Breastfeeding is widely recognized as the best source of nutrition for newborns, yet many hospitalized infants face significant challenges in establishing breastfeeding. Midwives play a crucial role in supporting mothers and infants during this time. A recent narrative review analyzed midwifery-led interventions in various hospital settings, focusing on practices that improve breastfeeding success. The study highlighted five key measures that midwives can implement. Findings show that skin-to-skin contact, early and regular breastmilk expression, supervised breastfeeding attempts, breastfeeding counselling, and unrestricted visiting hours significantly enhance breastfeeding outcomes. These interventions help establish lactation, strengthen the mother–child bond, and improve overall breastfeeding rates.

Breastfeeding provides essential health benefits for both newborns and mothers. It reduces the risk of infections, supports long-term metabolic health, and strengthens the immune system. For example, children who were breastfed are at decreased risk to develop respiratory infections, diabetes type II, or leukemia. However, hospitalization, particularly in neonatal wards, can disrupt the breastfeeding process. Separation of infant and mother, medical procedures, and the need for intensive care often result in delayed or reduced breastfeeding. This makes targeted support from midwives crucial in overcoming these challenges.

A new review from Germany assessed studies focusing on midwifery-led interventions that enhance breastfeeding success in hospitalized newborns. A total of 20 studies were included and compared for different breastfeeding support strategies in hospital environments and their impact on breastfeeding rates.

Key Measures to Improve Breastfeeding Outcomes

One of the most effective interventions identified is skin-to-skin contact. The results indicate that early and prolonged skin-to-skin contact improves sucking behaviour, increases exclusive breastfeeding rates, and shortens the time to full enteral feeding. This intervention is particularly effective when implemented within the first hours after birth.

Another critical measure is breastmilk expression and supervised breastfeeding attempts. Mothers who begin expressing milk early and receive guidance from midwives on breastfeeding techniques are more likely to maintain an adequate milk supply. Regular pumping and early breastfeeding attempts improve the likelihood of exclusive breastfeeding at discharge.

Breastfeeding counseling has been shown to significantly improve mothers' confidence and ability to sustain breastfeeding. Access to lactation education helps mothers manage challenges effectively, while regular consultations with midwives provide ongoing support. Studies show that mothers who receive structured breastfeeding education are more likely to continue breastfeeding over a longer period.

Furthermore, uninterrupted visiting hours contribute to higher exclusive breastfeeding rates. When parents are allowed extended contact with their newborns, they are more actively involved in the feeding process, reinforcing the establishment of breastfeeding. Rooming-in policies further support breastfeeding by enabling infants to feed when needed and not according to schedule.

Findings Encourage Parents and Midwives

These findings underscore the importance of midwifery-led interventions in neonatal and postnatal care. Midwives have valuable opportunities and potential to support successful breastfeeding and serve as key points of contact for mothers, as they interact with families on an almost daily basis and provide essential guidance during the critical early days and weeks. However, midwives are often not sufficiently involved in neonatal wards. Encouraging greater midwifery involvement in hospital settings can help ensure that all hospitalized newborns receive the best possible breastfeeding support.

In addition, the agency of parents should be acknowledged. If caregivers and parents are educated to understand the benefits of breastfeeding practices, it enables them to make informed decisions about their infant’s feeding journey.

Paper available at: https://www.europeanjournalofmidwifery.eu/Optimizing-breastfeeding-for-hospitalized-newborns-A-narrative-review-of-midwifery,200341,0,2.html 

Full list of authors: Kira Madeleine Harting, Dominique Singer, Julia Heiter 

DOI: https://doi.org/10.18332/ejm/200341