Factors associated with exclusive breastfeeding in low birth weight infants at NICU discharge and the start of complementary feeding

The aim of the present study was to clarify clinical factors in low birth weight infants and their mothers associated with exclusive breastfeeding at both neonatal intensive care unit (NICU) discharge and the start of complementary feeding. One hundred and fifteen low birth weight children and 98 mothers attending the follow-up clinic of two tertiary NICUs in Nara prefecture (Japan), between June and September, 2011, were enrolled. The relationship between the feeding categories at NICU discharge or the start of complementary feeding, and clinical factors of the mothers and low birth weight infants collected by either their charts or a face-to-face interview was analyzed. The prevalence of exclusive breastfeeding was 22.6% at NICU discharge, and 15.7% at the start of complementary feeding. In logistic analysis, exclusive breastfeecling at NICU discharge was associated with mother's younger age at delivery and an earlier start of oral nutrition. Among 26 exclusively breast-fed infants at NICU discharge, fifteen infants (57.7%) were still being exclusively breast-fed at the start of complementary feeding. In low birth weight infants, a shorter stay at NICU and an earlier start of oral nutrition were associated factors with exclusive breastfeeding at the start of complementary feeding. None of maternal factors were found to be associated with exclusive breastfeeding at the start of complementary feeding. Conclusively, starting of oral nutrition as early as possible is thought to be crucial for introducing exclusive breastfeeding in low birth weight infants both at NICU discharge and the start of complementary feeding.