Thread by @Meg_Parker_MD

(1/5) Started drafting this in 2018!! A guide for evidenced based lactation support in the NICU! here are high points: 1) Lactation care is a Team Sport (not just IBCLCs!)

Promoting Human Milk and Breastfeeding for the Very Low Birth Weight Infant pediatrics.aappublications.org/content/early/…

(2/5); 2) The goal is to support mothers in their personal BF goals. This means actually assessing them and integrating into feeding plans; 3) Initiate milk expression by 6-8 hours; 4) Express Q3-4 hours;

(3/5): 5) Mothers of VLBWs need a "hospital grade" pump for hospital AND HOME to optimize milk production. Mothers need the pump and training before their own discharge home; 6) Consider pCMV as a cause of late onset sepsis; risk of pCMV does not outweigh risk of fresh BM

(4/5); 7) Encourage STS as much as desired. Many NICUs do STS with intubated babies with secured lines. These are not contraindications. 8) We re-affirm that MM is optimal nutrition source, give DM when MM not available and social disparities are a major issue to address;

(5/5): Notably- we do NOT have a recommendation regarding human HMF. We feel data does not consistently support this. Thank you! @crmartin90 @ravimpatelmd @DrM_Fam @AmyHairMD @alokapatelmd @MandyBelfort_MD #AAP