Breastfeeding Duration After NICU Discharge: A National Survey of Mothers of Preterm Infants

Background: Breastfeeding is vital for the health and development of preterm infants; however, maintaining breastfeeding after NICU discharge continues to be challenging. Research aim: This study aimed to assess the prevalence and factors influencing breastfeeding continuation after NICU discharge among mothers of preterm infants in Brazil. Methods: Cross-sectional study from January 2019 to January 2021 using an online survey distributed by Prematuridade.com, a Brazilian nonprofit organization. Data were collected from 1,000 mothers of preterm infants across all Brazilian federative units. Statistical analyses included descriptive statistics, Poisson regression, and Kaplan–Meier survival analysis. Results: Among respondents, 76.7% continued breastfeeding after hospital discharge. Breastfeeding at NICU discharge (Relative Risk [ RR ] = 2.41; 95% CI: 2.07–2.81; p < .001), breastfeeding during NICU stay ( RR = 0.87, 95% CI: [0.79,0.95], p= .003) and shorter NICU stays ( RR = .997; 95% CI: [0.995,0.999]; p = .002) were significantly associated with breastfeeding post-discharge. Kaplan–Meier analysis revealed that breastfeeding at NICU discharge was associated with longer breastfeeding duration (log-rank test, p = .03), but not with achieving the six-month threshold ( OR = 1.37; 95% CI: [0.85,2.32], p = .20). Conclusion: Breastfeeding at NICU discharge and shorter NICU stays are predictors of sustained breastfeeding post-discharge. These findings highlight the need for targeted interventions during the NICU stay and extended lactation support after discharge to address barriers and promote equitable breastfeeding outcomes for preterm infants in Brazil.