[Practical strategies for promoting breastfeeding in neonatal intensive care]

Strategies for promoting the use of human milk in NICU Human milk has several advantages in the nutrition of very-low-birthweight (VLBW) and high risk infants admitted to neonatal intensive care unit (NICU). Limited data available demonstrate that at discharge from NICU breastfeeding rate is relatively low. In a recent italian study (Davanzo R et aL; Pediatric and Perinatal Epidemiology 2009) only 30.5% of VLBW infants were exclusively breast fed and among the exclusively breastfed infants only 10% sucked directly at the breast. Strategies to promote breastfeeding and the use of human milk in NICUs are needed. They are well known, yet limitedly applied. Among them current literature lists: (1) access at anytime for both parents to NICU; (2) specific knowledge of the science of lactation and multidisciplinary breastfeeding training as provided by the Baby Friendly Hospital Training package; (3) peer support in hospital; (4) kangaroo mother care; (5) breastmilk expression using simultaneous pumping with an electric pump particularly in the first 2 weeks. On the contrary, pharmaceutical galactagogues and cup feeding have little benefit.