Abstract
Breast milk usage among very low birth weight (VLBW) infants remains under-utilized in the U.S., at approximately 40 percent, even though it is associated with improved neurodevelopmental outcomes. Current research indicates the use of breast milk with VLBW infants significantly decreases associated pathologies such as necrotizing enterocolitis (NEC), enteral feeding intolerance, nosocomial infection, and retinopathy of prematurity. A breast feeding initiative with several modified interventions started at a Level III NICU in 2008 that significantly increased breast milk usage and reduced the occurrence of NEC in VLBW infants. When initiated, breast feeding rates among VLBW infants was 30 percent with NEC rates at 7.5 percent. Initially, the program's focus targeted educating parents of VLBW infants on benefits of breast milk. After two years, breast milk usage among VLBW infants had increased to 45 percent, but NEC had increased to 9.5 percent. At that time, neonatologists examined feeding protocols and initiated a conservative, standardized feeding approach with emphasis on breast milk-only feedings when possible. In addition, a dedicated NICU lactation consultant was instituted. In 2011, breast milk usage increased to 48 percent and NEC rates deceased to 5.5 percent, and by 2012, breast milk usage was 51 percent and NEC was 1 percent.