Guidelines for Primary Pediatric Care Professionals to Help Patients Establish and Protect Milk Supply.
Courtney N Slater, Diane L Spatz
PMID 40202439WHAT IT FOUND
Primary care nurses should assess 8-12 feeds or expressions in 24 hours, cue-based feeding, safe skin-to-skin, detailed feeding history, and delayed milk-production risk factors at newborn visits.
Key findings
018-12 direct feedings or expressions in 24 hours, including overnight, are recommended to facilitate establishment and maintenance of milk supply.
02Screening for delayed secretory activation risk factors should occur prenatally or at the first newborn encounter, with care coordinated for underlying conditions.
03Diaper output, stool transition, and weight loss not exceeding 7-10% of birth weight, with birth weight regained by 10-14 days, are recommended intake monitoring points.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a resource of recommendations, not a study that tested these steps in patients. It applies to healthy term infants and does not address premature, low-birth-weight, or hospitalized infants. Some suggested actions depend on nurse practitioner, midwife, physician assistant, or physician treatment plans, so nurses may not be able to complete them alone. There are no current universal risk factor screening tools for delayed secretory activation. The recommendations are informed by clinical experience as well as cited guidelines and research.
Declared interests
One author was a 2024 MCN Editorial Fellow and a National Institute of Nursing Research Ruth L. Kirschstein NRSA F31 predoctoral fellow. The authors declare no other relevant financial or non-financial conflicts of interest.
The easy way to misread this
Do not read these recommendations as proof that a specific pump or practice will increase milk supply. The paper is a clinical resource compiled from existing guidelines and prior research, with no original participants or outcomes.