How to prioritize breastfeeding in the NICU

Human milk is the ideal food for all infants and is especially important for those in NICU. How can hospitals help support breastfeeding? A new position statement from the Canadian Paediatric Society covers how this can be achieved. Breastmilk helps support babies’ neurodevelopment, immune function and general growth, it says, as well as helping to prevent bowel and septic complications. The World Health Organization and UNICEF have supported its use in the NICU. And evidence shows fresh breastmilk from a baby’s mother contains uniquely beneficial probiotics. Read: Unproven premature birth drug Makena forced off market by U.S. FDA The position statement contains a number of recommendations. First, Canadian hospitals should create evidence-based infant feeding policies that are supported by a multidisciplinary team that includes lactation consultants and nursing staff. They should create a family-centred environment that encourages families to participate as much as possible in their babies’ feeding and care. That should involve starting skin-to-skin care early and supporting it throughout the NICU stay. It also includes a physical environment that allows parents to room in or sleep close to their babies. It should also support breastfeeding, starting within one hour after birth or as soon as the mother and infant are stable. Mothers and babies unable to breastfeed should be helped to express milk to feed their babies. Read: Kids prescribed antibiotics but not fed breast milk at triple risk of asthma: study If a mother’s milk isn’t available, pasteurized donor human milk can supplement or replace it. Commercial milk formulas should be avoided if possible. As babies grow, they should transition from enteral feeding to feeding at the breast. They should also be switched from scheduled feeds to cue-based ones without what the society calls “unjustified restrictions on frequency, intervals between feeds, or duration of feeds at the breast.” The hospital should ensure they coordinate feeds with the mother. The goal should be for all infants in the NICU to achieve exclusive breastfeeding. Feeding guidelines and a supportive environment can help mothers and babies exclusively breastfeed at the breast between 34 and 39 weeks and as early as 32 weeks. When babies can be discharged, staff and parents should leave with a personalized feeding plan that includes breastfeeding support referrals if needed. Read: Breast milk is beneficial for the brains of premature babies

How to prioritize breastfeeding in the NICU

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