Systematic Review of Factors Associated with Promoting or Delaying the Establishment of Breastfeeding in Preterm Infants in the NICU

Abstract

Abstract Background Despite increased understanding of the benefits of breastfeeding for preterm infants to reduce morbidity and improve early brain growth, the initiation of preterm infant breastfeeding continues to be low. Feeding preterm infants at breast has been described challenging for mothers particularly during infants NICU stays. Aim The aim of this systematic review was to identify the factors associated with establishment of preterm infants’ breastfeeding in NICU. Methods An electronic search was conducted from 1st to 16th June 2020, across seven databases; CINAHL, Medline (Ovid), Cochrane, PubMed, PsychoINFO, Web of Science, and EMBASE via Kings’ College London E-library portal using keywords combined in structured search strategy. Then, the retrieved studies filtered using stringent inclusion and exclusion criteria. Ten studies have been included in this review. Data was extracted using the JBI mixed methods tool, analyzed following the convergent integrated approach, and synthesized as narrative review. Results Throughout the ten studies included, three main themes were identified in an association with initiation breastfeeding for preterm infants before NICUs’ discharge ; maternal and infant factors, factors related hospital culture and policies, and healthcare professionals factors. Conclusion For breastfeeding success, preterm infants need a specific range of intervention. Future research should be aimed to identify and evaluate particular strategies to better serve this at-risk population in order to incorporate the correct strategies.