Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit

Lena Carolin Herich, Marina Cuttini, Ileana Croci, Francesco Franco, Domenico Di Lallo, Dante Baronciani, Katia Fares, Giancarlo Gargano, Massimiliano Raponi, Jennifer Zeitlin, Italian Effective Perinatal Intensive Care in Europe (EPICE) Network

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units.

STUDY DESIGN: This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect.

RESULTS: There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers.

CONCLUSION: In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.

Original languageEnglish
Pages (from-to)59-65.e7
JournalJournal of Pediatrics
Volume182
DOIs
Publication statusPublished - Nov 17 2016

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Neonatal Intensive Care Units
Enteral Nutrition
Breast Feeding
Mothers
Education
Milk
Premature Infants
Breast
Multilevel Analysis
Maternal Age
Italy
Population
Cohort Studies

Keywords

  • Journal Article

Cite this

Herich, L. C., Cuttini, M., Croci, I., Franco, F., Lallo, D. D., Baronciani, D., ... Italian Effective Perinatal Intensive Care in Europe (EPICE) Network (2016). Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit. Journal of Pediatrics, 182, 59-65.e7. https://doi.org/10.1016/j.jpeds.2016.10.046

Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit. / Herich, Lena Carolin; Cuttini, Marina; Croci, Ileana; Franco, Francesco; Lallo, Domenico Di; Baronciani, Dante; Fares, Katia; Gargano, Giancarlo; Raponi, Massimiliano; Zeitlin, Jennifer; Italian Effective Perinatal Intensive Care in Europe (EPICE) Network.

In: Journal of Pediatrics, Vol. 182, 17.11.2016, p. 59-65.e7.

Research output: Contribution to journalArticle

Herich, LC, Cuttini, M, Croci, I, Franco, F, Lallo, DD, Baronciani, D, Fares, K, Gargano, G, Raponi, M, Zeitlin, J & Italian Effective Perinatal Intensive Care in Europe (EPICE) Network 2016, 'Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit', Journal of Pediatrics, vol. 182, pp. 59-65.e7. https://doi.org/10.1016/j.jpeds.2016.10.046
Herich, Lena Carolin ; Cuttini, Marina ; Croci, Ileana ; Franco, Francesco ; Lallo, Domenico Di ; Baronciani, Dante ; Fares, Katia ; Gargano, Giancarlo ; Raponi, Massimiliano ; Zeitlin, Jennifer ; Italian Effective Perinatal Intensive Care in Europe (EPICE) Network. / Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit. In: Journal of Pediatrics. 2016 ; Vol. 182. pp. 59-65.e7.
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abstract = "OBJECTIVE: To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units.STUDY DESIGN: This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect.RESULTS: There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers.CONCLUSION: In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.",
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AU - Herich, Lena Carolin

AU - Cuttini, Marina

AU - Croci, Ileana

AU - Franco, Francesco

AU - Lallo, Domenico Di

AU - Baronciani, Dante

AU - Fares, Katia

AU - Gargano, Giancarlo

AU - Raponi, Massimiliano

AU - Zeitlin, Jennifer

AU - Italian Effective Perinatal Intensive Care in Europe (EPICE) Network

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2016/11/17

Y1 - 2016/11/17

N2 - OBJECTIVE: To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units.STUDY DESIGN: This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect.RESULTS: There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers.CONCLUSION: In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.

AB - OBJECTIVE: To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units.STUDY DESIGN: This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect.RESULTS: There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers.CONCLUSION: In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.

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