Breastfeeding the premature newborn: a protocol without bottles

Premature babies can, and should, breastfeed. Although establishing a milk supply and the transition to breastfeeds can be difficult, both are possible. Because early bottle-feeds can impede later attempts to breastfeed, the newborn intensive care unit at Methodist Hospital in Indianapolis developed a protocol for successfully breastfeeding premature infants that excludes bottle-feeding. The babies are introduced to the breast as soon as possible, and supplementation is provided by gavage feeding. The amount of supplement is adjusted based on maternal and nursing observations of the breastfeeding experience. The hospital stays are not prolonged by this approach and most of the babies whose mothers intended to breasfeed are discharged exclusively breastfeeding.