e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

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Breastfeeding of low-birth-weight infants

Intervention | Last updated: 20 June 2023


Every year, more than 20 million infants are born weighing less than 2.5kg – over 96% of them in developing countries. These low-birth-weight (LBW) infants are at increased risk of early growth retardation, infectious disease, developmental delay and death during infancy and childhood.

Most LBW is a consequence of preterm birth, small size for gestational age, or both.

Interventions to improve the feeding of LBW infants are likely to improve the immediate and longer-term health and well-being of the individual infant and have a significant impact on neonatal and infant mortality levels in the population.

Breastfeeding has many health benefits for both the mother and infant. Breast milk contains all the nutrients an infant needs in the first six months of life. Breastfeeding further protects against diarrhoea and common childhood illnesses such as pneumonia, and may also have longer-term health benefits for the mother and child, such as reducing the risk of overweight and obesity in childhood and adolescence.

Evidence suggests that initiation of breastfeeding in the first day of life is associated with a significant reduction in the risk of neonatal mortality when compared with delaying breastfeeding for more than 24 hours after birth.

WHO Recommendations


LBW infants who are able to breastfeed should be put to the breast as soon as possible after birth when they are clinically stable, and should be exclusively breastfed until six months of age.

This recommendation does not address sick LBW infants or infants with birth weight less than 1.0 kg.



Evidence


Systematic reviews used to develop the guidelines


Optimal feeding of low-birth-weight infants: technical review

Edmond K, Rajiv B. Geneva: World Health Organization; 2006.


Related Cochrane reviews


Avoidance of bottles during the establishment of breast feeds in preterm infants

Collins CT, Gillis J, McPhee AJ, Suganuma H, Makrides M.Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD005252.

Summary of this review Alternate Text

Other related systematic reviews


Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis

Boyd CA, Quigley MA, Brocklehurst P. Archives of Disease in Childhood: Fetal and Neonatal Edition. 2007; 92:F169–F175.