Breastfeeding in hospitalised preterm infants: A survey from 18 tertiary neonatal intensive care units across mainland China

AIM: To understand the use of breast milk and breastfeeding in preterm infants in neonatal intensive care units (NICUs) in mainland China. METHODS: An online questionnaire survey of reported practices was conducted among 18 tertiary NICUs distributed across all seven districts in mainland China. The items of the questionnaire consisted of the following areas: breastfeeding rate of preterm infants (<37 weeks' gestation) at discharge, the standards used for guiding the clinical practice and the use of breast milk and breastfeeding. RESULTS: On average, across all hospitals, breastfeeding rate for preterm infants at discharge was 65%, with 41% preterm infants being exclusively breastfed during the hospitalisation prior to discharge. Sixteen (89%) NICUs had policies designating breast milk as the preferred first feed for preterm infants. Donor milk was available in 3 of 18 (17%) NICUs. Kangaroo care was provided in 11 of 18 (61%) NICUs, and 14 of 18 (78%) allowed parental access to the hospitalised preterm infants. A large variation was found in clinical practices around the breast milk testing, breast milk storage and transportation and breast milk fortification methods among different NICUs. CONCLUSIONS: The use of breast milk in hospitalised preterm infants has increased greatly but still needs to be further improved. A recommendation is made to conduct high-quality original trials to find evidence of the controversial problems, develop evidence-based guidelines, promote the best implementation of the guidelines and provide updated breastfeeding education to health-care providers in order to standardise the use of breast milk and breastfeeding in hospitalised preterm infants.