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.
Learning Objectives:
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.
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