Evidence map›Paper›PMID 39748409›Full record

ArticleInternational breastfeeding journal2025

Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe.

Bente Silnes Tandberg, Hege Grundt, Ragnhild Maastrup, Annie Aloysius, Livia Nagy, Renée Flacking

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Article in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Bente Silnes TandbergDepartment of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Vestre Viken HT, Post Box 800, Drammen, 3004, Norway. btandb@vestreviken.no.ORCID 0000-0002-1183-4532
Hege GrundtDepartment of Neonatology, Haukeland University Hospital, Bergen, Norway.
Ragnhild MaastrupKnowledge Centre for Breastfeeding Infants with Special Needs, Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Annie AloysiusDepartment of Neonatology, Imperial College Healthcare NHS Trust, London, UK.
Livia NagyMelletted a helyem Egyesület (Right(s) Beside You Association), Budapest, Hungary.
Renée FlackingSchool of Health and Welfare, Dalarna University, Falun, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in neonatal intensive care units (NICUs) is scarce. Therefore, the aim was to describe supporting practices for cue-based breastfeeding.

methodThrough Delphi rounds, a questionnaire was developed comprising questions on the usage and occurrence of supportive practices for cue-based breastfeeding. A multinational online survey was distributed September to October in 2023 to NICUs in Europe using snowball sampling. Practices such as the practice of skin-to-skin contact (SSC), restrictions for breastfeeding, providing information to parents, observing and responding to infants' cues were explored.

resultsThe survey was completed by 105 neonatal units across 15 European countries. Less than half (46%) of the NICUs had no restrictions upon placing the infant in SSC with the parents. Approximately half (49%) of the NICUs stated that infants had SSC within the first hour after birth. Many units (68%) had some restriction for breastfeeding. One week after birth, 48% of the NICUs encouraged breastfeeding for infants at 33 postmenstrual age whenever the infant showed cues, regardless of scheduled tube feeding time. This percentage increased to 59% at 33-35 gestational age. Less than half of the units (47%) stated that they had the necessary tools/instruments to support the transition from tube feeding to breastfeeding. There were variations in how milk intake was assessed, such as weighing before and after breastfeeding or estimating milk intake by time spent sucking. Infants in 50% of the units had to be fed exclusively orally before discharge. Many units (65%) provided specific support to or enabled discharge before the infant was exclusively orally fed.

conclusionEuropean NICUs employ supportive practices, SSC, early initiation of breastfeeding, and provide information to parents. Staff plays a significant role in fostering cue-based feeding in preterm infant-mother dyads. There still exist restrictions for SSC and breastfeeding. To understand the impact of different strategies and practices, there is need for evaluations by parents and testing of the implementation of cue-based feeding practices in neonatal care.

Indexed as

Breast FeedingCuesInfant, PrematureIntensive Care Units, NeonatalAdultEuropeFemaleHumansInfant, NewbornMaleSurveys and QuestionnairesBreastfeedingCue-based feedingNeonatal intensive careNeonatal intensive care unitPreterm infant

Identifiers

PMID39748409
PMCPMC11697679

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.