Human Milk in the NICU

In February of 2009 the National Association of Neonatal Nurses Board of Directors published a position statement entitled "The Use of Human Milk and Breastfeeding in the Neonatal Intensive Care Unit."
Based on a body of research which clearly demonstrates the superiority of human milk for premature infants, this position statement clearly enunciates optimal guidelines which should all NICU nurses should follow.


Responsibility toward the Mother
It is critically important, according to this position statement, that mothers be provided a hospital-grade double breastpump and pump kit. They should be encouraged to pump every 3 hours for optimal milk production. Keeping a pumping log will help both mother and healthcare provider to make assessments and adjustments. Receiving the mother's colostrum helps prepare the immature intestine by coating it with Immunoglobulin A. Fat content is an important factor when looking at the milk a mother pumps for her preterm baby. The paper recommends the use of a crematocrit to determine the fat content in order to determine how much human milk fortifier might be necessary to provide the caloric value necessary for optimal growth and development.

Responsibility toward the Infant
Obviously the neonate is the nurse's primary patient. Studies show that even a preterm baby as young as 28-30 weeks can demonstrate rooting and areolar grasp and latching behavior. Skin to skin exposure has been shown to have a myriad of benefits. After pumping a mother can allow her baby to nuzzle and lick her empty breast. The authors of the position paper recommend the use of a nipple shield to help the premature infant suckle more effectively and obtain more milk in early feeds.

The publication of this position paper is an important step in validating what many NICU nurses already knew. As research-based evidence continues to mount about the amazing benefits of breastmilk for at-risk infants, hopefully we will see more and more breastfeeding support in NICU's everywhere!