(OR13-04-24) Breastfeeding Patterns and Growth Outcomes Among Newborns in Sylhet, Bangladesh

Sunday, June 30, 2024

10:36 AM – 10:48 AM CT

Location: W375A

Presenting Author(s)

UR

Unmesha Roy Paladhi, PhD, MPH (she/her/hers)

Postdoctoral Research Fellow
Harvard Medical School
Boston, Massachusetts, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

IO

Ingrid Olsaro

JSI Research and Training Institute, Inc., United States
SA

Salahuddin Ahmed

Projahnmo Research Foundation
AB

Abdullah H. Baqui

Johns Hopkins Bloomberg School of Public Health
NC

Nabid H. Chowdury

Projahnmo Research Foundation
RK

Rasheda Khanam

Johns Hopkins Bloomberg School of Public Health
SR

Sayedur Rahman

Uppsala University
CA

Chloe Andrews, M.S, RD, CLC

PhD Student/Project Manager
Tufts University/Brigham and Women's Hospital
Boston, Massachusetts, United States
SC

Sara Cherkerzian, PhD

Instructor
Brigham and Women's Hospital
Boston, Massachusetts, United States
Krysten North, MD, MPH (she/her/hers)

Instructor
Harvard Medical School
Boston, Massachusetts, United States
SS

Sarbattama Sen, M.D

Brigham and Women's Hospital
Boston, Massachusetts, United States
AL

Anne C. Lee, MD, MPH

Associate Professor
Harvard Medical School
Boston, Massachusetts, United States

Objectives: Describe breastfeeding patterns (frequency, duration, milk transfer) among small vulnerable newborns and associations between breastfeeding patterns and growth outcomes.

Methods: From March-August 2018 we enrolled 93 women and collected 24-hour breastfeeding diaries and pre-post feed weights in a pregnancy-birth cohort in Sylhet, Bangladesh. Milk transfer is weight difference before vs after a feed and weight gain velocity was calculated (g/day) between 1-4 month visits. We compared frequency and total daily duration of feeding (minutes) by preterm, small for gestational age [SGA] and low birth weight [LBW] ( < 2500gm) status using one-way ANOVA or t-tests. Using multiple linear regression we investigated associations between total daily feeding duration and daily milk transfer, and outcomes (weight gain velocity, weight for age z-score [WAZ]) adjusting for maternal education, infant GA, and birthweight z-score.

Results: At 1 and 4 months, 93 and 79 infants were assessed respectively. The prevalence of SGA was 42%, LBW 26%, and preterm 6%. Early term infants (GA 37-38 weeks) fed more frequently than infants ≥39 weeks (12.3 feeds/day, SD=1.7 vs 10.9, SD=2.2). There were no significant differences in daily feeding frequency by SGA or LBW status. In the full cohort, the mean total daily breastfeeding duration (minutes) decreased between 1 (207, SD=124) and 4 months (179, SD=100). Preterm infants at 1 month had longer daily feeding duration than term infants (239, SD=43.4 vs 197, SD=125), similar to SGA infants compared to non-SGA infants (215, SD=140 vs 201, SD=111), and LBW infants compared to >2500g (231, SD=119 vs 199, SD=125); differences were not statistically significant. Average milk transfer was 39.8mL/feed (SD=26.9) at 1 month and increased significantly to 61.0mL (SD=30.4) at 4 months. Mean daily weight gain velocity was 21.3g/day (SD=6.6) between study visits. We found no significant association between total daily feeding duration or milk transfer and weight gain velocity or WAZ at 1 and 4 months.

Conclusions: Increased infant postnatal age resulted in higher suckling efficiency as infants fed for shorter total daily duration and milk transfer volumes increased. Early term infants fed more frequently than term infants, had longer total feeding duration, and lower total volume transfer.

Funding Sources: Bill & Melinda Gates Foundation, BWH Microgrant