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Nipple shield use in preterm infants: Prevalence, motives for use and association with exclusive breastfeeding-Results from a national cohort study

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@article{7201546ca3d1403c8ce5eb019ddb1392,
title = "Nipple shield use in preterm infants: Prevalence, motives for use and association with exclusive breastfeeding-Results from a national cohort study",
abstract = "BACKGROUND AND AIM: Prevalence and motives for nipple shield use are not well studied in preterm infants and recommendations of nipple shield use in preterm infants are inconsistent. The aim of this study was to determine the prevalence of nipple shield use, explore the motives for nipple shield use and elucidate the association with exclusive breastfeeding in preterm infants.METHODS: The study was part of a prospective survey of a Danish national cohort of preterm infants based on questionnaires answered by the 1221 mothers of 1488 preterm infants with gestational age of 24-36 weeks. Data on nipple shield use was available for 1407 infants.RESULTS: Nipple shields were used by 54{\%} of the mother-infant dyads for many different motives and was more often related to breastfeeding problems associated with the infant than with the mother. The most common motive for nipple shield use was {"}infant slipped the nipple{"} (52{\%}). The lower the gestational age, the more frequently nipple shields were used for motives related to the infant. For those using a nipple shield, only the motive {"}infant fell asleep at the breast{"} was associated with a higher risk of not breastfeeding exclusively at discharge (OR 1.90 (95{\%} CI 1.15; 3.13), p = 0.012), and {"}breast too engorged{"} with a lower risk of not breastfeeding exclusively (OR 0.32 (0.16; 0.63), p = 0.001), but overall nipple shield use was associated with failure of exclusive breastfeeding.CONCLUSION: The present study does not give justifiable motives for nipple shield use, except for {"}breast too engorged{"}. Nipple shields should not be recommended for infants falling asleep at the breast, instead, staff and mothers should be patient, allowing the dyad time skin-to-skin. The results indicate that the use of a nipple shield does not promote exclusive breastfeeding in preterm infants.",
author = "Ragnhild Maastrup and Sisse Walloee and Hanne Kronborg",
year = "2019",
doi = "10.1371/journal.pone.0222811",
language = "English",
volume = "14",
pages = "e0222811",
journal = "P L o S One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "9",

}

RIS

TY - JOUR

T1 - Nipple shield use in preterm infants

T2 - Prevalence, motives for use and association with exclusive breastfeeding-Results from a national cohort study

AU - Maastrup, Ragnhild

AU - Walloee, Sisse

AU - Kronborg, Hanne

PY - 2019

Y1 - 2019

N2 - BACKGROUND AND AIM: Prevalence and motives for nipple shield use are not well studied in preterm infants and recommendations of nipple shield use in preterm infants are inconsistent. The aim of this study was to determine the prevalence of nipple shield use, explore the motives for nipple shield use and elucidate the association with exclusive breastfeeding in preterm infants.METHODS: The study was part of a prospective survey of a Danish national cohort of preterm infants based on questionnaires answered by the 1221 mothers of 1488 preterm infants with gestational age of 24-36 weeks. Data on nipple shield use was available for 1407 infants.RESULTS: Nipple shields were used by 54% of the mother-infant dyads for many different motives and was more often related to breastfeeding problems associated with the infant than with the mother. The most common motive for nipple shield use was "infant slipped the nipple" (52%). The lower the gestational age, the more frequently nipple shields were used for motives related to the infant. For those using a nipple shield, only the motive "infant fell asleep at the breast" was associated with a higher risk of not breastfeeding exclusively at discharge (OR 1.90 (95% CI 1.15; 3.13), p = 0.012), and "breast too engorged" with a lower risk of not breastfeeding exclusively (OR 0.32 (0.16; 0.63), p = 0.001), but overall nipple shield use was associated with failure of exclusive breastfeeding.CONCLUSION: The present study does not give justifiable motives for nipple shield use, except for "breast too engorged". Nipple shields should not be recommended for infants falling asleep at the breast, instead, staff and mothers should be patient, allowing the dyad time skin-to-skin. The results indicate that the use of a nipple shield does not promote exclusive breastfeeding in preterm infants.

AB - BACKGROUND AND AIM: Prevalence and motives for nipple shield use are not well studied in preterm infants and recommendations of nipple shield use in preterm infants are inconsistent. The aim of this study was to determine the prevalence of nipple shield use, explore the motives for nipple shield use and elucidate the association with exclusive breastfeeding in preterm infants.METHODS: The study was part of a prospective survey of a Danish national cohort of preterm infants based on questionnaires answered by the 1221 mothers of 1488 preterm infants with gestational age of 24-36 weeks. Data on nipple shield use was available for 1407 infants.RESULTS: Nipple shields were used by 54% of the mother-infant dyads for many different motives and was more often related to breastfeeding problems associated with the infant than with the mother. The most common motive for nipple shield use was "infant slipped the nipple" (52%). The lower the gestational age, the more frequently nipple shields were used for motives related to the infant. For those using a nipple shield, only the motive "infant fell asleep at the breast" was associated with a higher risk of not breastfeeding exclusively at discharge (OR 1.90 (95% CI 1.15; 3.13), p = 0.012), and "breast too engorged" with a lower risk of not breastfeeding exclusively (OR 0.32 (0.16; 0.63), p = 0.001), but overall nipple shield use was associated with failure of exclusive breastfeeding.CONCLUSION: The present study does not give justifiable motives for nipple shield use, except for "breast too engorged". Nipple shields should not be recommended for infants falling asleep at the breast, instead, staff and mothers should be patient, allowing the dyad time skin-to-skin. The results indicate that the use of a nipple shield does not promote exclusive breastfeeding in preterm infants.

U2 - 10.1371/journal.pone.0222811

DO - 10.1371/journal.pone.0222811

M3 - Journal article

VL - 14

SP - e0222811

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 9

ER -

ID: 58090077