Risk of early breastfeeding cessation among symmetrical, small for gestational age infants

Background: Many studies have shown that children born small for gestational age are at a metabolic disadvantage. Breastfeeding is associated with reduced risk of developing metabolic syndrome. Objective: To determine whether ponderal index, weight, length or head circumference at birth affect early exclusive breastfeeding discontinuation. Design: Information from medical records of full-term infants attending the same paediatric clinic was used to examine the relationship between birth size and failure to breastfeed within 28 days after birth. Details of demographics and diagnoses were prospectively recorded. Feeding method was assessed at each child visit by their healthcare provider. Feeding practices were compared between infants of high, normal and low ponderal index at birth. Results: Multivariate models (p's <= 0.02) confirmed that the chance of exclusive breastfeeding continuation within 4 weeks of life was less in infants whose birth weight was below 2780 g or whose neonatal head circumference was < 33 cm. Birth length did not account for this effect. Ponderal index was not associated with a higher risk of early discontinuation of exclusive breastfeeding. Conclusions: This study reports that birth weight >= 2780 g and head circumference at birth >= 33 cm are independent predictors of breastfeeding onset success.