Early discharge with tube feeding at home for preterm infants is associated with longer duration of breastfeeding

Anita E Meerlo ¹, Elisabeth A Kosters ¹, Helen Klip ² and Paul L P Brand ^1*

¹ Princess Amalia Children's Clinic, Isala Klinieken, Zwolle, Netherlands
² Department of Epidemiology and Biostatistics, Isala Klinieken, Zwolle, Netherlands

^* To whom correspondence should be addressed. E-mail: p.l.p.brand{at}isala.nl.

Accepted 6 December 2008

Abstract

Objective: Mothers of preterm infants are more likely to discontinue breastfeeding early than mothers of term infants. We evaluated the effect of Early Discharge with tube feeding of preterm infants under close supervision by paediatric nurse specialists on the duration of breastfeeding.

Design: Controlled non-randomized clinical trial.

Setting: medium/high-care neonatal unit of large district general hospital.

Patients: Preterm infants (< 37 wks gestational age).

Interventions: Early Discharge with tube feeding under close supervision by paediatric nurse specialists, or regular follow-up of preterm infants discharged with oral feeding.

Main outcome measure: Duration of breastfeeding assessed by telephone interview 6 months after birth.

Results: There were 50 infants in the Early Discharge group and 78 in the control group. Mothers in the Early Discharge group continued to breastfeed longer than mothers in the control group (log rank test, p=0.028). Four months after discharge, 63% of infants in the control group were fed formula compared to 36% in the early discharge group (95% CI for difference 9-43%, p=0.04). The relative risk of breastfeeding cessation 6 months after birth in the Early Discharge group as compared to the control group was 0.63 (95% CI 0.41-0.96). After adjustment for smoking, gestational age, and birth weight, this relative risk was 0.67 (95% CI 0.43-1.05).

Conclusions: Close supervision and follow-up by paediatric nurse specialists of preterm infants discharged early with tube feeding appears to increase the duration of breastfeeding. A randomized controlled trial to confirm these findings is warranted.