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NICU

Adopting lactation best practice pathways supports NICU mothers to establish lactation, at-breast feeding and most critically support NICU infants to receive their own mother’s milk for that all-important start in life.​1–4​ 

A woman gets advice on pumping from a healthcare professional in hospital.
Effective Initiation

First expression

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An infant with special feeding needs receives a dose of OMM, its own mother's milk, while lying on its mum's chest.
Effective Initiation

Dose of own mother's milk (OMM) – Effective initiation results

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Effective Initiation

Informed decision – Effective initiation interventions

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Effective Initiation

Frequent expression – Effective initiation interventions

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An illustration from Medela on "Coming to volume is an indicator of the efficacy for the interventions to support effective initiation".
Effective Initiation

Coming to volume – Effective initiation results

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A new mother checks to see if her breast milk is coming in.
Effective Initiation

Time to milk ‘coming in’ – Effective initiation results

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Woman sitting on a couch holding a newborn baby and kissing the baby's hand.
Transition to at-Breast Feeding

Breastfeeding rates – Transition to at-breast feeding results

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A premature baby has skin-to-skin contact with its mother.
Transition to at-Breast Feeding

Skin-to-skin care – Transition to at-breast feeding interventions

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A mother breastfeeds her premature baby.
Transition to at-Breast Feeding

Transitioning to direct feeding at breast –Transition to at-breast feeding interventions

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A premature baby receives oral therapy in the NICU.
Transition to at-Breast Feeding

Oral therapy with own mother’s milk (OMM) – Transition to at-breast feeding interventions

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A woman gets advice on pumping from a healthcare professional in hospital.
Effective Initiation

First expression

Read more
An infant with special feeding needs receives a dose of OMM, its own mother's milk, while lying on its mum's chest.
Effective Initiation

Dose of own mother's milk (OMM) – Effective initiation results

Read more
Effective Initiation

Informed decision – Effective initiation interventions

Read more
Effective Initiation

Frequent expression – Effective initiation interventions

Read more
An illustration from Medela on "Coming to volume is an indicator of the efficacy for the interventions to support effective initiation".
Effective Initiation

Coming to volume – Effective initiation results

Read more
A new mother checks to see if her breast milk is coming in.
Effective Initiation

Time to milk ‘coming in’ – Effective initiation results

Read more
Woman sitting on a couch holding a newborn baby and kissing the baby's hand.
Transition to at-Breast Feeding

Breastfeeding rates – Transition to at-breast feeding results

Read more
A premature baby has skin-to-skin contact with its mother.
Transition to at-Breast Feeding

Skin-to-skin care – Transition to at-breast feeding interventions

Read more
A mother breastfeeds her premature baby.
Transition to at-Breast Feeding

Transitioning to direct feeding at breast –Transition to at-breast feeding interventions

Read more
A premature baby receives oral therapy in the NICU.
Transition to at-Breast Feeding

Oral therapy with own mother’s milk (OMM) – Transition to at-breast feeding interventions

Read more
References 

1 Bigger HR et al. Quality indicators for human milk use in very low-birthweight infants: are we measuring what we should be measuring? J Perinatol. 2014; 34(4):287–291. 

2 Spatz DL et al. Pump Early, Pump Often: A Continuous Quality Improvement Project. J Perinat Educ. 2015; 24(3):160–170. 

3 Spatz DL. Getting it right – the critical window to effectively establish lactation. Infant. 2020; 16(2):58–60. 

4 Meier PP. Prioritizing High-Dose Long Exposure to Mothers' Own Milk During the Neonatal Intensive Care Unit Hospitalization. Breastfeed Med. 2019; 14(S1):S20-S21. 

5 Hoban R et al. Milk volume at 2 weeks predicts mother's own milk feeding at neonatal intensive care unit discharge for very low birthweight infants. Breastfeed Med. 2018; 13(2):135–141. 

6 Meier PP et al. Human milk in the neonatal intensive care unit. In: Family Larsson-Rosenquist Foundation, editor. Breastfeeding and breast milk - From biochemistry to impact: A multidisciplinary introduction. 1st ed. Stuttgart: Thieme; 2018. 

7 Snyder R et al. Early provision of oropharyngeal colostrum leads to sustained breast milk feedings in preterm infants. PediatrNeonatol. 2017; 58(6):534–540. 

8 Kumar J et al. Oropharyngeal application of colostrum or mother's own milk in preterm infants: a systematic review and meta-analysis. Nutr Rev. 2023; 81(10):1254–1266. 

9 Acuña-Muga J et al. Volume of milk obtained in relation to location and circumstances of expression in mothers of very low birth weight infants. J Hum Lact. 2014; 30(1):41–46. 

10 Haase B et al. The development of an accurate test weighing technique for preterm and high-risk hospitalized infants. Breastfeed Med. 2009; 4(3):151–156. 

11 Narayanan I et al. Sucking on the 'emptied' breast: non-nutritive sucking with a difference. Arch Dis Child. 1991; 66(2):241–244.

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