Five Steps to Improve Bedside Breastfeeding Care

Contextualizing online human milk sharing: Structural factors and lactation disparity among middle income women in the U.S.

“…For instance, compared with breastfeeding mothers of healthy term babies, mothers of preterm infants who exclusively express their milk are more likely to have insufficient milk production (Hill et al, 2007), which is the most common reason for breastfeeding cessation (Almqvist-Tangen et al, 2012;Arora et al, 2000). Preterm infants have more post-partum health complications and hospital readmissions related to insufficient milk intake (Morton et al, 2013). Preterm births are often associated with medically indicated Cesarean sections (Goldenberg et al, 2008) which may result in delayed initiation of breastfeeding and/or breast milk expression, delayed onset of lactation, maternal-infant separation, early supplementation with formula, and breastfeeding cessation (Augustin et al, 2014;Smith, 2007).…”

“…Moreover, initiation and continuation of breastfeeding among mothers with preterm infants in NICUs are highly correlated with education and income, marital status, spousal and partner support, other family support, and support by health providers with lactation expertise (Alves et al, 2013;Lessen and Crivelli-Kovach, 2007;Smith et al, 2006). Hospital practices that attend to the special needs of preterm infants and their mothers can mean the difference between lactation sufficiency and insufficiency (Brett et al, 2011;Morton et al, 2013), but not all families have access to such care.…”

Effect of pumping pressure on onset of lactation after caesarean section: A randomized controlled study

“…For mother–infant separation, preterm infants, and babies with latch issues, breast pumping at effective suction pressure can be one option for mothers to promote their onset and maintenance of lactation. Effective breast stimulation as early as possible has become the consensus for successful breastfeeding (Morton, Hall, & Pessl, ). Besides the suction pressure, hand expression has been shown to increase milk production in mothers of preterm infants (Morton et al, ).…”

A Breastfeeding Algorithm to Guide Bedside Health Care Practice for Term Newborns

“…Milk production begins with sufficient and frequent removal of colostrum. Hand expression of colostrum is an effective strategy to decrease the risk of insufficient milk production, and spoon feeding expressed milk avoids the use of artificial nipples and reduces the risk of inadequate newborn intake (Morton, Hall, & Pessl, 2013). Newborns who fail to latch need frequent assessment for feeding cues and should be put to the breast at the first signs of hunger.…”

“…Although nurses may receive education and training on supportive breastfeeding practices, variations in recall of which intervention is best for individualized care can lead to inconsistent information provided to women. Morton et al (2013) presented a model plan for nurses to overcome the most common challenges of insufficient time, insufficient provider skill, and lack of accountability for managing lactation problems. Recommendations emphasized having a hospital policy based on the Ten Steps, educating staff using a streamlined Nurses play key roles in helping women establish breastfeeding and encouraging them to continue after discharge home from the hospital breastfeeding curriculum with consistent language and core competencies, and completing daily rounds to assess newborn nutrition and breastfeeding needs.…”