Does early hospital discharge with home support of families with preterm infants affect breastfeeding success? A randomized trial

The aim of the present study was to determine if earlier discharge of prete rm infants (<37 wk) from hospital is safe and if it affects breastfeeding r ates. In a pilot observational study, premature infants received full oral (sucking) feeds for a mean (SD) 7.7 +/- 7.9 d before discharge. In the main study, 308 preterm infants were randomly assigned to either Early Discharg e (148 infants) when fully orally fed but not yet gaining weight or Routine Discharge (160 infants) when fully orally fed and also gaining weight befo re discharge. A further 122 mothers declined randomization. The Early Disch arge group was followed by Visiting Nurse Specialists who were available 24 h a day, while the Routine group was followed by the Home Care Nurses avai lable on week days. There were no significant differences between the group s in birthweight or gestational age. The Early Discharge group were dischar ged 2.5 +/- 2 d after full oral feeding compared to 4.4 +/- 2.7 d for the R outine group (p < 0.001) and 6.1 +/- 5 d for those who declined. However, t here was no significant difference between the Early and Routine groups for breastfeeding either at discharge (80 vs 83%), or 6 wk (55 vs 60%) or 6 mo after discharge (36 vs 36%), or for weight gain, or rates of re hospitaliz ation (8.8% vs 11.9% at 6 wk, p = 0.37). Conclusions: Early discharges from hospital once a preterm infant can take full oral feeds does not alter later breastfeeding rates when adequate visi ting nursing support is available.