{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:40:10Z","timestamp":1784130010542,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T00:00:00Z","timestamp":1568246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Multiple pregnancy increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure. However, studies on predictive factors of breastfeeding duration in preterm twin infants have a conflicting result. The purpose of this observational study was to compare feeding practices, at hospital discharge, of twin and singleton very low birth weight infants. The study is part of a prospective survey of a national Spanish cohort of very low birth weight infants (SEN1500) that includes 62 neonatal units. The study population comprised all infants registered in the network from 2002 to 2013. They were grouped into singletons and multiples. The explanatory variables were first analyzed using univariate models; subsequently, significant variables were analyzed simultaneously in a multiple stepwise backward model. During the twelve-year period, 32,770 very low birth weight infants were included in the database, of which 26.957 were discharged alive and included in this analysis. Nine thousand seven hundred and fifty-eight neonates were multiples, and 17,199 were singletons. At discharge, 31% of singleton infants were being exclusively breastfed, 43% were bottle-fed, and 26% were fed a combination of both. In comparison, at discharge, only 24% of multiple infants were exclusively breastfed, 43% were bottle-fed, and 33% were fed a combination of both (p &lt; 0.001). On multivariable analysis, twin pregnancy had a statistically significant, but small effect, on cessation of breastfeeding before discharge (OR 1.10; 95% CI: 1.02, 1.19). Risks of early in-hospital breastfeeding cessation were also independently associated with multiple mother-infant stress factors, such as sepsis, intraventricular hemorrhage, retinopathy, necrotizing enterocolitis, intubation, and use of inotropes. Instead, antibiotic treatment at delivery, In vitro fertilization and prenatal steroids were associated with a decreased risk for shorter in-hospital breastfeeding duration. Multiple pregnancy, even in the absence of pathological conditions associated to very low birth weight twin infants, may be an impeding factor for in-hospital breastfeeding.<\/jats:p>","DOI":"10.3390\/nu11092191","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T10:56:06Z","timestamp":1568285766000},"page":"2191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Breastfeeding Disparities between Multiples and Singletons by NICU Discharge"],"prefix":"10.3390","volume":"11","author":[{"given":"Roser","family":"Porta","sequence":"first","affiliation":[{"name":"Neonatal Unit, Dexeus University Hospital, 5 Sabino Arana st, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Capdevila","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Primary Care, Catalonia Health Authority, Balmes st, 08007 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Botet","sequence":"additional","affiliation":[{"name":"Neonatal Unit, University Maternity Hospital, 5 Sabino Arana st. 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Ginovart","sequence":"additional","affiliation":[{"name":"Neonatal Unit, Santa Creu i Sant Pau University Hospital, 87 mSant Quinti st. 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisenda","family":"Moliner","sequence":"additional","affiliation":[{"name":"Neonatal Unit, Santa Creu i Sant Pau University Hospital, 87 mSant Quinti st. 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Nicol\u00e0s","sequence":"additional","affiliation":[{"name":"Neonatal Unit, Germans Trias i Pujol University Hospital, Canyet Road, 08916 Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Department of Hematology, Son Espases University Hospital, IdISBa Balearic Medical Research Council. Valldemossa Road, 79, 07010 Palma de Mallorca, Spain"},{"name":"COMIB Advisory, Passeig de Mallorca, 42, 07012 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-2135","authenticated-orcid":false,"given":"Jaume","family":"Ponce-Taylor","sequence":"additional","affiliation":[{"name":"Urgent Care Centre, Department of Primary Care, Balearic Health Authority, 1 Illes Balears st. 07014 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0261-8811","authenticated-orcid":false,"given":"Sergio","family":"Verd","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Primary Care, Balearic Health Authority, Matamusinos st. 07013 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.clp.2016.11.008","article-title":"The importance of human milk for immunity in preterm infants","volume":"44","author":"Lewis","year":"2017","journal-title":"Clin. 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