2025  •  Developmental Observer •  21  

P O S T E R  A B S T R A C T  —  N I D C A P  T R A I N E R S  M E E T I N G  2 0 2 4

Conclusion / Relevance to NIDCAP
Collaboration with the administration is the way to consol-
idate the model in all ICS hospitals. Together with the Sant 
Joan de Deu group of hospitals, we provide care for over 70% 
of very premature babies in the Catalan health system. Our 
goal is to improve communication with the administration to 
establish NIDCAP as a standardized model across all units in 
Catalonia, and hopefully Spain.

Collaboration with the administration facilitates conduct-
ing research studies on the implementation of the model.
This collaboration also supports initiatives aimed at improving 
training skills. We believe that sharing our experience with 
other regions of the state can serve as an example and an en-
couragement to promote similar programs.

The impact of neurodevelopmental observations of preterm 
infants such as those offered in the NIDCAP program is still 
debated. By supporting oral feeding development, NIDCAP 
observations could enhance breast milk feeding at discharge of 
very preterm infants.

Aim
To describe breast milk feeding at discharge among very 
preterm infants according to the level of NIDCAP implemen-
tation in neonatal units.

Materials and Methods
Using the French national population-based EPIPAGE-2 
cohort, implementation of NIDCAP in each of 11 NIDCAP 
neonatal units was defined as the proportion of very preterm 
infants (< 32 weeks’ gestation) who had at least one NIDCAP 
observation during hospitalization. Breast milk feeding at dis-
charge -partial, breast/bottle exclusive, and breast only exclu-
sive- was evaluated after adjustment on maternal and neonatal 
characteristics, and unit policies to support lactating mothers.

Results
Among 569 very preterm infants included, 14% (78/569) had 
at least one observation during hospitalization. Implementa-
tion was defined as low in nine units and high in two units, 
with 7% (extremes: 0-13%) and 86% (75 and 100%) of infants 

having at least one observation, respectively. Breast milk feed-
ing at discharge was reported in 55% of infants. In neonatal 
units with low NIDCAP implementation vs high, we observed 
25%/6% of partial breast milk feeding at discharge, 16%/24% 
of breast/bottle exclusive, and 14%/28% of breast only exclu-
sive. High NIDCAP implementation was associated with high-
er proportions of exclusive - only breast- breast milk feeding at 
discharge: adjusted odds ratio 4.72 (95% CI 2.79-7.99).

Conclusion/Relevance for NIDCAP
The level of NIDCAP implementation was associated with 
higher rates of breast milk feeding at discharge exclusively 
at breast. Investment of professionals and families in very 
preterm infants’ observation could be an effective strategy 
to support exclusive breast milk feeding at discharge in this 
vulnerable population.

NIDCAP Implementation in Neonatal Units and 
Breast Milk Feeding at Discharge: the EPIPAGE-2 
Cohort Study 
Mitha A1,2, Kana G1, Marchand L1, Lescure S3, Pierrat V1,4

1Université Paris Cité, Epidemiology and Statistics Research Center/CRESS, Obstetrical, perinatal and  
Pediatric Epidemiology Research Team (EPOPé), INSERM, INRAE, F-75004 Paris, France.  
2Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, SE- 17176 Stockholm, Sweden
3Department of Neonatal Medicine, Toulouse University Hospital, Toulouse, France
4Department of Neonatalogy, CHI Créteil, F-94028 Créteil, France

DOI: 10.14434/do.v18i1.40896