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Breast feeding very-low-birthweight infants at discharge: a multicentre study using WHO definitions
Paediatric and Perinatal Epidemiology, 10/16/09

Davanzo R et al. – At discharge, 30.5% of VLBW infants were exclusively breast fed, 0.2% were predominantly breast fed, 23.8% were on complementary feeding and 45.5% were exclusively formula fed. A wide variability in BF rates was seen between centres. Among exclusively breast–fed VLBW infants, only 10% sucked directly and exclusively at the breast. WHO definitions can be used to assess type of feeding at discharge from NICUs. The authors speculate that common feeding definitions may allow both comparisons among different NICUs and ratings of quality improvement programmes.

Exclusive Author Commentary
Dr Riccardo Davanzo, 10/19/09

The use of human milk is more and more common in the nutrition of VLBWIs due its well recognized benefits. Nevertheless, many VLBWIs are discharged from hospital with a mixed feeding and most of them using the bottle. The great majority of this population stop definitely feeding breast milk in few weeks. On the contrary, discharge of VLBWIs exclusively breast fed and possibly to the breast, could facilitate mantaining breastfeeding longer, therefore increasing the health vaucher for this category of high need babies. A strong effort from health workers should be spent to send home VLBWIs exclusively breast fed. Yet, our study show that only a very small percentage of VLBWIs go home without the bottle. This is not an easy task for nurses and neonatologist, but it is a worthy challange.

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