Background and Aims The beneficial effects of human milk for preterm babies are recognised, but little is known about rates and factors associated with breast milk feeds in very preterm babies in Europe. The aim of this study was to identify maternal, clinical and neonatal care characteristics associated with breast milk feeds at discharge.

Methods The analysis sample included 2701 babies discharged home from hospital in seven European regions participating in the MOSAIC study, a population-based cohort of babies born between 22 and 31 weeks of gestation. Information was collected from medical records on feeding method at discharge (exclusive breast milk, mixed and formula) and mothers’ and infants’ characteristics.

Results 38% of the babies received breast milk at discharge home in the total sample. Rates varied from 70% in Lazio (Italy) to 24% in Ile-de-France (France). Babies received mostly exclusive breast milk feeds in the region of Trent (29%) and Wielkopolska/Lubuskie in Poland (24%), but mixed feeds in Lazio (52%) and north Portugal (44%). Factors associated with a reduced likelihood of breast milk feeds at discharge were lower gestational age, small for gestational age, surgical intervention during hospitalisation, longer hospitalisation and oxygen dependence at 36 weeks of gestational age. However, these factors did not explain regional differences.

Conclusion Breast milk rates varied widely between European regions. Breastfeeding promotion policies in maternity and neonatal units that influence overall breastfeeding rates may also influence rates in very pretem babies.