Early Term Delivery and Breastfeeding Outcomes

Keenan-Devlin, Lauren S.; Awosemusi, Yetunde F.; Grobman, William; Simhan, Hyagriv; Adam, Emma; Culhane, Jennifer; Miller, Gregory; Borders, Ann E. B.

doi:10.1007/s10995-019-02787-4

Published: 19 June 2019

Early Term Delivery and Breastfeeding Outcomes

Lauren S. Keenan-Devlin ORCID: orcid.org/0000-0002-7908-2971^1,2,
Yetunde F. Awosemusi²,
William Grobman^3,4,
Hyagriv Simhan^5,6,
Emma Adam⁷,
Jennifer Culhane^8,9,
Gregory Miller¹⁰ &
Ann E. B. Borders^1,2,11

Maternal and Child Health Journal volume 23, pages 1339–1347 (2019)Cite this article

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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.

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Acknowledgements

Financial support for this research provided by the following sources: HHSN275201200007I–HHSN27500005. National Children’s Study: Vanguard Study – Task Order 5: Stress and Cortisol Measurement for the National Children’s Study. Principal Investigator: Ann E.B. Borders, MD, MSc, MPH. We are grateful for the support of the MOMS Study Collaboration including research staff and participants. We also appreciate the important contribution of the MOM-le pilot study collaboration.

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Authors and Affiliations

Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave Walgreen Bldg, Ste 1507, Evanston, IL, 60201, USA
Lauren S. Keenan-Devlin & Ann E. B. Borders
Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
Lauren S. Keenan-Devlin, Yetunde F. Awosemusi & Ann E. B. Borders
Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
William Grobman
Center for Healthcare Studies – Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA
William Grobman
Division of Maternal–Fetal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Hyagriv Simhan
Division of Obstetrical Services, Magee Women’s Hospital, Pittsburgh, PA, USA
Hyagriv Simhan
School of Education and Social Policy, Institute for Policy Research, Northwestern University, Evanston, IL, USA
Emma Adam
Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Jennifer Culhane
Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Jennifer Culhane
Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, IL, USA
Gregory Miller
Center for Healthcare Studies—Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA
Ann E. B. Borders

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Lauren S. Keenan-Devlin
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Yetunde F. Awosemusi
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William Grobman
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Hyagriv Simhan
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Emma Adam
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Jennifer Culhane
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Gregory Miller
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Ann E. B. Borders
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Correspondence to Lauren S. Keenan-Devlin.

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Keenan-Devlin, L.S., Awosemusi, Y.F., Grobman, W. et al. Early Term Delivery and Breastfeeding Outcomes. Matern Child Health J 23, 1339–1347 (2019). https://doi.org/10.1007/s10995-019-02787-4

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Published: 19 June 2019
Issue Date: October 2019
DOI: https://doi.org/10.1007/s10995-019-02787-4

Keywords

Breastfeeding
Breastfeeding initiation
Disparities
Early term
Exclusive breastfeeding