title: Hospital care and early breastfeeding outcomes among late preterm, early-term, and term infants.
abstract: BACKGROUND
  Compared with term infants (39-41 weeks), early-term (37-38 weeks) and late preterm (34-36 weeks) infants have increased breastfeeding difficulties. We evaluated how hospital practices affect breastfeeding by gestational age.
  
  
  METHODS
  This Listening to Mothers III survey cohort included 1,860 mothers who delivered a 34-41-week singleton from July 2011 to June 2012. High hospital support was defined as at least seven practices consistent with the Baby-Friendly Hospital Initiative's Ten Steps for United States hospitals. Logistic regression tested mediating effects of hospital support on the relationship between gestational age and breastfeeding at 1 week postpartum.
  
  
  RESULTS
  High hospital support was associated with increased exclusive breastfeeding (AOR 2.21 [95% CI 1.58-3.09]). Just 16.4 percent of late preterm infants experienced such support, compared with early-term (37.9%) and term (30.7%) infants (p = 0.004). Although overall breastfeeding rates among late preterm, early-term, and term infants were 87, 88, and 92 percent, respectively, (p = 0.21), late preterm versus term infants were less likely to exclusively breastfeed (39.8 vs. 62.3%, p = 0.002). Inclusion of hospital support in multivariable modeling did not attenuate the effect of late preterm gestation.
  
  
  CONCLUSIONS
  Differences in practices do not account for decreased exclusive breastfeeding among late preterm infants. Hospital supportive practices increase the likelihood of any breastfeeding.
authors.affiliation: Division of Neonatology and Division of Hospital Medicine, Cincinnati Children's Research Foundation and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Neera K
authors.initials: NK
authors.lastname: Goyal
authors.forename: Laura B
authors.initials: LB
authors.lastname: Attanasio
authors.forename: Katy B
authors.initials: KB
authors.lastname: Kozhimannil
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007224:Infant Care / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D016015:Logistic Models; D011247:Pregnancy; D047928:Premature Birth; D012386:Rooming-in Care / Q000706:statistics & numerical data; D012944:Social Support; D047929:Term Birth; D055815:Young Adult
keywords: Baby-Friendly Hospital Initiative; breastfeeding; early-term; hospital practices; late preterm