Introduction
Mothers who deliver preterm or have infants requiring intensive care face a heightened risk of lactation failure. Research indicates that expressing milk within the first hour after delivery can boost milk supply by 130% within three weeks. Our study aimed to explore the cultural and logistical challenges surrounding early lactation for late preterm infants in the well newborn service at Von Voigtlander Women’s Hospital.
Methods
We conducted a pre-intervention survey with 25 patients who intended to breastfeed, inquiring about the presence of a breast pump and supplies, and early milk expression. In-person interviews with antepartum, postpartum, and PACU nursing staff were conducted to discuss the logistics of initiating milk expression within 1 hour after birth. Following these assessments, educational flyers with QR codes linking to hand expression demonstrations were posted in common work areas for nursing and ancillary staff.
Results
The survey revealed that a breast pump was available 84% of the time, but necessary supplies were present only 60% of the time. Breast pump usage before meeting a lactation consultant occurred in about half of the cases, with hand expression reported in under 45%. Nursing staff highlighted that initiating pumping within 1 hour is impractical due to understaffing and time constraints, with an average start time of 8-12 hours postpartum. Their recommendations included hiring more lactation consultants to expedite education, especially during night shifts.
Conclusion
Overall, while breast pumps were sufficiently available, mothers lacked necessary pump supplies, with only 52% expressing milk before consulting a lactation expert. The lack of supplies and inadequate education hindered early milk expression. This revealed a supply chain gap and the need for cultural support in establishing milk supply during this critical period. Moving forward, we plan to train antepartum technicians to provide hand pumps with QR codes for instructions upon admission and implement a postpartum survey to document the timing of first milk expression. By addressing both logistical and educational deficiencies, we aim to improve early milk expression rates and support lactation success among mothers of late preterm infants.
Tables and Figures
Figure 1: Educational handout for nursing and ancillary staff
References
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