Publication:

The breastfeeding support practices, related barriers and facilitators in the neonatal intensive care unit, Uttarakhand, India

Background Within the bustling and stressful neonatal intensive care unit (NICU) environment, implementing Baby-friendly practices presents numerous challenges. Breastfeeding initiation and duration rates among NICU infants are lower compared to healthy full-term infants. Objectives were to explore breastfeeding support practices and related barriers and facilitators in the NICU.

Methods A retrospective study of 496 babies admitted to NICU of Sahota Superspeciality Hospital Kashipur, Uttarakhand during the time period March 2018 to February 2020 and examined maternal and infant factors. The 496 infants divided in two groups: group A: breast milk use at discharge (n=398) and group B: no breast milk use at discharge (n=98).

Results The incidence of morbidity factors like sepsis, chronic lung disease, retinopathy of prematurity, intraventricular hemorrhage, gastrostomy tube feeds at discharge, gavage feeds at discharge noted more among the babies of group of ‘no breast milk use at discharge’ compared to other group (p<0.05). The usage of donor milk and formula milk is significantly very less in babies of group ‘breast milk use at discharge’ compared to other group (p<0.05). Duration of hospital stay was very less in the group A compare to group B (p<0.05). Respiratory distress was the most common diagnosis among the babies of group A and apnea was the most common among babies of group B.

Conclusions Obstacles to maintaining breastfeeding in the NICU, which warrant focused efforts for enhancing practices, encompassed inadequate resources for facilitating parental involvement, impediments to expressing and providing maternal breast milk, and a notable prevalence of bottle-feeding supplemented with formula.