Introducing a Lactation Consultant into a NICU Service Improves Early Access to Breast Milk

Background: Providing breast milk for extremely premature and sick neonates has documented benefits. Lactation consultants (LC) have become important additions to neonatal intensive care unit teams to improve provision of maternal breast milk, particularly in the early hours after birth.

Aim: To assess the impact of the introduction of a permanent LC on: 1) provision of breast milk for neonates; and 2) education and lactation support for mothers and staff.

Methods: A mixed method study including a retrospective chart audit and a pre and post LC staff survey. Information collected included: first expressed breast milk, episodes of lactation education and support. Survey questions provided staff feedback regarding: education access to support and meeting maternal needs. Data was analysed using descriptive statistics and Chi-square tests.

Results: 161 charts were included (82 pre LC and 79 post LC). Post LC service there was a significant increase in maternal access to LC appointments (12/82 vs 63/79; p< 0.01) as well as breast pump education (53/82 vs 64/79; p<0.01). There was an increase in EBM provision at 12 hours postnatally (38/82 vs 48/79; p<0.01). Staff surveys (36 pre LC and 56 post LC) showed there was a significant increase in staff confidence in providing BF education to mothers (25% vs 46%; p= 0.013) and improved access to LC appointments (5% vs 89%; p<0.01).

Conclusions: LC services can significantly improve the provision of breast milk within the first 12 hours of life for very preterm neonates, and improve maternal access to education and support. Further research is required to assess the effect of LC’s on improving long term breast feeding rates.