Human milk feeding for moderate and late preterm infants at age 2 months: Insights from a cluster randomized controlled trial 2-month follow-up

• Published in: PEC innovation 2024-12, Vol.5, p.100345, Article 100345
• Main Authors: Moe, Amanda M., Brockway, Meredith L., McNeil, Deborah A., Afzal, Arfan R., Benzies, Karen M.
• Format: Article
• Language: English
• Subjects: (max 6): Preterm infant; Breastfeeding; Breastfeeding self-efficacy; Family integrated care; from Special issue on Family Integrated Neonatal Care: Innovative developments in health promotion, education, and communication; Edited by Nanon H.M. Labrie, Nicole R. van Veenendaal and Anne A.M.W. van Kempen; Human milk feeding; Randomized controlled trial
• ISSN: 2772-6282; 2772-6282
• DOI: 10.1016/j.pecinn.2024.100345

Human milk (HM) is the optimal nutrition for infants; preterm infants demonstrate shorter HM feeding duration. Care interventions may increase HM feeding among preterm infants after NICU discharge. We compared Alberta Family Integrated Care (FICare) versus Standard Care on HM feeding in preterm infants at age 2 months. We conducted a follow-up of a cluster randomized controlled trial of 455 infants and their mothers with data linked to the infant's 2-month public health visit. We used partial proportional odds to model group differences and factors associated with feeding type: exclusive HM (EHM), Non-EHM, or no HM (NHM). Compared to Standard Care, mothers in Alberta FICare were less likely to provide EHM versus NHM. There was no group difference between EHM and Non-EHM. Mothers with higher education who were on maternity leave or employed were more likely to provide EHM. Infants who received EHM at discharge were more likely to continue at age 2 months. Higher maternal breastfeeding self-efficacy at discharge was associated with a greater likelihood of EHM. Alberta FICare was not associated with EHM feeding at age 2 months. Different factors predicted the three HM feeding categories, suggesting the need to individualize feeding supports. Trial Registration. ClinicalTrials.gov Identifier NCT02879799, retrospectively registered August 26, 2016. •Examining three distinct categories of preterm infant feeding outcomes is novel.•Each feeding outcome was variably influenced by different factors.•Infants fed exclusive human milk at discharge more likely to sustain to age 2 months•Mothers with higher education and employment more likely to feed exclusive human milk•Higher breastfeeding self-efficacy increased odds of feeding exclusive human milk.