Knowledge, Attitudes, and Practices of Breast Milk Feeding Among Mothers of Very Low Birth Weight Infants: A Study From Two Tertiary Centers.

BACKGROUND: Breastfeeding is advocated as optimal for very low birth weight (VLBW) infants. However, initiating breastfeeding presents significant challenges due to their immature suckling and fragile health status. This study evaluated maternal knowledge, attitude, and breast milk expression practices among mothers of VLBW infants. METHODS: A descriptive cross-sectional study was conducted in two Neonatal Intensive Care Units located in the Klang Valley, Malaysia, from March to December 2020. Mothers of VLBW infants were included once their infants achieved full enteral feeding. Data were collected using a self-reported questionnaire that incorporated sociodemography, breastfeeding knowledge, attitudes, and practices (KAP). Descriptive statistics were used to summarize participant characteristics, while Spearman's correlation analysis examined the relationships among KAP variables. Statistical significance was set at P < 0.05. RESULTS: A total of 111 mothers participated, with the majority demonstrating good knowledge (mean score 9.20 ± 0.90) and neutral attitudes toward breastfeeding (mean score of 61.76 ± 4.81). Although more than half (60, 54.1%) initiated breast milk expression within 24 hours after delivery, only 30 (27%) produced colostrum within this timeframe, reflecting delayed lactogenesis associated with preterm delivery and maternal-infant separation. Despite a moderate positive correlation between maternal knowledge and attitudes toward breastfeeding (Spearman's rho = 0.41, P < 0.001), only 31 out of 111 mothers (27.9%) provided sufficient expressed breast milk until their VLBW infants achieved full enteral feeding.  Conclusions: Despite VLBW mothers exhibiting adequate knowledge about breastfeeding and acceptable attitudes towards breastmilk feeding, actual practices are suboptimal. Identifying barriers, improving healthcare protocols, and strengthening the family support system are essential steps to enhance breastfeeding rates and improve health outcomes for VLBW infants.