title: Effect of pre- and postdischarge interventions on breastfeeding outcomes and weight gain among premature infants.
abstract: OBJECTIVE
  To investigate the effect of pre- and postdischarge interventions on breastfeeding outcomes and weight gain among preterm infants.
  
  
  METHODS
  PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database were searched for study selection using MeSH terms infant/premature, breastfeeding, weight gain, patient discharge, postnatal care, and counseling.
  
  
  METHODS
  Inclusion criteria included studies that involved preterm infants who were born less than or equal to 37 weeks of gestation, randomized controlled trials that were in English, conducted in developed countries, and had breastfeeding and weight gain outcomes. A total of 8 articles met inclusion criteria.
  
  
  METHODS
  All data related to breastfeeding outcomes including duration, exclusivity, maternal satisfaction, and weight gain were extracted from the randomized controlled trials for the purpose of data synthesis.
  
  
  RESULTS
  A total of 310 studies were reviewed. Eight randomized controlled trials met the inclusion criteria. Gestational age of the infants in the studies ranged from 26 to 37 weeks. The results revealed that kangaroo care, peer counseling, in-home breast milk intake measurement, and postdischarge lactation support improved breastfeeding outcomes among preterm infants, and that maternal satisfaction improved with postdischarge interventions. No significant evidence of pre- and postdischarge interventions on weight gain was found.
  
  
  CONCLUSIONS
  Pre- and postdischarge interventions were effective in promoting breastfeeding exclusivity, duration, and maternal satisfaction among mothers of preterm infants. These findings have important clinical implications that support the need for evidence-based breastfeeding interventions for preterm infants before discharge and vigilant postdischarge support. Research to determine more effective interventions to promote exclusive and long-term breastfeeding among preterm infants is required.
authors.affiliation: School of Nursing, Purdue University, West Lafayette, IN.. Electronic address: ahmedah@purdue.edu.
authors.forename: Azza H
authors.initials: AH
authors.lastname: Ahmed
authors.affiliation: School of Nursing and director of the Regenstrief Center for Health Care Engineering at Purdue University, West Lafayette, IN.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Sands
mesh_terms: D000359:Aftercare / Q000458:organization & administration*; D015982:Bias; D001942:Breast Feeding / Q000453:epidemiology / Q000523:psychology / Q000706:statistics & numerical data; D055317:Evidence-Based Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D009035:Mothers / Q000193:education / Q000523:psychology; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D010353:Patient Education as Topic; D011181:Postnatal Care / Q000458:organization & administration*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012944:Social Support; D013997:Time Factors; D015430:Weight Gain / Q000502:physiology