Preterm infants discharged from the NICU require ongoing breastfeeding support after hospital discharge.

Excerpts from the Academy of Breastfeeding Medicine Protocol #12. "Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home" reinforce the important role of early breastfeeding support after NICU discharge, when families are seeing their primary care provider: 

• “Nutrition monitoring as early as possible, preferably within 72 hours.”
• “Take detailed feeding history… details on providing expressed human milk versus direct breastfeeding, a full pumping history, and the use of fortified human milk or formula.  Ask the mother how she is coping with caring for the infant and discuss revising the feeding plan if not sustainable…” 
• “Observation of a feeding”
• “Weekly following-up until the infant has demonstrated appropriate growth on the feeding plan”
• “Ideally, all mothers discharged from the NICU with a breastfeeding or human milk feeding infant should have follow-up examinations with a trained, skilled lactation professional within 2 to 3 days after discharge for ongoing support and troubleshooting”

All of these excerpts highlight yet another opportunity for integrated primary care/lactation consultant visits to improve access to needed breastfeeding support. 

Protocol #12 makes clear that team-based care is critical support infrastructure for our families of preterm infants. That's why we've put together a video, handouts, and a space for virtual community support toward the development of Team-Based Care Lactation Care in primary care offices.

CLICK HERE for the Research on Team-Based Care

Research Updates

Breastfeeding vs Bottle feeding for Preterm Infants

• This study assessed the first oral feeding of preterm infants, focusing on oxygen saturation, heart rate, volume taken, and feeding performance.
• Breastfeeding improved oxygen saturation and decreased heart rate, and infants took more volume more efficiently at the breast than with bottle.
• from Journal of Pediatric Gastroenterology and Nutrition, Feb 2026

Galactogogues & Low Milk Supply

• A systematic review of "Herbal galactagogues to improve breastmilk production and lactation in mothers of preterm babies" examined 10 randomized controlled trials that included preterm infant mothers. 
• They noted while prior reviews in term infants noted a positive effect on milk volume, there are limited studies in preterm infants.
• The authors concluded there is low certainty of evidence that the studied galactagogues may increase milk supply for preterm infants specifically, and more high quality research is needed for these families. 
• from Nature, December 2025

Breastfeeding, bonding, and olfaction

• How important is our babies' sense of smell for establishing breastfeeding and bonding?  The authors of this paper review the importance of considering how human mothers and neonates communicate through odor and establishing policies to support this.
• Facilitating policies include: maintaining proximity (such as holding baby skin to skin), allowing infants to learn smells (i.e. via breast crawl), and exchanging odors between mothers and infants when separated (i.e. preterm infants in the NICU).
• from The Lancet, January 2026

Helpful Resources

• Feeling pressed for time?  Check out our blog post Time for Primary Care Breastfeeding Support.
• Handout for parents Hypoglycemia: Low Blood Sugar in Newborns, from Academy of Breastfeeding Medicine
• Three to Five Days Postpartum: A Gap in Care details why breastfeeding support integrated into the routine first outpatient primary care visit should be standard of care.