Pediatric researchers at The Children’s Hospital of Philadelphia describe a successful program in which nurses helped mothers attain high rates of breast-feeding in newborns with complex birth defects requiring surgery and intensive care.
Many of these highly vulnerable newborns immediately experience a paradoxical situation. Their mothers milk helps to fend off infection and provides easily digestible, nutritious ingredients that can reduce the infants stay in the NICU. But because the babies are often in critical condition, breast-feeding may not be considered a priority, or even be feasible, when compared to urgent medical problems.
Human milk is important for all newborns, but especially for sick infants, project mentor Diane L. Spatz, RN-BC, PhD, nurse researcher at CHOP, said in a news release.Taryn M. Edwards, RN-BC
The study, a continuous quality improvement project, appeared in the July/September 2010 issue of the Journal of Perinatal & Neonatal Nursing.
Spatz and co-author Taryn M. Edwards, RN-BC, BSN, also of CHOP, describe a series of steps called the Transition to Breast Pathway, in which NICU nurses systematically guide the mother in breast-feeding practices, which culminated in a majority of the infants in the study (58 out of 80) feeding at their mothers breast before being discharged from the hospital.
This project was driven by bedside nurses, who carried out a goal of systematically integrating evidence-based lactation support and education as part of standard nursing care, Spatz said.
The Transition to Breast Pathway begins with the mother learning to pump breast milk shortly after delivery. Before the baby is able to nurse at the breast, mothers learn to provide mouth care supplying the infant with a bit of human milk on a cotton swab or a pacifier. Nurses also teach skin-to-skin care, letting the mother hold the child close to her body.
The skin-to-skin contact reduces stress in both child and mother, increases the mothers milk supply, and nurtures the mother-infant bond.
Funding support for this study came from the Maternal-Child Health Leadership Academy, sponsored by Sigma Theta Tau International and Johnson & Johnson.