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Breastfeeding Difficulties and Exclusivity Among Late Preterm and Term Infants: Results From the All Our Babies Study

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Abstract

OBJECTIVE: To compare breastfeeding difficulties attributable to the baby and mother/milk and exclusive breastfeeding between a group of late preterm (LP) infants and term infants.

METHODS: We utilized data from a prospective community-based cohort (n=2977) in Calgary, Alberta, and performed bivariate and multivariable analyses to identify demographic, obstetric, maternal and infant health indicators that were independently associated with term status and breastfeeding outcomes.

RESULTS: Multivariable analyses found that LP status was an independent risk factor for breastfeeding difficulties attributable to the baby (OR 1.72, 95% CI 1.24–2.38), but not for difficulties due to mother/milk (defined as not producing enough milk or having flat or inverted nipples). Among women who were breastfeeding at hospital discharge, mothers of LP infants were less likely to report exclusive breastfeeding at 4 months (OR 0.67, 95% CI 0.46–0.97), after controlling for household income level, mode of delivery and postpartum maternal physical health.

CONCLUSIONS: Mothers of LP infants need increased support to establish successful breastfeeding outcomes and to ensure that these infants receive the full benefits of breast milk.

Résumé

OBJECTIF: Comparer les difficultés à allaiter imputables au bébé et celles imputables à la mère/au lait et la pratique de l’allaitement maternel exclusif entre un groupe de nourrissons peu prématurés (PP) et de nourrissons nés à terme.

MÉTHODE: Nous nous sommes servis des données d’une cohorte communautaire prospective (n=2 977) à Calgary, en Alberta, pour effectuer des analyses bivariées et multivariées afin de cerner les indicateurs de santé démographiques, obstétriques, maternels et du nourrisson indépendamment associés à la naissance à terme et aux résultats de l’allaitement maternel.

RÉSULTATS: Selon nos analyses multivariées, le statut PP était un facteur de risque indépendant pour les difficultés d’allaitement imputables au bébé (RC 1,72, IC de 95 % 1,24-2,38), mais pas pour les difficultés imputables à la mère/au lait (définies comme ne produisant pas assez de lait ou ayant des mamelons plats ou invertis). Chez les femmes qui allaitaient à leur sortie de l’hôpital, les mères de nourrissons PP étaient moins susceptibles de déclarer pratiquer l’allaitement maternel exclusif à 4 mois (RC 0,67, IC de 95 % 0,46-0,97), après prise en compte du revenu du ménage, du mode d’accouchement et de la santé physique maternelle post-partum.

CONCLUSIONS: Les mères de nourrissons PP ont besoin de soutien supplémentaire pour allaiter avec succès et pour que leurs nourrissons profitent entièrement des avantages du lait maternel.

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Authors and Affiliations

  1. Department of Community Health Sciences, Alberta Children’s Hospital Research Institute, Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Tharsiya Nagulesapillai MSc, Tanis R. Fenton PhD & Suzanne C. Tough PhD

  2. Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Sheila W. McDonald PhD, Hannah Faye G. Mercader BHSc & Suzanne C. Tough PhD

  3. Department of Nutrition Services, Alberta Health Services, Calgary, AB, Canada

    Tanis R. Fenton PhD

Authors
  1. Tharsiya Nagulesapillai MSc
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  2. Sheila W. McDonald PhD
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  3. Tanis R. Fenton PhD
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  4. Hannah Faye G. Mercader BHSc
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  5. Suzanne C. Tough PhD
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Corresponding author

Correspondence to Suzanne C. Tough PhD.

Additional information

Acknowledgements: We are grateful to all the families who took part in this study. Our thanks to the investigators, co-ordinators, research assistants, graduate and undergraduate students, volunteers, clerical staff and managers of the All Our Babies Study team. Alberta Innovates Health Solutions provided funding for this cohort; additional funding from the Alberta Centre for Child, Family, and Community Research assisted with the analysis of data presented in this paper. The University of Calgary provided trainee salary support. Preterm Birth and Healthy Outcomes (PreHOT) Alberta Innovates Health Solutions Interdisciplinary Team Grant #200700595.

Conflict of Interest: None to declare.

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Nagulesapillai, T., McDonald, S.W., Fenton, T.R. et al. Breastfeeding Difficulties and Exclusivity Among Late Preterm and Term Infants: Results From the All Our Babies Study. Can J Public Health 104, e351–e356 (2013). https://doi.org/10.17269/cjph.104.3803

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  • DOI: https://doi.org/10.17269/cjph.104.3803

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