438 - Gender Disparity in Breastfeeding Continuity in the NICU: Risk Factors for Early Cessation Among Preterm Infants

Poster Number: 438
Publication Number: 438.1906

Background: Providing breastmilk to preterm infants has been shown to have many benefits, however, many mothers choose to stop breastfeeding their babies during their NICU stay. Numerous studies have explored the risk factors associated with breastfeeding cessation in NICU-admitted infants, however little has been done to study the correlation of gender with breastfeeding cessation in preterm infants. This study aims to understand and identify why males are more likely than females to stop breastfeeding during their NICU course and the major risk factors behind breastfeeding cessation.

Objective: To investigate the factors contributing to the lower rate of breastfeeding at discharge among preterm male infants compared to preterm females in the NICU.

Design/Methods: We performed a retrospective cohort study of preterm infants, aged 32 weeks and below in a level IV NICU, evaluating breastfeeding rates in male versus female infants over a 2 year period. Maternal and neonatal data were collected from the electronic medical record. Statistical analysis included Chi-square test, Mann Whitney test, stratification analysis and multivariable logistic regression analysis (MLVR).

Results: During the study period, 149 premature infants were evaluated with 69 males and 80 females. Significant gender disparity in breastfeeding rates at discharge were observed, with males exhibiting a lower likelihood compared to females (p < 0.05). Using a MLVR model, surfactant administration, maternal diabetes, male sex, marital status and level of resuscitation at delivery all correlated with increased risk of breastfeeding cessation at discharge with p-values < 0.1 (Table 1). With a stratification table (Table 2), male gender was identified as a potential confounder of the data. Our data shows that as NICU course severity increases breastfeeding rates decrease, especially in preterm males compared to preterm females (Table 3).

Conclusion(s): There is an association between male gender and early breastfeeding cessation in the NICU however, this is likely a confounder as our data shows that males are statistically more likely to have more severe NICU courses. By understanding the risk factors and identifying infants at risk for early breastfeeding cessation, more support and maternal counseling can be provided to mothers of these infants, hence improving breastfeeding rates.