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What Is the Impact of NICU-Dedicated Lactation Consultants? An Evidence-Based Practice Brief

Mercado, Kathryn DNP, APRN, NNP-BC; Vittner, Dorothy PhD, RN, CHPE; McGrath, Jacqueline PhD, RN, FNAP, FAAN

Section Editor(s): Parker, Leslie A.

doi: 10.1097/ANC.0000000000000602
Human Milk Science: Special Series

Background: Benefits of exclusive human milk diets for preterm and low birth-weight infants are well established. Despite known benefits, supporting mothers in the provision of mother's own milk for high-risk infants is challenging. Lactation support in the neonatal intensive care unit (NICU) is highly variable. Lactations consultants (LCs) are often shared between postpartum units and the NICU, potentially increasing LC workload with less time spent with high-risk mothers. Furthermore, less than half of NICUs in the United States staff an international board-certified lactation consultant. Limited understanding exists regarding impacts of NICU-specific lactation support on breastfeeding outcomes.

Purpose: The purpose of this evidence-based practice brief is to synthesize the literature on the impact of NICU-specific lactation support, LCs who work exclusively in the NICU, and provide guidance about how NICU staffing with LCs solely focused on supporting mothers of high-risk infants impacts breastfeeding outcomes for low birth-weight infants.

Search Strategy: CINAHL PLUS, PubMed, Cochrane Library, and OVID databases were searched using key words and restricted to English language.

Findings: During hospitalization, NICUs staffed with dedicated board-certified LCs have increased potential to yield improved breastfeeding rates through hospital discharge, increased proportion of infants who receive mother's own milk, and increased duration of breastfeeding or human milk expression through hospital discharge.

Implications for Practice: Human milk nutrition is related to improved outcomes for high-risk infants. Neonatal intensive care unit–specific lactation support can potentially optimize maternal breastfeeding practices and improve outcomes for high-risk infants.

Implications for Research: There is a need for further studies pertaining to NICU-specific lactation consultants and influences on breastfeeding outcomes.

University of Connecticut, School of Nursing, Storrs (Drs Mercado, Vittner, and McGrath); Pediatrix Medical Group, Las Vegas, Nevada (Dr Mercado); Valley Health System, Las Vegas, Nevada (Dr Mercado); WakeMed Health & Hospitals, Raleigh, North Carolina (Dr Vittner); and The University of Texas Health Science Center, School of Nursing, San Antonio (Dr McGrath).

Correspondence: Kathryn Mercado, DNP, APRN, NNP-BC, Pediatrix Medical Group, 653 N Town Center Dr, Ste 112, Las Vegas, NV 89144 ( or

This study was conducted at the University of Connecticut, Storrs, Connecticut.

Jacqueline McGrath, who is an Editor-in-Chief for Advances in Neonatal Care and a coauthor of this article, was not involved in the editorial review or decision to publish this article. The entire process from submission, referee assignment, and editorial decisions was handled by other members of the editorial team for the journal.

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses