Abstract
BACKGROUND: Human milk, especially the mother's own milk (MOM), is highly recommended for preterm babies considering its numerous benefits. Prioritising the use of exclusive MOM in enteral feeding plans is essential for maximising the health and development of preterm babies. This study evaluated the effect of early establishment of full enteral feed (FEF) with exclusive MOM on feeding rate and neonatal nutritional outcomes at discharge among preterm babies. METHODS: A retrospective cohort study was conducted using medical records of single preterm babies born between 27 and 33(+6) weeks of gestational age and admitted to a single tertiary care hospital in South India between June 2019 and May 2022. The primary exposure was the establishment of FEF with exclusive MOM. The outcomes assessed were the exclusive MOM feeding rate and neonatal nutritional outcomes at discharge. RESULTS: A total of 160 preterm babies met the inclusion criteria. Among these 104 (65%) achieved FEF with exclusive MOM. The exclusive MOM feeding rate at discharge was significantly higher among preterm babies who achieved FEF with exclusive MOM, 91.3% vs 62.5% (RR: 1.46 (95% CI: 1.18 to 1.81)). Preterm babies who achieved FEF with exclusive MOM were five times more likely to continue exclusive MOM feeding at discharge (aOR: 5.37, 95% CI: 2.04 to 14.16). The median time taken to achieve exclusive MOM among the exposure group was 6 days (95% CI: 5.6 to 6.3) compared with 12 days (95% CI: 10.2 to 13.8) for the unexposed group (HR: 0.26 (95% CI: 0.17 to 0.38; p<0.001)). There was no significant difference in growth and neonatal complications between the groups. Availability of MOM within 48 hours was strongly associated with achieving FEF with exclusive MOM, with an adjusted OR of 6.12 (95% CI: 2.81 to 13.30). CONCLUSIONS: Early establishment of FEF with exclusive MOM increases the exclusive MOM feeding rate at discharge. Early access to MOM within 48 hours significantly enhances the likelihood of achieving FEF with exclusive MOM.