There are considerable challenges in providing nursing care of smallest of small premature infants in the Neonatal Intensive Care Unit (NICU) while supporting mothers in their role in the intensive, technology driven environment. Nurses must anticipate the physiologic needs of the infant and intervene appropriately while assessing for opportunities for meaningful mother-infant interaction. In addition, it is evident in practice that an increasing number of the NICU mothers choose to express breast milk for the feedings and have difficulty sustaining their supply amidst the stress of their experiences in the NICU. Interventions such as skin-to-skin holding that may support lactation and the physiologic needs of the neonate while offering meaningful mother-infant interaction play a major role in NICU nursing care. Nurses working with mothers of the most premature infants have noted in practice that skin-to-skin holding appears to facilitate the mother’s ability to produce increasing volumes of breast milk after holding, but this has not been empirically tested. This study quantifies this maternal experience of skin-to-skin holding premature infants as it relates to breast milk while contributing one of the few empirical studies that measures an important physiologic effect of holding.
Research examining the effects of early feedings of maternal breast milk to the smallest infants, particularly the very low birth weight (VLBW) with birth weights of less than 1,500 g, shows promising results including improved pulmonary outcome as well as decreased incidence of retinopathy, necrotizing enterocolitis and incidence of sepsis requiring long courses of antibiotic therapy.