title: Initiation of breastfeeding among mothers of very low birth weight infants.
abstract: OBJECTIVE
  To examine factors that predict the initiation of expressed milk feedings and the transition to direct breastfeedings among mothers of very low birth weight (VLBW) infants.
  
  
  METHODS
  The sample consists of 361 mother-infant pairs enrolled in a follow-up study of children aged 6 to 8 years who were born weighing <1501 g in 1 of 5 hospitals between 1991-1993. Chart review at birth provided data on neonatal characteristics and demographic factors at delivery were obtained by postpartum maternal interview. Information regarding infant feeding practices was obtained at follow-up.
  
  
  RESULTS
  In this study, 60% of mothers initiated expressed milk feedings for their VLBW infants. However, the duration of these feedings was brief with 52% of infants receiving 1 to 3 months or less of human milk feedings. Greater educational attainment, private insurance, and breastfeeding experience were each independently associated with the decision to provide expressed milk feedings. Only 27% of mothers reported directly breastfeeding their VLBW infants. The transition from expressed milk feedings to direct breastfeedings was positively associated with sociodemographic factors including maternal age, insurance status, and breastfeeding experience as well as the length of hospitalization, an indicator of infant health.
  
  
  CONCLUSIONS
  Sociodemographic factors were associated with both the decision to initiate expressed milk feedings and the transition to direct breastfeedings. However, factors relating to infant health only influenced the transition to direct breastfeedings. Intervention programs need to consider the sociodemographic factors that influence infant feeding decisions as well as specific challenges encountered by mothers of VLBW infants.
authors.affiliation: Gertrude H. Sergievsky Center, New York, New York, USA.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Smith
authors.forename: Maureen
authors.initials: M
authors.lastname: Durkin
authors.forename: Veronica J
authors.initials: VJ
authors.lastname: Hinton
authors.forename: David
authors.initials: D
authors.lastname: Bellinger
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000523:psychology; D001942:Breast Feeding / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007348:Insurance, Health; D007360:Intelligence; D017533:Marital Status; D008895:Milk, Human / Q000378:metabolism; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012959:Socioeconomic Factors