For our 47th podcast episode, I review some of the general benefits of maternal breast milk and why it is so important for all infants, but especially those who are critically ill and in the NICU, to receive maternal milk. Human milk, often referred to as liquid gold, is considered the gold standard feeding plan for all infants. Maternal human milk provides many nutritional advantages for infants, but it is also advantageous in non nutritional aspects as well.

Unfortunately, NICU mothers face additional barriers that make it more difficult for them to effectively express their milk and ultimately breastfeed. Data has shown that for all NICU infants, whether preterm and/or critically ill, receive less than 20% of their own mother’s milk at 6 months of age, most commonly due to insufficient maternal milk production. Mothers whose infants are admitted to the NICU are faced with both physical, emotional, mental, and social inhibiting circumstances that make it much more difficult for them to not only establish their milk supply, but also maintain it. There are also significant racial disparities that exist and human milk provision is lowest among non-Hispanic Black and American Indian/Alaska Native populations.

It is the standard of care for most NICUs to utilize Donor Human Milk (DHM) as an alternative or to help bridge the gap for infants when the mother’s breast milk is either not available or there is insufficient volume. Although donor breast milk is a great option that is beneficial, it does not have the same overall protective mechanisms and bioactivity as the mother’s milk.

In the episode, we review what some of the common barriers are for NICU mothers in their physical ability and desire to provide breast milk for their infant. I share recommendations on what we as NICU clinicians can do to educate, support, and guide all mothers in a culturally sensitive and supportive manner. By recognizing the common and individualized barriers for NICU mothers, we can share our knowledge in an empathetic and holistic manner. Therefore, mothers and their care partners are able to make an informed decision and one that has the potential to impact their infant while they are in the NICU and in the months and years that follow!

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