Lauren S Keenan-Devlin1,2, Yetunde F Awosemusi3, William Grobman4,5, Hyagriv Simhan6,7, Emma Adam8, Jennifer Culhane9,10, Gregory Miller11, Ann E B Borders12,3,13. 1. Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave Walgreen Bldg, Ste 1507, Evanston, IL, 60201, USA. lkeenan-devlin@northshore.org. 2. Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA. lkeenan-devlin@northshore.org. 3. Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA. 4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 5. Center for Healthcare Studies - Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA. 6. Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 7. Division of Obstetrical Services, Magee Women's Hospital, Pittsburgh, PA, USA. 8. School of Education and Social Policy, Institute for Policy Research, Northwestern University, Evanston, IL, USA. 9. Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 10. Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. 11. Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, IL, USA. 12. Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave Walgreen Bldg, Ste 1507, Evanston, IL, 60201, USA. 13. Center for Healthcare Studies-Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA.
Abstract
OBJECTIVE: Higher rates of adverse outcomes have been reported for early term (37 0 to 38 6 weeks) versus full term (≥ 39 0 weeks) infants, but differences in breastfeeding outcomes have not been systematically evaluated. This study examined breastfeeding initiation and exclusivity in early and full term infants in a large US based sample. METHODS: This secondary analysis included 743 geographically- and racially-diverse women from the Measurement of Maternal Stress Study cohort, and 295 women from a quality assessment at a hospital-based clinic in Evanston, IL. Only subjects delivering ≥ 37 weeks were included. Initiation of breastfeeding (IBF) and exclusive breastfeeding (EBF) were assessed via electronic medical record review after discharge. Associations of IBF and EBF with early and full term delivery were assessed via univariate and multivariate logistic regression. RESULTS: Among 872 women eligible for inclusion, 85.7% IBF and 44.0% EBF. Early term delivery was not associated with any difference in frequency of IBF (p = 0.43), but was associated with significantly lower odds of EBF (unadjusted OR 0.61, 95% CI 0.466, 0.803, p < 0.001). This association remained significant (adjusted OR 0.694, 95% CI 0.515, 0.935, p = 0.016) after adjusting for maternal diabetes, hypertensive disorders of pregnancy, cesarean delivery, maternal age, race/ethnicity, parity, Medicaid status, NICU admission, current smoking, and delivery hospital. CONCLUSIONS FOR PRACTICE: Despite comparable breastfeeding initiation frequencies, early term infants were significantly less likely to be exclusively breastfed compared to full term infants. These data suggest that women with early term infants may benefit from counseling regarding the potential for breastfeeding difficulties as well as additional breastfeeding support after delivery.
OBJECTIVE: Higher rates of adverse outcomes have been reported for early term (37 0 to 38 6 weeks) versus full term (≥ 39 0 weeks) infants, but differences in breastfeeding outcomes have not been systematically evaluated. This study examined breastfeeding initiation and exclusivity in early and full term infants in a large US based sample. METHODS: This secondary analysis included 743 geographically- and racially-diverse women from the Measurement of Maternal Stress Study cohort, and 295 women from a quality assessment at a hospital-based clinic in Evanston, IL. Only subjects delivering ≥ 37 weeks were included. Initiation of breastfeeding (IBF) and exclusive breastfeeding (EBF) were assessed via electronic medical record review after discharge. Associations of IBF and EBF with early and full term delivery were assessed via univariate and multivariate logistic regression. RESULTS: Among 872 women eligible for inclusion, 85.7% IBF and 44.0% EBF. Early term delivery was not associated with any difference in frequency of IBF (p = 0.43), but was associated with significantly lower odds of EBF (unadjusted OR 0.61, 95% CI 0.466, 0.803, p < 0.001). This association remained significant (adjusted OR 0.694, 95% CI 0.515, 0.935, p = 0.016) after adjusting for maternal diabetes, hypertensive disorders of pregnancy, cesarean delivery, maternal age, race/ethnicity, parity, Medicaid status, NICU admission, current smoking, and delivery hospital. CONCLUSIONS FOR PRACTICE: Despite comparable breastfeeding initiation frequencies, early term infants were significantly less likely to be exclusively breastfed compared to full term infants. These data suggest that women with early term infants may benefit from counseling regarding the potential for breastfeeding difficulties as well as additional breastfeeding support after delivery.
Entities:
Keywords:
Breastfeeding; Breastfeeding initiation; Disparities; Early term; Exclusive breastfeeding