Breastfeeding Support in Neonatal Care: An Example of the Integration of International Evidence and Experience

Breastfeeding in neonatal care is facilitated by a general positive attitude to breastfeeding in society, mothers' right to leave of absence from work and maternal allowance after childbirth, guidelines for early introduction of breastfeeding, and knowledge among professionals about preterm infants' breastfeeding capacity. Models of care relevant for breastfeeding support are Kangaroo Mother Care, the Humane Neonatal Care Initiative, and developmentally supportive family-centered care using the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Hospital policies and practices should include unrestricted parental visiting, care-by-parent guidelines, early frequent breast milk expression, breastfeeding observation and individualized breastfeeding support, cup instead of bottle feeding, the use of a nipple shield when indicated, and early introduction of semi-demand feeding. Test weighing may facilitate early attainment of exclusive breastfeeding. Early discharge is recommended provided there is an adequate follow-up program.