title: Changes in the prevalence of breast feeding in preterm infants discharged from neonatal units: a register study over 10 years.
abstract: There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants.
  
  
  
  This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004-2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups.
  
  
  
  From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22-27 weeks) from 55% to 16%, in very preterm (GA 28-31 weeks) from 41% to 34% and in moderately preterm infants (GA 32-36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding and which became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants).
  
  
  
  In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.|Centre for Clinical Research Dalarna, Falun, Sweden.|Department of Pediatrics, Falu Hospital, Falun, Sweden.
authors.forename: Jenny
authors.identifier: 0000-0002-3460-7500
authors.initials: J
authors.lastname: Ericson
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Renée
authors.initials: R
authors.lastname: Flacking
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Hellström-Westas
authors.affiliation: Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
authors.forename: Mats
authors.identifier: 0000-0002-5996-2584
authors.initials: M
authors.lastname: Eriksson
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012042:Registries; D013548:Sweden / Q000453:epidemiology
keywords: NEONATOLOGY; PAEDIATRICS