Key determinants of breastfeeding success in infants born before 30 weeks gestation : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy at Massey University, Auckland, New Zealand

Breastfeeding is promoted at a public health level by many agencies internationally and nationally. While there is an abundance of literature to guide practice regarding breastfeeding term healthy infants, there is little regarding premature infants, particularly those born before 30 weeks gestation. Data on breastfeeding outcomes in this population is limited in the New Zealand literature. The aims of the study were to identify the breastfeeding outcomes of premature infants born before 30 weeks gestation: to identify key determinants that may contribute to the success of breastfeeding outcomes; and to describe the feeding practices of this population during hospitalisation and post-discharge. This audit used a non-experimental, cross-sectional, descriptive, correlational design using pre-existing medical records, to obtain variables of interest. Independent variables included maternal and infant characteristic and infant feeding characteristic. Key determinant variables were identified as maternal support, maternal milk supply, kangaroo care and bottle use. Feeding problems and growth were also considered as independent variables. Breastfeeding outcomes are comparable to the New Zealand population of breastfed infants in duration but not intensity of breast milk received. Maori and Polynesian infants have poorer breastfeeding outcomes compared to Caucasian and Asian infants and have higher rates of feeding problems. Further research is required to identify the cause of increased feeding problems in these cultures