Journal of Human Lactation 1–8 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0890334415581164 jhl.sagepub.com Original Research Well Established Breast milk is beneficial for infants born at < 32 weeks of gesta- tion, since it reduces the risk of neonatal morbidity. Despite the benefits, the duration of breastfeeding is shorter in very preterm infants than in term infants. Newly Expressed It is possible to achieve high rates of breastfeeding in infants born at < 32 weeks of gestation. High provision of mother’s own milk during the first postnatal week is associated with exclusive breast milk feeding at 36 weeks postmenstrual age. Background The World Health Organization recommends that term as well as preterm infants be exclusively breastfed for the first 6 months of life. 1 Breast milk has been shown to decrease the risk of respiratory and gastrointestinal tract infections 2 and is associated with lower risk for necrotizing enterocoli- tis 3,4 and retinopathy of prematurity. 5,6 Breastfeeding has also been associated with improved neurological develop- ment after very preterm birth. 7,8 Despite the benefits of 581164JHL XX X 10.1177/0890334415581164Journal of Human LactationWilson et al research-article 2015 1 Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden 2 Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden 3 Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden Date submitted: September 11, 2014; Date accepted: March 17, 2015. Corresponding Author: Emilija Wilson, RN, RM, Neonatal Research Unit Q2:07 ALB, Karolinska Institutet, 171 76 Stockholm, Sweden. Email: emilija.wilson@ki.se Early Provision of Mother’s Own Milk and Other Predictors of Successful Breast Milk Feeding after Very Preterm Birth: A Regional Observational Study Emilija Wilson, RN, RM 1 , Kyllike Christensson, RN, RM, PhD 2 , Lena Brandt, MSc 3 , Maria Altman, MD, PhD 1,3 , and Anna-Karin Bonamy, MD, PhD, IBCLC 2,3 Abstract Background: Breast milk is associated with a lower risk of neonatal morbidity in very preterm infants. Despite the benefits, the duration of breastfeeding is shorter in very preterm infants than in term infants. Objective: This study aimed to investigate how early provision of mother’s own milk (MOM) and maternal and infant characteristics are related to breast milk feeding (BMF) between 36 and 40 weeks postmenstrual age (PMA) after very preterm birth. Methods: A regional observational study of 138 singleton infants born at < 32 weeks of gestation in Stockholm, Sweden, was conducted. Data were derived from medical charts to investigate the association between early provision of MOM; maternal and infant characteristics; and exclusive, partial, or no BMF at 36 weeks PMA. Moreover, changes in BMF between 36 and 40 weeks PMA were studied. Results: Most infants (80%) received MOM at 36 weeks PMA (55% exclusively, 25% partial). High provision of MOM at postnatal day 7 was associated with exclusive BMF at 36 weeks PMA, odds ratio (OR) 1.18 per 10 mL/kg MOM (95% confidence interval [CI], 1.06-1.32). Mothers born in non-Nordic countries provided MOM exclusively less often, adjusted OR 0.27 (95% CI, 0.10-0.69), compared to Nordic mothers. Between 36 and 40 weeks PMA, BMF decreased overall. This change was not associated with investigated predictors. Conclusion: It is possible to achieve high rates of BMF in very preterm infants. High intake of MOM early in the postnatal period is strongly related to exclusive BMF at 36 weeks PMA. Keywords breastfeeding, breast milk, breast milk feeding, home-based care, lactation, neonatal intensive care, preterm infants at Karolinska Institutets Universitetsbibliotek on April 28, 2015 jhl.sagepub.com Downloaded from