667 - Beneficial Effects and Factors Associated with Breastmilk Feeding at Neonatal Intensive Care Unit Discharge Among Very Low Birth Weight Infants: A Nationwide Cohort Study in Korea

Publication Number: 667.3794

Seung Hyun Shin, Korea university Guro Hospital, Seoul, Seoul-t'ukpyolsi, Republic of Korea; Hyunseo Kim, Korea University, Seoul, Seoul-t'ukpyolsi, Republic of Korea; Eui Kyung Choi, Korea University Guro Hospital, Seoul, Seoul-t'ukpyolsi, Republic of Korea

Background: The incidence of preterm births in Korea has increased from 6.5% in 2013 to 9.7% in 2020. Very low birth weight (VLBW) infants, defined as those weighing < 1,500 g, are particularly vulnerable to numerous health risks. Breastmilk feeding has been shown to reduce complications in this vulnerable population, making it essential to examine breastfeeding trends among VLBW infants to guide future interventions.

Objective: The objective of this study was to determine the rate of breast milk use at neonatal intensive care units (NICU) discharge in a nationwide cohort of VLBW infants and to assess the relationship between breast milk and long-term growth and developmental outcomes at 18–24 months of corrected age (CA).

Design/Methods: We conducted a cohort study using data from over 70 neonatal intensive care units participating in the Korean Neonatal Network (KNN). VLBW infants born between January 2019 and December 2020 at a gestational age of 24 + 0 – 31 + 6 weeks were included. Discharge feeding types were analyzed in 2,490 infants, with follow-up assessments of neurodevelopmental outcomes at 18–24 months corrected age available for 1,426 infants. Propensity score matching was used for the comparative analysis.

Results: At discharge, 56.2% of the infants were fed breast milk, with no significant differences between 2019 and 2020. Factors positively associated with breastfeeding included higher maternal education and antenatal steroid use. In contrast, maternal hypertensive disorders and severe neonatal morbidities (e.g., necrotizing enterocolitis) were correlated with lower breastfeeding rates at the time of discharge. Neurodevelopmental assessments indicated that breastfeeding was linked to a reduced risk of developmental delays (adjusted OR 0.72, 95% CI 0.56–0.94) at follow-up.

Conclusion(s): The breastfeeding rate at discharge for VLBW infants in Korea was comparable to rates observed in other countries. This nationwide study highlighted the critical role of breast milk in promoting neurodevelopment in VLBW infants. Future efforts should focus on identifying the barriers to breast milk provision to improve health outcomes in this vulnerable population.