exclusively breastfeeding, low resource setting, sub-Saharan Africa, very low birthweight infants, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627

Introduction In recent decades, there has been a global increase in the birth and survival rates of very low birthweight (VLBW) infants. Breastfeeding plays a crucial role in providing optimal nutrition for the growth and development of these infants, particularly in poverty-stricken areas with a high prevalence of childhood malnutrition.Aim This study aimed to assess the rate of exclusive breastfeeding (EBF) among VLBW infants at six months’ corrected age and to identify the reasons for premature cessation of EBF. Additionally, it examined the volume of replacement feeds administered to infants who were not exclusively breastfed.Method A retrospective study was conducted on VLBW infants born at a tertiary hospital in South Africa. Data on infant–mother pairs were collected at birth and the follow-up visits at one, three and six months to document feeding practices and reasons for discontinuation of exclusive breastfeeding (EBF).Results Of 117 infant–mother pairs, the prevalence of EBF at six months’ corrected age was 22%. The primary reasons for discontinuation of EBF were maternal commitments to school or work and perceived insufficient supply of breast milk. Over time, there was an increase in replacement feeds, predominantly formula, with a significant portion being prepared incorrectly.Conclusions The prevalence of EBF among VLBW infants at six months remains suboptimal, influenced by maternal perceptions and commitments. Effective interventions are crucial to improve EBF rates, especially in this vulnerable population.