Amamentação de recém-nascidos muito prematuros : cada semana conta

Abstract

Objectives: to investigate if exclusive breastfeeding at discharge of very low birth weight preterm infants would be reduced in mothers who expressed breast milk less frequently. To assess clinical factors associated with exclusive breastfeeding failure at discharge of very low birth weight preterm infants. Methods: prospective cohort study, including infants with gestational age ≤ 30 weeks and / or birth weight ≤ 1500g. Patients with genetic syndromes, malformations, absolute contraindications to breast milk or those who died were excluded. Patients were divided into two groups, according to times when mothers could express milk at home (Group 1) or not (Group 2). Dependent variable was diet at discharge (exclusive breastmilk, breastmilk and supplement, exclusive supplement) and independent variables were evaluated through Student's t test (parametric quantitative), Mann-Whittney (non- parametric quantitative) and exact test of Fischer (categorical variables) in a univariate model. The variables with p <0.05 were included in a logistic regression model. The project was approved by the institution’s ethics committee. Results: of the 433 patients followed up until hospital discharge, 147 were included in Group 1 and 286 in Group 2. Group 2 received prenatal corticosteroids more frequently, had lower gestational age, higher frequency of enterocolitis and remained hospitalized longer (p <0.001). Group 2 patients received less exclusive breast milk at discharge (p = 0.01). The reduction with increasing patients using formula to complement breast milk (p = 0.04). In a multivariate logistic regression model, only corrected age remained independently associated with exclusive breastfeeding failure at discharge. Conclusion: less opportunities to stimulate milk expression and longer hospital stay are associated with reduction of exclusive breastfeeding at discharge. Each additional week of hospitalization reduces the chance of exclusive breastfeeding by 10%.