Unravelling the role of alanine in mental disorders: a Mendelian randomisation study.

Breastfeeding is considered the gold standard for preterm infant feeding (). Human milk, with its complex and adaptive composition of micronutrients, macronutrients, and bioactive and immunological factors, has been shown to protect preterm infants from necrotizing enterocolitis (NEC), late sepsis, bronchopulmonary dysplasia, retinopathy of prematurity (ROP). It also improves developmental outcomes and decreases the risk of metabolic syndrome and insulin resistance in later years of life (–). Preterm infant-mother dyads encounter many obstacles in breastfeeding including initiating lactation, transitioning from tube to oral feeds, and development and maintenance of milk supply (). Since almost all very preterm babies are hospitalized in neonatal intensive care units (NICU), separation of mother and infant after birth, long-term need for milk expression, low milk supply, and high levels maternal stress become significant breastfeeding challenges (, ). Limited studies from various countries indicate lower breastfeeding rates in preterm infants compared with term infants (, ). Mothers of preterm babies often report not being able to breastfeed as long as they desired (). Lower gestational age, longer NICU stay, lower maternal education, lack of lactation support after discharge, and mixed feeding at discharge are thought to contribute to lower breastfeeding rates among preterm infants (, ).