Post-discharge nutrition of the breastfed preterm infant

Deborah L O'Connor; Sharon Unger

doi:10.1016/j.siny.2013.05.001

Post-discharge nutrition of the breastfed preterm infant

Semin Fetal Neonatal Med. 2013 Jun;18(3):124-128. doi: 10.1016/j.siny.2013.05.001. Epub 2013 May 21.

Authors

Deborah L O'Connor¹, Sharon Unger²

Affiliations

¹ Department of Nutritional Sciences, University of Toronto, Professional Practice and Research Institute, The Hospital for Sick Children, Room 8511C, 555 University Avenue, Toronto M5G 1X8, Canada. Electronic address: Deborah_L.oconnor@sickkids.ca.
² Department of Pediatrics, University of Toronto, Department of Neonatology, Mount Sinai Hospital, Toronto, Canada.

PMID: 23706724
DOI: 10.1016/j.siny.2013.05.001

Abstract

Provision of mother's own milk is the optimal way to nourish infants, including the preterm infant. The importance of mother's own milk during initial hospitalization to improve feeding tolerance, reduce serious infection and necrotizing enterocolitis is well appreciated. As a result, there has been a culture shift in neonatology such that breastfeeding is now encouraged and the majority of mothers of preterm infants attempt to express breastmilk. While more can be done during the hospital stay, nutrient intakes and growth are monitored and lactation support is provided. After hospital discharge, however, nutrient intakes and growth are frequently not monitored in a coordinated fashion and lactation support is often inaccessible. Few data are available to guide the clinician on the best approach to supporting the breastfed infant after discharge and expert guidance is frequently non-existent. This review provides evidence for a 'proactive' rather than a 'reactive' approach to supporting the breastfed preterm infant after discharge in terms of breastfeeding promotion, resolving acquired nutrient deficits, normalizing feeding and promoting optimal growth.