ArticlePloS one2021
Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Breastfeeding infants with CHD: an evidence summary and recommendations from the Cardiac Newborn Neuroprotective Network, a special interest group of the Cardiac Neurodevelopmental Outcome Collaborative.Cardiology in the young · 2025Guideline
- Positive breastfeeding experiences and facilitators in mothers of preterm and low birthweight infants: a meta-ethnographic review.International breastfeeding journal · 2021Pooled it
- Efficacy of a breastfeeding support education program for nurses and midwives: a randomized controlled trial.International breastfeeding journal · 2022Trial
- The effect of a planned lactation education program on the mother's breastfeeding practice and weight gain in low birth weight infants: a randomized clinical trial study.BMC pregnancy and childbirth · 2022Trial
- Critical Factors Influencing the Uptake of Breastfeeding Support Interventions in Neonatal Intensive Care Units: A Scoping Review.International journal of environmental research and public health · 2026Article
- Breastfeeding support in Italian Pediatric Intensive Care Units: a nationwide survey on protocols, practices, and challenges.European journal of pediatrics · 2026Article
- An investigation into the status of human milk feeding in very low birth weight infants: a multicenter study.International breastfeeding journal · 2026Observational
- WHO exclusive breastfeeding recommendation and cognitive development in Germany.Scientific reports · 2026Article
- Neonatal Intensive Care Admissions and Outcomes in Malta from 2019 to 2022-A Retrospective Observational Study.Children (Basel, Switzerland) · 2026Article
- Obstetric and neonatal conditions and associations with early skin-to-skin contact - a cross-sectional study.BMC pregnancy and childbirth · 2025Article
- Mother's Own Milk Provision During the First 12 Weeks of Life by Gestational Age.JAMA network open · 2025Article
- Article
- Predicting early cessation of exclusive breastfeeding using machine learning techniques.PloS one · 2025Article
- Differences between neonatal units with high and low rates of breast milk feeding for very preterm babies at discharge: a qualitative study of staff experiences.BMC pregnancy and childbirth · 2024Article
- Monitoring the Use of Human Milk, the Ideal Food for Very Low-Birth-Weight Infants-A Narrative Review.Foods (Basel, Switzerland) · 2024Review
- Perception and experiences of adolescent mothers and communities in caring for their preterm babies: findings from an in-depth study in rural Bangladesh.BMC pregnancy and childbirth · 2024Article
- Challenges and Strategies of Providing Effective Antenatal Education Services in Oman's Public Healthcare System: Perspectives of service providers and pregnant women.Sultan Qaboos University medical journal · 2023Article
- Predictors of Human Milk Feeding and Direct Breastfeeding for Infants with Single Ventricle Congenital Heart Disease: Machine Learning Analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.The Journal of pediatrics · 2023Article
- Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge.Nutrients · 2023Article
- Patterns of Breastfeeding and Human Milk Feeding in Infants with Single-Ventricle Congenital Heart Disease: A Population Study of the National Pediatric Cardiology Quality Improvement Collaborative Registry.Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine · 2023Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly breast milk expression, prolonged skin-to-skin contact, rooming-in, use of test-weighing and minimizing use of pacifiers are positively associated with exclusive breastfeeding of preterm infants, whereas use of nipple shields is negatively associated.
aimTo test whether a training program for neonatal nurses with a focus on these six breastfeeding-supportive clinical practices affects the rate of preterm infants exclusively breastfed at discharge to home, the postmenstrual age at establishment of exclusive breastfeeding, and maternal self-reported use of the practice in the neonatal intensive care unit, the.
methodsA quasi-experimental multi-centre intervention study from 2016-2019 including a control group of 420 preterm mother-infant dyads, an intervention with a training program for neonatal nurses and implementation of weekly breastfeeding meetings for neonatal nurses, and an intervention group of 494 preterm mother-infant dyads.
resultsSignificantly more preterm infants in the intervention group were exclusively breastfed at discharge to home (66.6%) than in the control group (58.1%) p = 0.008. There was no significant difference in postmenstrual age at establishment of exclusive breastfeeding between control and intervention group (37.5 vs.37.8 weeks, p = 0.073). Compared to the control group the number of infants continuing daily skin-to-skin contact after incubator care increased (83.2% vs. 88.3%, p = 0.035), infants using a nipple shield decreased (61.8% vs. 54.2%, p = 0.029), and the number of mothers initiating breast milk expression before six hours post-partum increased (32.6% vs. 42.4%, p = 0.007). There was a significant correlation between percentage of neonatal nurses participating in the breastfeeding training program and changes in exclusive breastfeeding rates (Pearson Correlation 0.638, p = 0.047).
conclusionExclusive breastfeeding rates in preterm infants and maternal self-reported use of breastfeeding-supportive practices increased by training neonatal nurses in the six clinical practices. It is important to include all nurses in the breastfeeding training program to ensure positive effect on exclusive breastfeeding rates.
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