Optimizing breastfeeding for hospitalized newborns: A narrative review of midwifery-led interventions

Breastmilk is the best source of nutrition for newborns. The World Health Organization recommends exclusive breastfeeding for the first six months of life as it has benefits to mother and child. However, breastfeeding can be challenging. Especially when the newborn is hospitalized, the physical separation of mother and child can make breastfeeding difficult. Hence pre- and post-natal midwife care supporting breastfeeding become more important. The aim of this narrative review is to identify measures taken by midwives in the labor ward, on the postpartum unit and at home that can influence breastfeeding success positively in hospitalized newborns. A literature review was conducted in PubMed and CINAHL and on the website of the European Institute for Breastfeeding and Lactation from April to September 2023. Studies from 2013 to 2023 written in German or English comparing two different measures/groups were considered. Twenty studies were included and five measures, taken by midwives, were identified. Skin-to-skin contact leads to higher (exclusive) breastmilk feeding rates, better sucking behavior and a shorter time to full enteral feeding. Regular breastmilk expression and supervised breastfeeding attempts result in higher breast milk feeding rates. Breastfeeding counselling enables the mothers to access lactation education. Uninterrupted visiting hours lead to higher exclusive breastmilk feeding rates. Midwives play a key role in promoting breastfeeding among hospitalized newborns involving initiating lactation, strengthening the mother-child bond and providing appropriate breastfeeding advice. There is a further need for research, as midwives are rarely involved in studies.