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Impact of a Lactation Consultant Support Program on Breastfeeding Rates, Infant Growth, and Morbidity: A Randomized
Mireia Pascual-Tutusaus1, Margarita Manresa, Federico Migliorelli
1Author Affiliations: IBCLC, Department of Neonatology and Obstetrics (ICGON), BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Spain (Pascual-Tutusaus, de Lamo-Camino, and Vidal-Carbó); Nursing and Health Program, Faculty of Nursing, University of Barcelona, Spain (Pascual-Tutusaus); Department of Gynecology and Obstetrics (ICGON), BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Spain (Manresa, Migliorelli, and Arranz); Faculty of Medicine and Health Sciences, Clinical Campus, Barcelona, Spain (Arranz); Department of Public Health, Mental Health, and Maternal and Child Health Nursing. University of Barcelona, Spain (Biurrun-Garrido, and Goberna-Tricas).
A structured breastfeeding support program led by an International Board Certified Lactation Consultant (IBCLC) significantly increased exclusive breastfeeding (EBF) rates in preterm infants. This intervention also reduced infant morbidity and hospital readmissions.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Public health interventions
Background:
- Breastfeeding is crucial for preterm infants' health.
- The role of International Board Certified Lactation Consultants (IBCLCs) in neonatal units needs further evidence regarding morbidity reduction.
- Current integration of IBCLCs in neonatal care is inconsistent.
Purpose of the Study:
- To evaluate the effectiveness of a Breastfeeding Support and Promotion Program (PAP-LM) led by an IBCLC.
- To assess the program's impact on exclusive breastfeeding (EBF) rates, morbidity, and hospital readmissions in preterm infants.
Main Methods:
- A parallel-group randomized clinical trial involving 162 preterm infants (gestation 32 + 0 to 36 + 6 weeks).
- Infants were randomized (1:1) to either the PAP-LM intervention or standard care.
- Outcomes included breastfeeding rates, infant growth, neonatal morbidity, and hospital readmissions.
Main Results:
- Exclusive breastfeeding (EBF) rates were significantly higher in the intervention group at discharge (98.8% vs 21.2%), 3 months (98.8% vs 10%), and 6 months (91.4% vs 3.8%).
- First-year morbidity was substantially lower in the intervention group (32.1% vs 66.2%), with notable reductions in bronchitis and bronchiolitis.
- The IBCLC-led program demonstrated significant improvements in key health outcomes for preterm infants.
Conclusions:
- A structured IBCLC-led support program, from neonatal care through 6 months of home follow-up, effectively promotes sustained EBF.
- The program significantly reduces neonatal morbidity and hospital readmissions in preterm infants.
- Findings support integrating structured breastfeeding support into public health policies for high-risk newborns and expanding IBCLC services.
