Improving Direct Breastfeeding at the time of Hospital Discharge for Infants with Birthweight <1500 grams

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Human milk feeding in very low birth weight (VLBW, < 1500 g) infants is associated with reduced morbidity and improved neurodevelopmental outcomes, yet direct breastfeeding at NICU discharge remains uncommon (AAP, 2022; Victora et al., 2016). Barriers include staff discomfort, inconsistent education, and lack of standardized feeding pathways for medically fragile infants (Meier et al., 2017).

A multidisciplinary NICU quality improvement initiative implemented sequential PDSA cycles including staff education, bedside decision-making tools, protected breastfeeding as first oral feed, visual signage, and standardized messaging to families. Outcomes tracked included rates of first oral feed at breast and direct breastfeeding at hospital discharge among VLBW infants.

Following intervention implementation, first oral feeds at breast increased substantially from baseline 31% to 72% and breastfeeding at discharge rose from approximately 26% to 40% across measured quarters of 2025.

Structured education combined with standardized clinical pathways can significantly increase direct breastfeeding among VLBW infants at NICU discharge. These findings align with evidence that unit-based lactation support and protected breastfeeding practices improve breastfeeding success in preterm populations (Parker et al., 2019; Meier et al., 2017), suggesting scalable strategies for NICUs seeking to optimize human milk feeding outcomes.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2099

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