Background and objectives: For preterm infants breast milk plays a vital role in their development and protection from illness, however, prevalence and duration of breast milk feeding is lower in this high-risk group. The most common reason for not providing breast milk to preterm infants is simply the lack of availability. Specialist lactation support within the NICU was commenced in the Coombe hospital in October 2019 to improve breast milk intake to preterm infants. The aim of this study was to investigate whether introduction of specialist lactation support within the NICU would increase breastfeeding rates. Secondary research looked at whether this service led to improved timing to first milk expression post-birth and, therefore, earlier and optimal availability of colostrum to the preterm infant. Methods: A retrospective chart audit was carried out on 156 discharged infants, who were born under 32 weeks between January and June 2019, pre-introduction of NICU lactation support, and during the intervention, between January and June 2020 and January and June 2021, to assess breast milk intake and breastfeeding rate at discharge. A retrospective chart audit was also carried out on 61 preterm infants born at less than 32 weeks' gestation, who were inpatients during September 2019 pre-intervention, and in January and April 2020 and January 2021 during the intervention, to assess the timing of first assistance to express post-birth and the timing of colostrum availability to the infant in the NICU. Results: Findings demonstrated improved discharge breastfeeding rates of preterm infants. Pre-intervention, in 2019, any breast milk feeding at discharge was 59 per cent. This increased to 75 per cent in 2020, and to 85 per cent in 2021. Additional and ongoing improvements were seen in the timing when mothers received assistance with first hand expression. This increased from 27 per cent pre-intervention to 92 per cent of mothers receiving assistance within six hours post-birth. Due to this, colostrum was available at an earlier stage (within six hours) for these vulnerable infants, increasing from 13 per cent pre-intervention to 92 per cent during the intervention. Conclusion: This study shows the positive impact of an NICU dedicated lactation consultant on the availability of breast milk to preterm infants. Audit findings identified that specialist lactation support led to earlier and increased availability of maternal breast milk to preterm infants and improved maternal breast milk supplies and breastfeeding rates. It is recommended that such services be funded and extended to other neonatal units.
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