The Association Between Breastfeeding and Growth Among Infants with Moderately Low Birth Weight: A Prospective Cohort Study

Krysten North; Katherine E A Semrau; Roopa M Bellad; Sangappa M Dhaded; Leena Das; Jnanindranath N Behera; Irving Hoffman; Tisungane Mvalo; Rodrick Kisenge; Christopher R Sudfeld; Sarah Somji; Rana R Mokhtar; Linda Vesel; Shivaprasad Goudar; Sunil S Vernekar; E S Siddhartha; Bipsa Singh; M B Koujalagi; Sanghamitra Panda; Eddah Kafansiyanji; Naomie Nyirenda; Melda Phiri; Friday Saidi; Nahya S Masoud; Robert Moshiro; Danielle E Tuller; Kiersten Israel-Ballard; Christopher P Duggan; Anne C C Lee; Kimberly L Mansen; Melissa F Young; Karim Manji; LIFE study team

doi:10.1016/j.jpeds.2024.114003

The Association Between Breastfeeding and Growth Among Infants with Moderately Low Birth Weight: A Prospective Cohort Study

J Pediatr. 2024 Mar 4:269:114003. doi: 10.1016/j.jpeds.2024.114003. Online ahead of print.

Authors

Krysten North¹, Katherine E A Semrau², Roopa M Bellad³, Sangappa M Dhaded³, Leena Das⁴, Jnanindranath N Behera⁵, Irving Hoffman⁶, Tisungane Mvalo⁷, Rodrick Kisenge⁸, Christopher R Sudfeld⁹, Sarah Somji⁸, Rana R Mokhtar¹⁰, Linda Vesel¹⁰, Shivaprasad Goudar³, Sunil S Vernekar³, E S Siddhartha¹¹, Bipsa Singh¹², M B Koujalagi¹¹, Sanghamitra Panda¹³, Eddah Kafansiyanji¹⁴, Naomie Nyirenda¹⁴, Melda Phiri¹⁴, Friday Saidi¹⁴, Nahya S Masoud⁸, Robert Moshiro⁸, Danielle E Tuller¹⁰, Kiersten Israel-Ballard¹⁵, Christopher P Duggan¹⁶, Anne C C Lee¹⁷, Kimberly L Mansen¹⁵, Melissa F Young¹⁸, Karim Manji⁸; LIFE study team

Affiliations

¹ Department of Pediatrics, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: knorth1@bwh.harvard.edu.
² Harvard Medical School, Boston, MA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, MA.
³ Department of Pediatrics, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belgaum, Karnataka, India.
⁴ Department of Pediatrics, Postgraduate Institute of Medical Education & Research and Capital Hospital, Bhubaneswar, Odisha, India.
⁵ Department of Pediatrics, S.C.B. Medical College, Cuttack, Odisha, India.
⁶ University of North Carolina Project Malawi, Lilongwe, Malawi; Department of Medicine, Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, NC.
⁷ University of North Carolina Project Malawi, Lilongwe, Malawi; Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, NC.
⁸ Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
⁹ Departments of Global Health and Population and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
¹⁰ Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, MA.
¹¹ Department of Paediatrics, J J M Medical College, Davangere, Karnataka, India.
¹² Department of Paediatrics, Shri Jagannath Medical College and Hospital, Puri, Odisha, India.
¹³ Department of Paediatrics, City Hospital, Cuttack, Orissa, India.
¹⁴ University of North Carolina Project Malawi, Lilongwe, Malawi.
¹⁵ Integrated Maternal and Child Health and Development, PATH, Seattle, WA.
¹⁶ Division of Gastroenterology, Hepatology, and Nutrition, Center for Nutrition, Boston Children's Hospital, and Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA.
¹⁷ Department of Pediatrics, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
¹⁸ Hubert Department of Global Health, Emory University School of Public Health, Atlanta, GA.

PMID: 38447758
DOI: 10.1016/j.jpeds.2024.114003

Abstract

Objective: To assess the association between breastfeeding competency, as determined by Latch, Audible swallowing, Type of nipple, Comfort, and Hold (LATCH) and Preterm Infant Breastfeeding Behavior Scale (PIBBS) scores, and exclusive breastfeeding and growth among infants with low birth weight (LBW) in India, Malawi, and Tanzania.

Study design: We conducted LATCH and PIBBS assessments among mother-infant dyads enrolled in the Low Birthweight Infant Feeding Exploration (LIFE) observational study of infants with moderately LBW (1500g-2499 g) in India, Malawi, and Tanzania. We analyzed feeding and growth patterns among this cohort.

Results: We observed 988 infants. We found no association between LATCH or PIBBS scores and rates of exclusive breastfeeding at 4 or 6 months. Higher week 1 LATCH and PIBBS scores were associated with increased likelihood of regaining birth weight by 2 weeks of age [LATCH: aRR 1.42 (95% CI 1.15, 1.76); PIBBS: aRR 1.15 (95% CI 1.07, 1.23); adjusted for maternal age, parity, education, residence, delivery mode, LBW type, number of offspring, and site]. Higher PIBBS scores at 1 week were associated with improved weight gain velocity (weight-for-age z-score change) at 1, 4, and 6 months [adjusted beta coefficient: 1 month 0.04 (95% CI 0.01, 0.06); 4 month 0.04 (95% CI 0.01, 0.06); and 6 month 0.04 (95% CI 0.00, 0.08)].

Conclusion: Although week 1 LATCH and PIBBS scores were not associated with rates of exclusive breastfeeding, higher scores were positively associated with growth metrics among infants with LBW, suggesting that these tools may be useful to identify dyads who would benefit from early lactation support.

Keywords: LATCH; PIBBS; breastfeeding; infant feeding; infant growth; lactation support; low birth weight; preterm; small-for-gestational age.