Infants with conditions such as fetal and neonatal alloimmune thrombocytopenia (FNAIT), who may require close monitoring or a stay in a neonatal intensive care, were not more likely to be exclusively breastfed, according to a prospective observational study published recently in Pediatrics International.
Researchers found that time spent in the neonatal intensive care unit (NICU) did not improve breastfeeding rates during the first 6 months of life, a finding that may affect families expecting additional hospital support to help establish feeding.
The study followed 158 infants, including those admitted to the NICU and those discharged home without complications. Average gestational age was 38 weeks and mean birth weight was 3185 g. Overall, 44.6% of infants were exclusively breastfed for the first six months. Rates were 39.2% in NICU-treated infants and about 50% in those without hospitalization, a difference that was not statistically significant.
For families of infants with FNAIT, who often experience early medical interventions or monitoring similar to NICU care, these findings suggest that hospitalization alone does not guarantee better breastfeeding outcomes. Instead, feeding success appears influenced by other factors beyond the hospital setting.
Read more about helpful links and resources for FNAIT
Certain risk factors were linked to lower exclusive breastfeeding rates. Infants born by cesarean section and those born late preterm were more likely to receive formula supplementation. Maternal smoking was also associated with reduced breastfeeding, with 70% of mothers who smoked relying partly or entirely on formula. In addition, mothers without breast complications such as nipple injury or infection were significantly more likely to breastfeed exclusively.
“Mothers should also be informed about the adverse effects of smoking after birth, given its negative association with breastfeeding outcomes,” explained the authors of this study.
Among 88 mothers who introduced formula, 51.7% cited medical advice or health reasons. Others reported concerns about insufficient milk or infant crying. These perceptions may be particularly relevant for parents of infants with FNAIT, who may already feel uncertainty about their child’s health and feeding needs.
Globally, exclusive breastfeeding rates remain below recommended levels. The World Health Organization set a target of 50% by 2025, yet rates vary widely, including about 25.4% in the United States. The study’s findings align with prior research showing that NICU admission does not independently drive breastfeeding success.
For patients and families affected by FNAIT, the results highlight the need for targeted lactation support rather than relying on hospital care alone. Early education, addressing maternal concerns and reducing modifiable risks such as smoking may play a more meaningful role in helping infants receive the benefits of exclusive breastfeeding.
Sign up here to get the latest news, perspectives, and information about FNAIT sent directly to your inbox. Registration is free and only takes a minute.
