Breastfeeding promotion in special care and neonatal intensive care units
News release from NETSCC, HTA
15 September 2009
Providing mothers with babies in neonatal units with extra help with breastfeeding and expression of breastmilk, is more effective and less costly than normal staff contact. These research findings are newly published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme
For pre-term babies the use of breastmilk substitutes is associated with increased short and long-term adverse outcomes. These include mortality and serious morbidity in the infant and adverse health outcomes in the mother. The fragility of such infants, their changing nutritional and health needs, the increased difficulty in producing breastmilk experienced by preterm mothers, the anxiety that is provoked in mothers and family members, and the fact that health-care staff may not have the skills or the time needed, can make breastfeeding a difficult process.
To complicate the issue further, starting and continuing to breastfeed, or to express breast milk, is particularly difficult in special and intensive care settings where care is dominated by medical procedures. Parents are likely to be anxious and distressed and mothers are often separated from their babies. Despite strong policy support for breastfeeding initiation and duration in recent years in the UK, there has never been a policy initiative that aims to increase breastfeeding rates in special and intensive care units.
The study, led by Professor Mary Renfrew, Director of the Mother and Infant Research Unit at the University of York, reviewed existing literature on a number of interventions to assess which effectively promote breastfeeding in special and intensive care settings.
The results showed that kangaroo skin-to-skin contact, peer support, simultaneous breast milk pumping, multidisciplinary staff training and the Unicef Baby Friendly accreditation of the associated maternity hospital are all effective interventions. Skilled support from trained staff in hospital has been shown to be potentially cost-effective. Enhanced staff contact which provided additional skilled professional support in hospital, was found to be the most clinical and cost-effective option.
“Breastfeeding rates in the UK are among the lowest in Europe” says Professor Renfrew. “Babies of mothers from disadvantaged groups are least likely to be breastfed, yet these babies are also most likely to be born too soon or too small. This aspect of early years care is really important in terms of health inequalities, along with disease prevention”.
Professor Renfrew continues, “This research illustrates again how important high quality care and support is following childbirth, especially when the babies are premature or small for dates. Lack of feeding with breastmilk for these infants is an important and costly problem that if addressed has the potential to improve babies’ outcomes.”
To view the full project details visit http://www.hta.ac.uk/1611
Notes for editors
1. The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme commissions research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 530 issues published to date. The journal’s 2009 Impact Factor (6.91) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk
2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk
Contact details
Naomi Williams, Programme Manager (Communications)
Telephone: 02380 595 646, Email: N.E.Williams@southampton.ac.uk
Kelly Waterman, Assistant Programme Manager (Communications)
Telephone: 02380 597 376, Email: k.waterman@southampton.ac.uk
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