Supporting Direct Breastfeeding for a Tracheostomy-Dependent Extremely Premature Infant: A Case Study

Area of Science:

• Neonatal care
• Pediatric gastroenterology
• Lactation support

Background:

• Human milk offers significant benefits for preterm infants.
• Extremely premature infants face challenges like infections, digestive issues, and chronic lung disease.
• Tracheostomies, sometimes necessary for ventilation weaning, pose aspiration risks during oral feeding.

Purpose of the Study:

• To describe a tertiary neonatal team's support for an extremely premature infant's direct breastfeeding goal.
• To document the process of enabling direct breastfeeding in an infant with bronchopulmonary dysplasia and a tracheostomy.

Main Methods:

• An interdisciplinary team collaborated with the family to establish feeding goals.
• The infant received initial gavage feeding with human milk.
• Positive oral stimulation, oral immune therapy, and skin-to-skin contact were employed.
• Oral feeding was initiated post-tracheotomy, leading to successful direct breastfeeding.

Main Results:

• Direct breastfeeding was achieved at 50 weeks and 1 day post-menstrual age.
• The infant utilized direct breastfeeding as a primary nutrition source with the tracheostomy in place.
• This represents the first case study of an extremely premature infant with a tracheostomy transitioning to direct breastfeeding.

Conclusions:

• Open communication between family and healthcare team was crucial for successful breastfeeding.
• Direct breastfeeding is achievable for extremely premature infants with tracheostomies, challenging previous assumptions.
• This case study provides valuable insights for supporting similar complex feeding situations in neonatal care.