In gestations with high risk of prematurity or potentially needing admission to the Neonatal Care Unit, prenatal admission is an opportunity for communication with the pregnant women.
Evidence-based counseling about the benefits of human milk feeding is a public health intervention that improves breastfeeding rates. Repeated prenatal informational interviews are more effective than isolated interventions and should be documented in the medical record.
A protocol with systematized information, adapted to the individual needs of the pregnant woman and her family, administered with sensitivity, that considers the social aspects and cultural context for prenatal breastfeeding discussion facilitates the work. This should include:
– The importance of human lactation.
– The value of colostrum and of the earliest possible initiation of lactation.
– Milk production as a process that sets in progressively, even after an extremely premature birth.
– Manual milk expression and frequent pumping.
– The benefits of bank milk if it is available, noting that it is only a "bridge" to achieving exclusive human milk feeding until the baby sucks and active milk production is established in the mother.
– The risks of giving formula or other human milk substitutes.
– The importance of immediate and sustained skin-to-skin contact, rooming in, recognition of infant cues for feeding, good positioning and bonding, exclusive breastfeeding for the first 6 months, and as an important food after 6 months when incorporating complementary foods.
Among the Ten Steps for breastfeeding preterm, small and/or sick newborns, the standard to be achieved under Step 3 is that at least 80% of pregnant women who received antenatal care:
• Report having received antenatal breastfeeding counseling.
• Can adequately describe what was discussed about two of the topics mentioned
