Increased lactation risk for late preterm infants and mothers: Evidence and management strategies to protect breastfeeding

Late preterm infants (34 0/7-36 6/7 weeks of gestation) are often cared for in general maternity units by clinicians who have limited experience with the specific needs of these newborns. Although the benefits of human milk are well documented, mothers and their late preterm infants are at risk for poor lactation outcomes. These include early breastfeeding cessation and lactation-associated morbidities, including poor growth, jaundice, and dehydration. Late preterm infants are more likely than term infants to develop temperature instability, hypoglycemia, respiratory distress, jaundice, feeding problems, and to require rehospitalization in the first 2 weeks postbirth. Breastfeeding can exacerbate these problems, because late preterm infants often lack the ability to consume an adequate volume of milk at breast, and their mothers are at risk for delayed lactogenesis. This article reviews strategies to protect breastfeeding for the late preterm infant and mother dyad by establishing and maintaining maternal milk volume while facilitating adequate infant intake. J Midwifery Womens Health 2007;52:579-587 (c) 2007 by the American College of Nurse-Midwives.