Authors: (including presenting author): :
Auyeung SW, Ip MY, Lee YT, So LK, Tang WY, Cheng SM
Affiliation: :
Department of Pediatrics, Prince of Wales Hospital
Keyword 1: :
Lactation Consultation
Keyword 2: :
Preterm infants
Introduction: :
Breast milk feeding certainly benefits preterm infants’ development and their protection from illness. Nonetheless, studies showed that the prevalence and duration of breast milk feeding were often lower in this high-risk group. To enhance the breastfeeding support in NICU, Lactation consultation (LC) sessions commenced in PWH from 1st May 2024. The content included breastfeeding counselling, educating the benefit of breast milk feeding in preterm infants and also offering practical help such as hand expression. This program not only provides early access of breastfeeding support to the mothers, but also increases and sustains breast milk feeding in these vulnerable preterm infants.
Objectives: :
The program’s aim is to improve lactation service for the mothers of below 32-week gestation preterm infants in NICU. Objectives: 1) To provide early lactation consultation sessions to the mothers of preterm infants. 2) To increase the availability and sustainability of breast milk feeding for the preterm infants in NICU.
Methodology: :
A literature review was conducted before the implementation of the program. The benefits of breast milk feeding in preterm infants and the effect of early lactation support service on breast feeding outcomes in the NICU were studied. The target population was the mothers of preterm infants born with < 32-week gestation admitted to NICU. The interventions included providing an early lactation consultation session (the first visit) within 5 days of NICU admission to the mothers of below 32-week preterm infants. Two follow-up sessions of the lactation consultation (1st follow up: 1 week after the first visit and 2nd follow up: 1-month old of the infant) were performed. All the LC sessions were provided by the International Board-Certified Lactation Consultants (IBCLCs) in our neonatal unit. A checklist of breastfeeding education for NICU mothers was designed for providing an education guide for the IBCLC to teach the mothers. The package of the program included breastfeeding counselling, educating mothers for the benefits of breast milk feeding, how to perform hand expression, breast milk pumping and safe milk storage. A kangaroo care information card was also designed and introduced to mothers during the LC sessions. IBCLCs would assess the fitness of NICU infants and propose the date of performing kangaroo care. A retrospective data collection for the periods: pre-intervention (from May 2023 to April 2024) and post-intervention (from May 2024 to February 2025) were conducted to investigate the effectiveness of implementing the LC sessions. A total of 111 discharged preterm infants (66 in the pre-intervention group) and (45 in the post-intervention group) were recruited. The data including breast milk feeding of below 32-gestation preterm infants at 1-month and at discharge were collected. A questionnaire to evaluate mother’s satisfaction was also collected after completion of all the LC sessions to evaluate the effectiveness of the program.
Result & Outcome: :
The mean gestational age of the preterm infants was 29.43 weeks (pre-intervention) and 29.25 weeks (post-intervention). The average access time for the first LC session was 4.8 days which met the target of the program. Findings demonstrated an increased breast milk feeding rate of < 32-week gestation preterm infants. Of the pre-intervention group, breast milk feeding at 1 month and at discharge were 76.1 % and 32.8 % respectively. Of the post-intervention group, breast milk feeding at 1 month and at discharge increased to 86.7% and 68.9% respectively. Mothers showed high satisfaction with the program and overall rating reached 4.87 out of 5. The Lactation Consultation sessions were effectively implemented, resulting in early access of breastfeeding support in the NICU and increased breast milk feeding in preterm infants. Mothers welcomed the program and showed high satisfaction. We would continue to implement the LC sessions in our unit to achieve the program’s aim.
