Late preterm and early term infants are at higher risk for complications and need extra breastfeeding support:
“Recognize that some early term infants, born between 37 0/8 and 38 6/7 are also at higher risk compared with term infants… for problems including hyperbilirubinemia, hospital readmission, and reduced breastfeeding initiation and durations.”
This excerpt from the The Academy of Breastfeeding Medicine (ABM) Protocol #10 highlights some of the challenges. The protocol also provides an overview of the extra support needed and practical counseling points including:
"Many of these infants will not effectively suckle when first offered the breast, so consider hand expression and feeding expressed colostrum to the infant... after the first attempted breastfeed"
"If the mother and infant are separated, the mother should begin hand expression of colostrum within the first hour of birth and at ~3 hour intervals"
Click Here to review the full protocol.
"Late Preterm and Early Term Infants" is one of several breastfeeding challenges topics covered in our course Primary Care Breastfeeding Support: The First Weeks. Interested in an overview of the course?
Click to learn more & access course content download
All March we are focusing on medical education for students and residents!
- For individual students interested in learning more but not needing CME or CERPS, you can get 50% off course access all month long! This gives you access to the FULL First Weeks Course for only $10! Just enter coupon code STUDENT50MAR26 at checkout.
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Research Updates
Antenatal Hand Expression
- The Express-MOM study adds to the research on the safety of antenatal hand expression to not induce preterm labor.
- Healthy nulliparous women were enrolled at 34 weeks of pregnancy and randomized to 10 minutes, 2 times daily of antenatal hand expression or the control group.
- 55 women completed the study and there was no difference in gestational age between the groups with a median age at delivery of 40 weeks in both groups.
Physician specialties not in direct contact with breastfeeding
- Training in lactation is important for all physicians, even those who only indirectly come in contact with breastfeeding families (i.e. an ER physician treating a breastfeeding parent for a medical condition)
- This survey of physicians in a health care system identified: of the physicians who treated a breastfeeding women at least once a year, 87% reported limited training, and 57% reported using a reliable source to look up information like drug compatbility
- More training in breastfeeding is needed and perhaps a multidisciplinary approach to breastfeeding education may help support more families.
- from International Breastfeeding Journal, 2025
Experiences of Lactation for Medical Trainees
- Personal experiences with lactating co-residents may improve knowledge of lactation and patient care
- from Maternal and Child Health Journal, 2025
Helpful Resources
- VIDEO: The Basics of Breast Massage and Hand Expression, from Breastfeeding Medicine of Northeast Ohio
- First Droplets: resources about hand expression from Jane Morton and her team at Stanford-- includes videos, resources for professionals, and information in many languages about maximizing milk production in the first 5 days postpartum
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