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Direct Breastfeeding of Mother’s Own Milk Benefits Preterm Infants

Direct Breastfeeding of Mother’s Own Milk Benefits Preterm Infants 1024 575 Mary Bates, PhD

Despite benefits, new study finds low rates of breastfeeding among preterm infants discharged from the NICU. Mother’s own milk (MOM) and direct breastfeeding (DBF) are associated with numerous health and development advantages, especially for preterm infants. However, the rates of MOM feeding and DBF among infants admitted to neonatal intensive care units (NICUs) are low, says Sudarshan Jadcherla, MD, a principal investigator at the Center for Perinatal Research and medical director of the Neonatal and Infant Feeding Disorders Program at Nationwide Children’s Hospital.

“Babies can get nutrition from bottle feeding, but it’s not the same as getting mother’s own milk through breastfeeding,” he says. “Although the fi eld of neonatology knows this, there are many issues resulting in an appallingly low rate of direct breastfeeding in the United States.”

In a recent study published in Breastfeeding Medicine, Dr. Jadcherla and colleagues examined the role of MOM and DBF in preterm infants with oral feeding difficulties. The researchers retrospectively analyzed data from 237 preterm infants who were referred to Nationwide Children’s NICU for evaluation of feeding difficulties and discharged home on full oral feeds.

The analyses showed that 35.4% of these infants received any MOM feeding at discharge. Consistent with other studies, the odds of MOM feeding at discharge were higher with higher maternal age and absence of maternal substance use.

Among the one-third of infants receiving any MOM at discharge, only 4.8% were exclusively breastfed, while 39.3% were partially breastfed. Infants who received DBF had higher birthweight, no incidence of being small for gestational age and lower incidences of respiratory support at birth or intraventricular hemorrhage. These infants also had a younger postmenstrual age at discharge and transitioned from first oral feed to full oral feeds in a shorter time than non-directly breastfed infants.

Dr. Jadcherla, who is also a professor of Pediatrics at The Ohio State University College of Medicine, suggests that “It appears plausible that there is a protective effect of the choice of DBF, even among preterm infants with feeding difficulties.”

To encourage more MOM feeding and DBF, breast-feeding education before conception and during early pregnancy may be particularly beneficial for mothers.

“Clinical management and research advocacy must focus on identifying modifiable factors and targeting interventions to the populations at the highest risk of not utilizing MOM, such as younger mothers and mothers who abuse substances,” says Dr. Jadcherla.

Educational and support programs to support the use of MOM and DBF should also target NICU staff and other health professionals who tend to sick preterm infants, he says. Hospital systems can take actions to help change perceptions and attitudes towards MOM and DBF for their patients, as well as put practices in place to help mothers provide DBF to their infants.

This article appeared in the 2025 Spring/Summer issue. Download the full issue.

Reference:

Bala F, Alshaikh E, Jadcherla SR. Factors associated with mother’s own milk feeding and direct breast-feeding at discharge in preterm infants with feeding difficulties: Clinical and research implications. Breastfeeding Medicine. 2024 Nov;19(11):827-836.

About the author

Mary a freelance science writer and blogger based in Boston. Her favorite topics include biology, psychology, neuroscience, ecology, and animal behavior. She has a BA in Biology-Psychology with a minor in English from Skidmore College in Saratoga Springs, NY, and a PhD from Brown University, where she researched bat echolocation and bullfrog chorusing.

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