Breastfeeding the premature newborn: a protocol without bottles

Area of Science:

• Neonatal care
• Lactation science
• Pediatrics

Background:

• Breastfeeding is crucial for infant health, but premature infants face unique challenges.
• Early feeding methods in neonatal intensive care units (NICUs) can impact long-term breastfeeding success.
• Bottle-feeding may interfere with the establishment of breastfeeding in vulnerable infant populations.

Purpose of the Study:

• To describe a protocol for facilitating breastfeeding in premature infants.
• To evaluate the efficacy of a bottle-feeding-exclusion protocol in a NICU setting.
• To support mothers intending to breastfeed their premature neonates.

Main Methods:

• Implementation of a protocol in the newborn intensive care unit at Methodist Hospital, Indianapolis.
• Exclusion of early bottle-feeding for premature infants.
• Introduction to breastfeeding as early as possible.
• Supplementation provided via gavage feeding, adjusted based on clinical observations.
• Maternal and nursing staff observations guided supplement adjustments.

Main Results:

• The protocol successfully enabled breastfeeding initiation and continuation for premature infants.
• Supplementation was managed effectively through gavage feeding.
• Hospital stays were not prolonged by this breastfeeding-focused approach.
• A majority of infants whose mothers intended to breastfeed were discharged exclusively breastfeeding.

Conclusions:

• A protocol excluding bottle-feeding can facilitate successful breastfeeding in premature infants.
• Early breastfeeding and adjusted gavage supplementation support a transition to exclusive breastfeeding.
• This approach supports maternal intent and promotes successful lactation in the NICU.