1.Post-Discharge Milk Feeding Practices and Complementary Feeding Among Malaysian Preterm Infants: An Exploratory Cross-Sectional Study
Filzatul Hanan Faizal ; Nuramira Yasmin Zaidi ; Haslina Abdul Hamid
Malaysian Journal of Health Sciences 2026;24(No. 2):227-241
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) corrected
age 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.

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