Human Milk in the NICU: Evidence-Based Principles, Tool-Kits, Talking Points and Case Studies

  • Description
  • Credit Hours
  • Outline



This program has been conceptualized from previous program evaluations wherein attendees have requested additional time for questions and dialogue between Drs. Meier and Spatz.  It has also been developed to capitalize on the combined expertise of the presenters:  Dr. Meier currently serves as the President of the International Society for Research in Human Milk and Lactation and Dr. Spatz serves as Chair for the American Academy of Nursing Expert Panel on Breastfeeding.  As such, the speakers--both of whom function in a combined research-practice-teaching model,  bring unique expertise in cutting-edge research and health policy.  However, both presenters provide direct clinical lactation care and infuse their presentations with clinical applications, "toolkits and talking points" and multiple case scenarios that apply the research and policy content. 

7 Hours 30 Minutes
Course ID

Credit Hours

  • Nursing - 6.0 Contact Hours
  • Dietitian - 6.0 CPE Credits


Topics & Objectives:

Human Milk Reduces the Risk of Prematurity-Specific Morbidities and their Associated Costs for Premature Infants (Dr. Meier)

  • Compare health outcomes and cost of NICU care for VLBW infants fed human milk and formula.
  • Articulate specific "talking points" to be used with families regarding the impact of human milk on health and cost outcomes for NICU infants.
  • Cite economic data to be used in preparing administrative proposals to increase lactation support resources in the NICU.

Replacing "Tradition" with "Evidence" for Preventing, Diagnosing and Managing Milk Volume Problems in the Breast Pump Dependent Mother (Dr. Meier)

  • Articulate the physiologic and hormonal differences between the initiation and the maintenance of lactation
  • Describe the critical period of "coming to volume" in a breast pump dependent mother, using these same physiologic and hormonal differences.
  • Cite best practices for optimizing maternal milk volume during the critical "coming to volume" period.
  • Identify evidence-based clinical translation materials, including maternal milk volume diaries and instructional videos, that translate this information to families.
  • Integrate the evidence about the cost of providing and/or acquiring mothers' own milk into an administrative proposal to increase lactation support resources in the NICU.

Donor Human Milk Banking: History and Current Trends (Dr. Mai Phung)

  • History of Milk Banking
  • Current Practices in Use of Donor Milk

Making Enough Milk When You are Sick Yourself:  Evidence and Case Studies in Delayed Lactogenesis and/or Maternal Complications (Dr. Spatz)

  • Review physiologic barriers to the initiation and maintenance of lactation in mothers with complicated pregnancies, chronic diseases, and breast surgeries, including:  elevated BMI, diabetes, hypertension, psychiatric problems, and autoimmune disease.
  • Differentiate between the diagnosis and management of delayed onset of lactation and primary lactation deficiency, applying these principles to breast pump dependent women with NICU infants.
  • Apply principles from selected case study examples to clinical practice.

Transition from Pumping Mother to Breastfeeding Mother:  Ideology versus Evidence (Drs. Meier and Spatz)

  • Review the scientific evidence for common "readiness to feed" criteria that impact both breast and bottle feeding initiation in the NICU.
  • Discuss the barriers to initiation and management of at-breast feedings for premature and term surgical infants in the NICU, including:  physiologic stability, energy expenditure, knowledge and adequacy of intake, and duration of feeding.
  • Describe the evidence and the utility of common lactation aids such as nipple shields and test-weights for preventing, diagnosing and managing progressive feeds at breast in the NICU infant.
  • List parent teaching "toolkits", talking points and other resources for managing at breast feedings during the late NICU and early post-discharge period.

Beyond the Consultation "Visit" in the NICU:  Embedding Lactation Care into the Fabric of NICU Practice for All Disciplines:  The Rush Mothers' Milk Club Model (Dr. Meier)

  • Detail the complementary roles of neonatologists, NNPs, bedside nurses, dietitians, NICU breastfeeding peer counselors and the nurse lactation specialist in providing lactation care in the NICU.
  • Articulate evidence about the feeding of human milk versus formula or donor human milk in the presence of maternal medications and other risk factors, using an evidence-based risk-to-benefit perspective.
  • Describe the effectiveness of and strategies for including families in understanding the "science" of human milk and lactation for their NICU infants.
  • Apply talking points, toolkits and clinical case studies from the Rush Mothers' Milk Club to individual practice.

Beyond the Consultation "Visit" in the NICU:  Embedding Lactation Care into the Fabric of NICU Practice for All Disciplines:  The Breastfeeding Resource Nurse Model (Dr. Spatz)

  • Compare and contrast the responsibilities for providing evidence-based lactation care in a birth hospital versus a children's hospital.
  • Describe the conceptualization, implementation and evaluation of the Breastfeeding Resource Nurse model at Children's Hospital in Philadelphia.
  • Apply talking points, toolkits and clinical case studies from the CHOP Breastfeeding Resource Nurse model to individual practice.

Ask the Experts:  What is the Most Challenging Lactation/Human Milk/Breastfeeding Problem in Your NICU?  (Drs. Meier and Spatz)

  • How do you acquire resources to establish and/or update NICU lactation care practices in today's health care environment?
  • What criteria do you use to choose and/or prioritize lactation/human milk products in the NICU--e.g., what questions should you ask to be cost-effective, evidence-based consumers?
  • Within a cost-effectiveness/cost-benefit perspective, what are the most important interventions to implement to support the use of human milk in the NICU?
  • We have a neonatologist who doesn't "believe" in human milk.  What studies should we give him/her?
  • We need to make a compelling argument for the economic case for using human milk in the NICU.  How do we start?
  • We have a children's hospital "foundation" that supports other clinical programs.  How can we approach it to provide breast pumps to mothers? 


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