[Feeding practices with human milk in newborns less than 1.500 g or less than 32 weeks]

Abstract

Introduction: There is currently no unified policy on either breastfeeding support or enteral nutrition practices, as regards human milk (HM) in pre-term newborns. The aim of this study was to describe breastfeeding support measures, as well as the use of HM in very preterm infants in Spanish public hospitals.

Method: A questionnaire on enteral feeding practices was distributed. Data were analysed from units caring for newborns less than 32 weeks or 1,500g. A univariate analysis was performed comparing level ii and iii care units.

Results: There was a 91% response rate. A total of 93 units cared for infants less than 32 weeks or 1,500g (17 level ii and 76 level iii), and 49% of the units recorded the breastfeeding rate on discharge. Around 75% (70/93) had a guideline on managing HM (level iii 81 vs. level ii 47%, P=.002), and 25% had access to donor human milk. Just under half (46%) started trophic feeding in the first 6h. Target enteral feeding volume in stable preterm infants was ≥ 180ml/kg/day in 89% of the units (level iii 93% vs. level ii 70%, P =.017). HM fortifier was used in 96% of the units. In 92%, it was added when the required enteral volume was tolerated. In 59% of the units, adjustments in the quantity of fortifier were made according to weight, and in 36%, it depended on analytical criteria. Some units (9%) used pure protein fortifier.

Conclusions: There is a marked variability in breastfeeding support measures and in feeding practices of preterm infants in Spanish neonatal units.

Keywords: Alimentación enteral; Apoyo a la lactancia materna; Breastfeeding support; Enteral feeding; Enteral nutrition; Fortificación de leche materna; Human milk; Human milk fortification; Leche materna; Nutrición enteral; Prematuros; Preterm infants; Recién nacidos de muy bajo peso; Very low birth weight.