Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia.
Haley Abugov, Sandra Catalina Ochoa Marín, Sonia Semenic and 1 others
PMID 33687815WHAT IT FOUND
In a Colombian NICU, 51 infant charts showed 98% received mother's milk and 96% breastfed before discharge, but 65% received formula for their first oral feed and only 10% intended exclusive breastfeeding after discharge.
Key findings
01In 51 chart-reviewed infants, 98% received mother's milk during NICU stay and 96% were fed directly at the breast at least once before discharge, but 65% received formula for their first oral feed and only 10% of mothers intended exclusive breastfeeding after discharge.
02The unit had a breastfeeding resource person and a family-centered care approach, but observations and records showed limited privacy, restricted pump access, no supervised clinical breastfeeding training for staff, and a policy barring milk expressed outside the unit.
03At discharge, 94% of infants were registered for community Kangaroo Program follow-up and parents received written breastfeeding guidance, but lack of comfortable rest facilities and rooming-in amenities limited parental presence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study assessed one NICU, so findings may not apply to other units. The self-assessment was completed by unit managers, who may have reported practices more positively than bedside staff or parents. The chart review lacked systematic documentation of several breastfeeding-related indicators, such as skin-to-skin time, pumping volumes, and bottle use. The study did not collect parents' own perceptions of breastfeeding support. It is descriptive and did not test whether any change in practice improved breastfeeding outcomes.
Declared interests
Funding was from McGill University graduate mobility and global health awards, a fellowship from the Institute for Health and Social Policy, Universidad de Antioquia, and Hospital San Vicente Fundación. No other conflict-of-interest statement is provided in the supplied text.
The easy way to misread this
Do not read the 98% mother's milk rate as proof that Neo-BFHI practices were fully implemented. This was a single descriptive NICU assessment, not an intervention trial, and chart and observation data showed frequent formula use, bottle feeding, limited staff training, and barriers to milk expression.