MOM breastfeeding recommended by multiple organizations through 6 months of age, but US population-based statistics reporting MOM feeding duration by GA have not been obtained.¹

“Data on the rates of MOM feeding initiation and continued MOM feedings are needed so that clinicians, researchers, and policy makers can quantify the gap between current MOM feeding rates and national goals and measure the effectiveness of initiatives seeking to increase initiation and duration of MOM feedings,” wrote investigators.

To evaluate MOM feeding initiation and continuation at 12 weeks based on GA, investigators conducted a retrospective cross-sectional study. Data between January 1 and December 31, 2021, was obtained from the Pregnancy Risk Assessment Monitoring System and included maternal characteristics, health behaviors, and maternal and infant health indicators.

Study design

Birth certificate and survey information was collected from 36 jurisdictions, with surveys completed by mail or telephone 2 to 6 months after delivery. MOM feeding initiation and MOM feeding continuation were reported as primary outcomes.

MOM provision at 12 weeks after delivery and with prior feeding initiation was considered feeding continuation. MOM provision at this time without initiation as a prior condition was also reported as a secondary outcome.

Categories of infant GA included early preterm (EPT), moderately preterm (MPT), LPT, and early term to postterm. Covariates included age, education level, marital status, health insurance enrollment 1 month before pregnancy, type of delivery, number of prior live births, births of multiples, prenatal care, body mass index, smoking, and race and ethnicity.

There were 29,098 births included in the final analysis, with 14.3% of mothers being Black, 18.1% Hispanic, 58% White, and 9.6% other race or ethnicity. EPT birth was reported in 0.4% of infants, MPT in 1.8%, LPT in 6.7%, and early term to postterm in 91.1%.

Study results and implications

MOM feeding initiation was reported in 89.7%, 88%, and 88.2% of EPT, MTM, and early term to postterm infants, respectively, indicating similar rates. However, LPT infants reported a reduced rate of 81.8%.

Additionally, 61.2% of mothers with MOM initiation in the LPT group continued providing MOM at 12 weeks, vs 58.6% of the MPT group, 63.1%, of the EPT group, and 71.6% of the early term to postterm group.

When adjusting for maternal characteristics, MOM feeding initiation rates did not significantly differ among MPT and EPT infants compared with early term to postterm infants, with differences of 2.4% and 3.1%, respectively. However, mothers of LPT infants were 4.4% less likely to initiate breastfeeding and 6.7% less likely to continue providing MOM at 12 weeks.

Adjusted continuation rates also did not differ among EPT and MPT infants vs early term to postterm infants. While significant differences were observed based on race and ethnicity, only Hispanic mothers had higher MOM continuation rates at 12 weeks among patients with MOM feeding initiation, at 73.1% vs 68.5% among Black mothers.

These results indicated similar MOM feeding initiation and continuation rates among early term to postterm, EPT, and MPT infants. However, reduced rates were observed among LPT infants.

“Previous investigators have sought to determine barriers and facilitators to continued MOM provision in various subgroups of infants,” wrote investigators. “The present data suggest the continued need for such investigations and novel strategies to assist families in meeting recommendations, particularly for families of LPT infants.”

Reference

1. Patel AL, Wilson J, Holmes M, Johnson TJ. Mother’s own milk provision during the first 12 weeks of life by gestational age. JAMA Netw Open. 2025;8(3):e250024. doi:10.1001/jamanetworkopen.2025.0024
2. Pérez-Escamilla R, Tomori C, Hernández-Cordero S, et al. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet. 2023;401(10375):472-485. doi:10.1016/S0140-6736(22)01932-8