The challenges of breastfeeding a late preterm or early term infant: Women's and clinician's perceptions of provision of antenatal information when considering early planned birth

Problem: Globally, there has been an increase in planned late preterm and early term births. These infants have poorer breastfeeding outcomes than full term infants. Background: There is a lack of evidence around the impact of providing information for pregnant women about potential breastfeeding challenges when considering the optimal timing of early planned birth. Aim: We explored what information is provided to pregnant women about potential breastfeeding challenges when early planned birth is being considered. We also explored obstetric doctors' knowledge about breastfeeding challenges for infants born before 38 weeks. Methods: Semi-structured interviews were conducted with 10 women who birthed a late preterm or early term infant (LP/ETI) through early planned birth, and with 6 obstetric consultants or registrars. Thematic analysis identified patterns of meaning in the data. Findings: Four themes were identified relating to the study questions: Absent information, Complex decisions, Early struggles, and Improving communication during decision making. Discussion: We identified an absence of information provided to women about the potential challenges of breastfeeding LP/ETI's when early birth was planned. Both women and doctors identified midwives as the health professionals with breastfeeding expertise. For women receiving high-risk care, minimal contact with midwives reduced opportunities to receive breastfeeding information. A lack of understanding of the characteristics of LP/ ETI's contributed to women feeling unprepared for the reality versus their expectations of breastfeeding. Conclusion: Strategies to support breastfeeding for these infants should include the provision of targeted antenatal information by midwives to prepare women for potential breastfeeding challenges.