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Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003

Journal of Perinatology volume 28, pages 505–510 (2008)Cite this article

Abstract

Objective:

We hypothesized that neonatal intensive care unit (NICU) admission reduces breastfeeding in a recent population of US infants, adjusting for confounding factors.

Study Design:

Using pregnancy risk assessment monitoring system data from 27 states for the years 2000 to 2003, we determined the relationship between breastfeeding and gestational age (GA) stratified by NICU status. We fitted a proportional odds model for breastfeeding duration as a function of NICU status adjusted for other covariates. SAS 9.1.3 and SUDAAN 9.0 were used for the weighted analyses.

Result:

In total 138 359 surveys, including 29 940 NICU-admitted infants, were analyzed. A total of 73% of mothers of nonadmitted infants initiated breastfeeding vs 70% of mothers of NICU-admitted infants. Mothers of GA <38 weeks NICU-admitted infants were 34% more likely to initiate breastfeeding and 21% more likely to breastfeed for 4 weeks than were mothers of nonadmitted preterm infants (P<0.001). However, mothers of term NICU-admitted infants were less likely to initiate and continue breastfeeding to 4 weeks than were mothers of term nonadmitted infants (P<0.001). Adjusting for GA, race, maternal age, maternal education, mode of delivery and Medicaid status, NICU admission was associated with increasing duration of breastfeeding (OR 1.10, CI 1.03, 1.17). Compared with mothers of term infants, mothers of <32-week infants were 40% more likely to continue breastfeeding for 4 weeks, mothers of 32 to 34 week infants were 13% less likely to continue and mothers of 35–37 week infants were 22% less likely to continue for at least 4 weeks (P<0.001).

Conclusion:

NICU admission is now a positive influence on breastfeeding continuation, improving the overall likelihood by 10%. Mothers of preterm NICU-admitted infants were more likely than mothers of nonadmitted infants to continue breastfeeding for 4 weeks, while mothers of term NICU-admitted infants were less likely to continue. Breastfeeding support should be enhanced for term and late preterm infants.

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Acknowledgements

The PRAMS Working Group: Alabama—Albert Woolbright, PhD; Alaska—Kathy Perham-Hester, MS, MPH; Arkansas—Gina Redford, MAP; Colorado—Alyson Shupe, PhD; Florida—Helen Marshall; Georgia—Carol Hoban, MS, MPH; Hawaii—Limin Song, MPH, CHES; Illinois—Theresa Sandidge, MA; Louisiana—Joan Wightkin; Maine—Kim Haggan; Maryland—Diana Cheng, MD; Michigan—Yasmina Bouraoui, MPH; Minnesota—Jan Jernell; Mississippi—Linda Pendleton, LMSW; Montana—JoAnn Dotson; Nebraska—Jennifer Severe-Oforah; New Jersey—Lakota Kruse, MD; New Mexico—Ssu Weng, MD, MPH; New York State—Anne Radigan-Garcia; New York City—Candace Mulready, MPH; North Carolina—Paul Buescher, PhD; North Dakota—Sandra Anseth, RN; Ohio—Amy Davis; Oklahoma—Dick Lorenz; Oregon—Ken Rosenberg, MD, MPH; Rhode Island—Sam Viner-Brown; South Carolina—Jim Ferguson, DrPH; Texas—Tanya J. Guthrie, PhD; Utah—Laurie Baksh; Vermont—Peggy Brozicevic; Washington—Linda Lohdefinck; West Virginia—Melissa Baker, MA; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health. The authors have no commercial, proprietary or financial conflicts to disclose.

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  1. Department of Pediatrics, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    T T Colaizy & F H Morriss

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Correspondence to T T Colaizy.

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Colaizy, T., Morriss, F. Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003. J Perinatol 28, 505–510 (2008). https://doi.org/10.1038/jp.2008.32

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