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Furthering Our Understanding of the Needs of Mothers Who Are Pumping Breast Milk for Infants in the NICU: An Integrative Review

Lucas, Ruth PhD, RNC-IPO, CLS; Paquette, Rebecca; Briere, Carrie-Ellen PhD, RN, CLC; McGrath, Jacqueline G. PhD, RN, FNAP, FAAN

Section Editor(s): Ikuta, Linda

doi: 10.1097/ANC.0000000000000110
Foundations in Newborn Care

The purpose of this integrative review was to uncover information regarding emotional and other types of support required by mothers providing breast milk for infants in the neonatal intensive care unit (NICU). These high-risk infants are often unable to directly breastfeed and, thus, mothers need to pump their breast milk for weeks to months, which can be both a pleasing experience that increases satisfaction and infant involvement, while at the same time being an uncomfortable and tiring endeavor. Understanding this notion is important because pumping at least 8 times each day is central to increasing or maintaining breast milk production. Articles were gathered using PubMed and CINAHL databases. Forty-four sources were chosen for inclusion in this review. Search terms included “breastfeeding,” “pumping,” “neonatal intensive care unit,” “emotional support,” and “breast milk.” We identified that the emotional and practical support for NICU mothers is different from those of other breastfeeding mothers, especially around the development of early bonding behaviors. These mothers require significant ongoing emotional support from healthcare professionals and their partners and peers. Healthcare providers need to monitor breast milk production and provide educated encouragement that anticipates breastfeeding challenges, especially when the mother is pumping for an extended period of time while their infant is maturing in the NICU. Effective providers' support may be best provided by selectively bundling interventions to support pumping initiation and transition to direct breastfeeding.

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University of Connecticut School of Nursing, Storrs, and Nursing Research, Connecticut Children's Medical Center, Storrs.

Correspondence: Ruth Lucas, PhD, RNC-IPO, CLS, University of Connecticut School of Nursing, Unit 4026, 231 Glenbrook Dr, Storrs, CT 06269 (

The authors thank the University of Connecticut's Undergraduate Social Sciences, Humanities, and Arts Research Award for the funding.

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

© 2014 by The National Association of Neonatal Nurses