ABM Clinical Protocol #12: Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home, Revised 2018

Noble, Lawrence; Okogbule-Wonodi, Adora C.; Young, Michal

doi:10.1089/bfm.2018.29090.ljn

Cited by 20 publications

(7 citation statements)

References 41 publications

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“…109 Multidisciplinary teams should be available to support breastfeeding and expression and provision of mother's milk, not just during the hospitalization but also after discharge for the transition to direct breastfeeding at home. 110,111…”

Section: Human Milk and Breastfeedingmentioning

confidence: 99%

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Transition to a Safe Home Sleep Environment for the NICU Patient

et al. 2021

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Of the nearly 3.8 million infants born in the United States in 2018, 8.3% had low birth weight (ie, weight <2500 g) and 10% were born preterm (ie, gestational age of <37 weeks). Ten to fifteen percent of infants (approximately 500 000 annually), including low birth weight and preterm infants and others with congenital anomalies, perinatally acquired infections, and other diseases, require admission to a NICU. Every year, approximately 3600 infants in the United States die of sudden unexpected infant death (SUID), including sudden infant death syndrome (SIDS), unknown and undetermined causes, and accidental suffocation and strangulation in an unsafe sleep environment. Preterm and low birth weight infants are 2 to 3 times more likely than healthy term infants to die suddenly and unexpectedly. Thus, it is important that health care professionals prepare families to maintain their infant in a safe home sleep environment as per recommendations of the American Academy of Pediatrics. Medical needs of the NICU infant often require practices such as nonsupine positioning, which should be transitioned as soon as medically possible and well before hospital discharge to sleep practices that are safe and appropriate for the home environment. This clinical report outlines the establishment of appropriate NICU protocols for the timely transition of these infants to a safe home sleep environment. The rationale for these recommendations is discussed in the accompanying technical report "Transition to a Safe Home Sleep Environment for the NICU Patient," included in this issue of Pediatrics.

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Section: Human Milk and Breastfeedingmentioning

confidence: 99%

“…c. For more information refer to the clinical report on DDH by the AAP. Human milk and breastfeeding 2,87,89,[101][102][103][104]110,111 a. The use of human milk is recommended for its numerous health benefits, including a reduced risk for SIDS.…”

Section: Table 1 Nicu Transition To a Safe Home Sleep Environmentmentioning

confidence: 99%

Transition to a Safe Home Sleep Environment for the NICU Patient

et al. 2021

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“…1 At discharge from the neonatal unit, combined breastfeeding and bottle feeding of MOM and/or infant formula may be advised to ensure adequate volume intake with the goal of transitioning to full breastfeeding. 19 Breastfeeding challenges may include an infant that is sleepy at the breast and attachment or sucking difficulties, while continued breast expression, nipple shield use, and a lack of support can be difficult and exhausting for the mother. 20,21 The method of feeding MOM is important, as maternal anticipation of a satisfying breastfeeding experience contrasts with the realities of continued breast expression, bottle feeding, and slow breastfeeding progress.…”

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confidence: 99%

Longitudinal Follow-up of Preterm Breastfeeding to 12 Weeks Corrected Gestational Age

Perrella

Nancarrow

Rea

et al. 2021

Advances in Neonatal Care

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Background: Preterm infants have shorter breastfeeding duration than that of term infants. Details of postdischarge feeding methods and difficulties are needed to inform the care of preterm breastfeeding dyads. Purpose: To describe postdischarge breastfeeding characteristics of mother-preterm infant dyads up to 12 weeks corrected gestational age (CGA). Methods: A prospective observational study of preterm dyads (birth 24-33 weeks' gestation) that fed their mother's own milk (MOM) at discharge from a neonatal unit in Perth, Western Australia. Feeding method and frequency, breastfeeding duration, difficulties, and nipple shield use were recorded at 2, 6, and 12 weeks CGA. Results: Data were obtained for 49 mothers (singleton infant n = 39, twins n = 10). At 12 weeks CGA, 59% fed any MOM with 47% exclusively fed MOM and 31% fully breastfed. Nipple shield use reduced from 42% at 2 weeks CGA to 11% at 12 weeks CGA. Compared with mothers who exclusively fed MOM at discharge (n = 41) those who fed both MOM and infant formula (n = 8) were more likely to wean before 12 weeks CGA (P < .001). Weaning occurred before 2 weeks CGA in 12/19 (63%), with low milk supply the most frequently cited reason. Implications for Practice: Most mothers with a full milk supply at discharge successfully transition to predominant breastfeeding. Frequent milk removal needs to be prioritized throughout the preterm infant's hospital stay. Implications for Research: Examination of facilitators and barriers to early and continued frequent milk removal across the postpartum period is required to identify strategies to optimize lactation after preterm birth.

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“…233 Furthermore, preterm infants and their mothers require significant support when they are discharged from the hospital and transition to direct breastfeeding in the home setting. 234 Finally, as noted in the previous discussion on SSC, it is critical that parents be aware of the dangers of falling asleep with their infant. This is especially important when mothers are rooming-in with their infant and not under constant observation by NICU staff.…”

Section: Human Milk and Breastfeedingmentioning

confidence: 93%

Transition to a Safe Home Sleep Environment for the NICU Patient

et al. 2021

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Of the nearly 3.8 million infants born in the United States in 2018, 8.3% had low birth weight (<2500 g [5.5 lb]) and 10% were born preterm (gestational age of <37 completed weeks). Many of these infants and others with congenital anomalies, perinatally acquired infections, and other disease require admission to a NICU. In the past decade, admission rates to NICUs have been increasing; it is estimated that between 10% and 15% of infants will spend time in a NICU, representing approximately 500 000 neonates annually. Approximately 3600 infants die annually in the United States from sleep-related deaths, including sudden infant death syndrome International Classification of Diseases, 10th Revision (R95), ill-defined deaths (R99), and accidental suffocation and strangulation in bed (W75). Preterm and low birth weight infants are particularly vulnerable, with an incidence of death 2 to 3 times greater than healthy term infants. Thus, it is important for health care professionals to prepare families to maintain their infant in a safe sleep environment, as per the recommendations of the American Academy of Pediatrics. However, infants in the NICU setting commonly require care that is inconsistent with infant sleep safety recommendations. The conflicting needs of the NICU infant with the necessity to provide a safe sleep environment before hospital discharge can create confusion for providers and distress for families. This technical report is intended to assist in the establishment of appropriate NICU protocols to achieve a consistent approach to transitioning NICU infants to a safe sleep environment as soon as medically possible, well before hospital discharge. INTRODUCTIONAccording to the 2016 policy statement from the American Academy of Pediatrics (AAP) Task Force on Sudden Infant Death Syndrome, all infants, including preterm and low birth weight infants, in the NICU should be placed in the supine position for sleep as soon as they are

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ABM Clinical Protocol #12: Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home, Revised 2018

Cited by 20 publications

References 41 publications

Transition to a Safe Home Sleep Environment for the NICU Patient

Transition to a Safe Home Sleep Environment for the NICU Patient

Longitudinal Follow-up of Preterm Breastfeeding to 12 Weeks Corrected Gestational Age

Transition to a Safe Home Sleep Environment for the NICU Patient

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