title: Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission?
abstract: OBJECTIVE
  Late preterm birth (at 34-36 6/7 weeks' gestation) is a risk factor for early breastfeeding cessation. The objective of this study was to determine barriers to and facilitators of breastfeeding continuation among late preterm infants (LPI) and to compare the barriers faced by LPI admitted to the well nursery versus the NICU.
  
  
  METHODS
  The SAS Complex Survey was used to perform multivariable logistic regression analysis by using data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. Data from 3 states (Illinois, Maine, and Vermont) for the years 2004 to 2008 were used.
  
  
  RESULTS
  A total of 2530 mothers of LPI were surveyed. Odds of breastfeeding initiation were similar among LPI admitted to the NICU versus the well nursery (adjusted odds ratio, 1.24 [95% confidence interval, 0.88-1.73]; P = .209). Odds of breastfeeding for ≥ 10 weeks were no different between LPI admitted to the NICU versus those admitted to the well-nursery (adjusted odds ratio, 1.02 [95% confidence interval, 0.73-1.43]; P = .904). Factors associated with increased odds of breastfeeding for ≥ 10 weeks among LPI were higher maternal education, mother being married, and normal maternal BMI. Regardless of NICU admission, the top reasons cited by mothers of LPI for early breastfeeding discontinuation were perceived inadequate milk supply and nursing difficulties.
  
  
  CONCLUSIONS
  Among LPIs, NICU admission was not associated with early breastfeeding cessation. Mothers of LPIs with lower odds of sustaining breastfeeding for at least 10 weeks were single mothers, those with a high school education only, and those who were obese. Breastfeeding support should be enhanced for LPIs and should address perceived maternal milk supply concerns and nursing difficulties.
authors.affiliation: Department of Pediatrics, University of Iowa Stead Family, Carver College of Medicine, Iowa City, Iowa, 52242, USA. laura-kair@uiowa.edu.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Kair
authors.affiliation: Department of Pediatrics, University of Iowa Stead Family, Carver College of Medicine, Iowa City, Iowa, 52242, USA.
authors.forename: Tarah T
authors.initials: TT
authors.lastname: Colaizy
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding; D004522:Educational Status; D005260:Female; D005865:Gestational Age; D006801:Humans; D007087:Illinois; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008281:Maine; D008393:Marriage; D008425:Maternal Behavior / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014707:Vermont; D055815:Young Adult