Giving critically ill babies the breast care – World Breastfeeding Week

If there is one thing I can attest to as a lactation specialist working in neonatal intensive care, it is that the power of breast milk should never be underestimated. It is much more than just nutrition and in fact, is often referred to as ‘liquid gold’ because its benefits are so far-reaching.

Science has proven, and continues to reveal, that breast milk plays a vital role in protecting babies from harmful bacteria and viruses, helping to lower the incidence of common illnesses and disease as well as promoting adequate growth and development. The act of breast feeding itself also provides a unique connection between a mother and her baby, enhancing a sense of purpose and attachment in the mother and providing her baby with warmth, protection and stability. These benefits are important for any newborn, but even more so when they are critically-unwell.

In the Grace Centre for Newborn Intensive Care, we care for more than 600 babies a year who fall into this category. Many of the babies admitted to our unit have complex medical needs and will require surgery or specialist care, which often delays normal feeding practice. For these babies, considerable extra support needs to be provided their mothers to establish to help them establish and maintain their milk supply so they can continue to provide breast milk for their sick baby during their admission and to ensure they have adequate milk supply once their baby is well enough to breast feed.

Around the world, the need for this to be a priority in the NICU is being increasingly recognised and our unit in Grace is no exception. Over the years, we have developed a variety of measures to ensure that each mother has optimal support to breast feed or provide expressed milk for her baby.  

One of the first things we do is encourage mothers to express and provide milk for their baby and we very fortunate in Grace to have access to breast pumps that enables them to do this*.

It is not uncommon for mothers to feel helpless when their baby is in NICU so providing milk helps them to foster a sense of purpose. We often have mothers remark on how they feel that expressing milk for their baby or breastfeeding is one of the few things they can do to enhance care and promote healing to improve their baby’s condition.

We also put steps in place in the lead up to breastfeeding to help foster the important elements of emotional, physiological and psychological wellbeing of both mother and baby. Some of these steps include the practice of skin to skin cuddles where the infant is held on their mother’s chest for prolonged periods of time. The warmth and scent of the mother’s skin, as well as the sound of their beating heart and voice, are familiar to babies from the time spent developing in the womb. This familiarity promotes a sense of closeness, safety and belonging in the infant; which helps to lull them into a deep sleep providing emotional and physical stability.

For babies who are more critically unwell, parents are also encouraged to provide mouth care with breast milk. Research has shown that doing this helps to provide immune protection with live antibodies absorbed through the inner cheeks of the baby.  

In addition, droplets of fresh breast milk on a dummy provide sucking practice for some babies, familiarising them with the pleasant taste of their mother’s milk for future feeding. It helps promote satiety and comfort when a baby has to be fed by a gastric feeding tube.

As babies progress with healing and growth, mothers are given further guidance and support by our nursing staff and lactation specialists to start introducing breastfeeds. They often begin with small feeds or simply licks and sucks at the breast, with the goal to continue practising until they are able to have breastfeeds.

Fortunately, more than 80% of the babies we care for in Grace do go home either partially or fully breastfeeding, which is an amazing outcome given how many hurdles they have had to face along the way.

Achieving this is made possible thanks to the support of educated staff, the provision of a private milk expressing room and modern hospital grade expressing pumps and equipment but true credit must be given to the babies and the sheer determination, dedication and courage of their parents and families.

Helen Mercieca
Lactation Specialist in the Grace Centre for Newborn Intensive Care

*Special thank you to Medela who recently donated two of their hospital-grade breast pumps to the Grace Centre for Newborn Intensive Care.

This week, 1 – 7 August, marks World Breastfeeding Week. The theme for 2020 is “Supporting breastfeeding for a healthier planet” and is focused on highlighting the importance of professions like Helen’s to ensure women have access to skilled breastfeeding counselling so every child can have the best possible start to life.