Post-Discharge Milk Feeding Practices and Complementary Feeding Among Malaysian Preterm Infants: An Exploratory Cross-Sectional Stu

Abstract

Feeding practices after hospital discharge are important for the growth and nutritional adequacy of preterm infants. However, local data on post-discharge milk feeding and complementary feeding practices remain limited. This study described post-discharge milk feeding practices and the timing and quality of complementary feeding among Malaysian preterm infants. An exploratory cross-sectional study was conducted among caregivers of preterm infants born before 37 weeks of gestation and aged 6–23 months corrected age. A structured online questionnaire collected information on clinical characteristics, milk feeding history, complementary feeding practices, and sociodemographic factors. Complementary feeding quality was assessed using the World Health Organization indicators: Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF), and Minimum Acceptable Diet (MAD). Descriptive analyses were performed. Twenty-three caregivers participated. All infants received breastmilk during their NICU stay. Predominant or exclusive breastmilk feeding decreased from 60.9% at 3 months to 52.2% at 6 months, while formula feeding increased to 47.8% at 6 months. The mean (SD) correctedage at complementary feeding initiation was 5.1 (1.2) months, corresponding to 7.1 (1.4) months chronological age. More than half of the infants (52.2%) started complementary feeding before 5 months corrected age. Plain or mixed porridge was the most common first complementary food (82.6%). Overall, 65.2% achieved MDD, 70.0% achieved MMF, and 47.8% achieved MAD. Post-discharge milk feeding and complementary feeding practices varied among Malaysian preterm infants. Less than half achieved the minimum acceptable diet. Clearer pretermspecific feeding guidance and enhanced caregiver education are needed to support optimal feeding practices after hospital discharge.