Author(s): Fawaz T Kashlan
Breast milk is considered the ideal nutrition for full-term infants. Its advantages for the feeding of preterm infants have received increasing attention. Described benefits for premature infants include prevention of infection, a reduction in the rate and severity of necrotizing enterocolitis and retinopathy of prematurity, and a possible beneficial effect on later intelligence. Because of infant immaturity and/or neonatal morbidity, most mothers of very low birth weight infants (VLBW <1500 g) need to express breast milk for weeks and sometimes months before their infant is able to nurse at the breast. Rates of successful lactation for mothers of preterm infants, especially VLBW infants, are low. We will explore ways to improve and sustain breast milk feeding for infants admitted to our NICU and possibly to postnatal ward.
Breast milk feeding protocol for improvement must be written and implemented. It should also be monitored to assess the magnitude of improvement and compliance. This was NICU quality improvement project which faced many difficulties. In the third edition of The Use of Human Milk and Breastfeeding in the Neonatal Intensive Care Unit, NANN recommends that all infants should be exclusively breastfed for the first 6 months of life with continued breastfeeding for 1 year or more. Data from the Centers for Disease Control and Prevention's 2014 Breastfeeding Report Card1 reveal that only 18.8% of infants are exclusively breastfed for the first 6 months of life, which is far below the Healthy People 2020 goal of 60.6%.
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