Early Introduction of Maternal Expressed Breast Milk in the Preterm and Low Birthweight Neonatal Population

Background: In 2011 East of England Perinatal Network developed a care bundle which looked at 4 key elements that could lead to prevention of NEC in neonates. We aimed to look at one of these elements and compared it with the practise in a level 3 neonatal unit.

Objective: To observe the practise of facilitating early introduction of maternal expressed breast milk (EBM) in preterm/ low birth weight babies, by commencing early expression (hand and pump expression).

Method: A retrospective review of babies,

Results: A total of 54 patients met our gestation and weight criteria; of which 10 mothers had no intension to express breast milk. 43 (98%)babies received maternal EBM as their first feed. Only 23 (53%) received EBM within the first 48 hours of life. 42 of the mother’s received advice and were shown how to hand express. 41 mothers were shown breast pump expression. 2 Babies of this group were treated for confirmed NEC and 2 were treated for suspected NEC.

Conclusion and suggested changes in practice: We concluded that even though our service is good at using EBM as the first feed, there is still plenty of room for improvement in early introduction of EBM. We plan to implement changes in our trust by introducing breast feeding champions and by producing a new expression log to monitor initiation and on-going support for breast milk expression. We have also introduced the concept of antenatal expression within our unit. We have raised awareness among doctors, neonatal nursing and midwifery teams by presenting our data.