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Updated: Aug 5, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Published on: August 25, 2014

Impact of Neonatal Intensive Care Unit (NICU) Environment on Maternal Breast Milk Utilization: : A Retrospective

Leia Heckman1,2, Kelsey Flynn1,2, Amy Mackley1,2

  • 1Department of Speech Pathology, ChristianaCare.

Delaware Journal of Public Health
|August 3, 2026
PubMed

Insights

Moving Neonatal Intensive Care Units (NICUs) from open-bay to single-family rooms (SFRs) improved overall breast milk use but did not significantly change maternal breast milk feeding. NICU design impacts feeding initiation, but clinical practices are key for optimizing breast milk utilization.

Area of Science:

  • Neonatal care
  • Pediatrics
  • Public Health

Background:

  • Prematurity is a major cause of infant mortality and morbidity.
  • Breastfeeding in the first six months improves infant outcomes.
  • Neonatal Intensive Care Unit (NICU) design may influence parental involvement and breast milk use.

Purpose of the Study:

  • To assess breast milk utilization at discharge in premature infants.
  • To compare breast milk use before and after NICU design changes (open-bay to single-family room).

Main Methods:

  • Retrospective observational study of infants born before 32 weeks gestation.
  • Compared infants in traditional open-bay NICUs versus single-family room (SFR) NICUs.
  • Primary outcome: breast milk utilization at discharge.

Main Results:

  • Overall breast milk utilization increased significantly in the SFR NICU (p=.04).
  • Maternal breast milk utilization did not significantly change (p=0.61).
  • Infants in SFR NICUs initiated oral feeding later than those in open-bay units (p=0.007).

Conclusions:

  • Transitioning to SFR NICUs impacted feeding initiation timing but not overall breast milk exposure.
  • Clinical practices and support systems appear more influential than physical environment on breastfeeding outcomes.
  • NICU environment's impact on feeding practices can inform policies to optimize breast milk utilization.
Abstract

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