Authors (including presenting author) :
Lam WK(1), Wong SK(2), Ng YHR(1), Lam SW(2), Leung HY(1)
Affiliation :
(1) Department of Paediatrics, Queen Elizabeth Hospital (QEH), (2) Department of Obstetrics & Gynaecology, QEH
Keyword 1: :
Donor breast milk
Keyword 2: :
integrated lactation care
Keyword 3: :
preterm infants
Keyword 4: :
mother's own milk
Keyword 5: :
breastfeeding support
Introduction :
Human milk is the optimal nutrition for all infants, with particular benefits for preterm infants including protection against necrotizing enterocolitis and other prematurity-related morbidities. However, premature birth often results in delayed maternal lactogenesis and insufficient milk supply. Pasteurised donor breast milk (PDBM) provides critical bridge nutrition while mothers establish lactation, yet exclusive mother’s own milk (MOM) remains the gold standard, as MOM contains unique immunological and bioactive components not preserved in processed donor milk.
Objectives :
To evaluate outcomes of an integrated proactive lactation care model across Obstetrics and Paediatrics departments designed to facilitate rapid MOM establishment in high-risk infants receiving PDBM.
Methodology :
Retrospective descriptive review of all PDBM recipients (March-December 2025) in a neonatal unit (NNU). All mothers received integrated proactive lactation care by International Board Certified Lactation Consultants (IBCLCs) and nurses across Obstetrics & Gynaecology and Paediatrics departments with seamless care coordination. The model included: (1) antenatal infant feeding counselling, (2) first IBCLC or nurse contact within 2 hours postpartum (100% compliance), (3) intensive early lactation support delivered by IBCLCs and nurses at both mother and baby bedsides, (4) breastfeeding skill review before mother and infant discharge, and (5) post-discharge follow-up. PDBM served as bridge therapy while mothers established lactation. Infant characteristics, time to exclusive MOM, and feeding composition were analysed.
Result & Outcome :
69 mothers of high-risk infants received the integrated lactation model. Infant characteristics: 8.7% < 28 weeks gestation, 89.9% < 37 weeks gestation, 33.3% < 1500g birth weight. Despite this high-risk population, 36 mothers (52.0%) achieved exclusive MOM and discontinued donor milk, with median time to exclusive MOM of only 6.5 days (IQR: 3-15 days, range: 0-42 days). Remarkably, 20 of these mothers (55.6%) achieved exclusive MOM within the first week. Overall infant feeding composition during NNU stay demonstrated near-exclusive human milk: MOM 77.75%, PDBM 21.86%, formula 0.39% (total human milk 99.61%). An integrated proactive lactation care model across Obstetrics and Paediatrics departments achieved rapid transition to exclusive MOM (median 6.5 days) in over half of high-risk PDBM recipients, with near-exclusive human milk feeding (99.61%) throughout hospitalisation. This cross-departmental approach effectively optimises maternal lactation outcomes while ensuring high-risk infants receive maximum benefits of their own mother’s milk.
