“The Little Engine That Could”: Breastfeeding Journeys of Very Premature Babies on Home Tube Feeds
Long NICU stays, invasive oral procedures, chronic lung disease, and gastrointestinal complications can contribute to a complex oral feeding journey for premature infants. Frequently, the NICU journey prioritizes bottle feeding over breast feeding. Breastmilk supply and transfer are challenging for mothers and infants born very premature. At the time of NICU discharge, most very premature infants remain fragile oral feeders with weak breast-feeding and bottle-feeding skills, and some require tube feeding support. Community-based breastfeeding support is often lacking, and breastmilk intake and direct breastfeeding diminish beyond discharge. The authors will highlight four remarkable case studies of very premature newborns who were discharged home on nasogastric tube feeding. All four babies had a complex oral feeding journey in the NICU with minimal opportunity to develop breastfeeding skills. Parent comments will be shared, including barriers and facilitators for breastfeeding. Take away messages will focus on helpful strategies to support families taking home a fragile feeder and progressing toward positive, enjoyable oral feedings and more importantly, weaning from tube support and advancing breastfeeding.
This presentation was originally offered at our GOLD Neonatal Online Conference 2023.
Karen Lasby leads a specialized nursing team in post-discharge follow-up of extremely premature infants and their families in Alberta, Canada. She has presented locally, nationally, and internationally on the topics of premature babies, neonatal oral feeding, and NICU-to-home transition, including the 2019 and 2022 GOLD Neonatal Conferences. She has been the co-investigator in several research studies examining outcomes for very low birth weight infants and has published articles on maternal work in the NICU, neonatal transition, and gastroesophageal reflux. An educator for nearly thirty years, Karen has taught, written instructional material, and produced online neonatal nursing courses. Formerly the president of the Canadian Association of Neonatal Nurses, she served on this national board for twelve years, and on the board of the Council for International Neonatal Nurses for three years. Karen’s work has been recognized by the Canadian Institute of Child Health and College and Association of Registered Nurses of Alberta. Karen is the co-author for the parent book, "Preemie Care: A guide to navigate the first year with your premature baby".
Noriko Woods is a member of a specialized nursing team in post-discharge follow-up of extremely premature infants and their families in Alberta, Canada. She started her Level 4 NICU RN career in Kanagawa, Japan, trained and worked for 5 years before moving to Canada. She worked 5 years as a Level 4 NICU RN in Calgary Alberta before she started her current position at Postpartum Community Health Services, as a public health nurse. She became passionate about breastfeeding with her own experience with her first child in 2009 and obtained the IBCLC in 2011. She has been working with early postpartum mothers and babies to reach their breastfeeding goals as a Lactation Consultant in her community. She is passionate about supporting families to achieve positive feeding experience with a bottle and at breasts. She has been participating with various committees such as Calgary NICU LC group to revise the breastfeeding guidebook for NICU parents, Calgary Breastfeeding Matters Group annual conference committee, GOLD Neonatal Professional Advisory Committee.
1. Describe common breastfeeding patterns experienced by very preterm newborns and their families.
2. List barriers and facilitators for breastfeeding, as described by our four mothers.
3. Create a plan of action to support fragile feeders and family breastfeeding goals.
Long NICU stays, invasive oral procedures, chronic lung disease, and gastrointestinal complications can contribute to a complex oral feeding journey for premature infants. Frequently, the NICU journey prioritizes bottle feeding over breast feeding. Breastmilk supply and transfer are challenging for mothers and infants born very premature. At the time of NICU discharge, most very premature infants remain fragile oral feeders with weak breast-feeding and bottle-feeding skills, and some require tube feeding support. Community-based breastfeeding support is often lacking, and breastmilk intake and direct breastfeeding diminish beyond discharge. The authors will highlight four remarkable case studies of very premature newborns who were discharged home on nasogastric tube feeding. All four babies had a complex oral feeding journey in the NICU with minimal opportunity to develop breastfeeding skills. Parent comments will be shared, including barriers and facilitators for breastfeeding. Take away messages will focus on helpful strategies to support families taking home a fragile feeder and progressing toward positive, enjoyable oral feedings and more importantly, weaning from tube support and advancing breastfeeding.
Accreditation
CERPs - Continuing Education Recognition Points
Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators. GOLD Conferences has been designated as a Long Term Provider of CERPs by IBLCE--Approval #CLT114-07. This program is approved for 1 L-CERP.
CMEs - Continuing Medical Education Credits for Physicians & Nurses
The AAFP has reviewed the activity and deemed it acceptable for AAFP credit. Term of approval is from 05/30/2023 to 05/30/2024. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is approved for 1 AAFP Prescribed CME credit.
Nursing CEUs - Nursing Contact Hours
This nursing continuing professional development activity was approved by the American Nurses Association Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation for 1 Nursing Contact Hours.
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Additional Details
Viewing Time: 2 Weeks
Tags / Categories
(IBCLC) Clinical Skills, (IBCLC) Development and Nutrition, (IBCLC) Techniques, Breastfeeding Strategies for the Preterm Infant
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