3: Unrestricted access to breastfeed and to receive breastfeeding support

(including early hand expression, pumping support and supplies, encouragement, and lactation support) for their infant in the NICU.

Expressing breast milk as soon as possible, ideally within the first three hours after birth, is linked to increased milk production.

Chapter 3 Key Points

Awareness

  • Breast milk is critical medical nutrition
  • Encouragement and hands-on help increase supply
  • Early expression builds confidence and bonding
  • Consistent lactation support reduces inequities

Assessment

  • Review policies on breast pumping and storage
  • Evaluate availability of pumps and supplies
  • Identify barriers to feeding at the bedside
  • Audit staff training and consistency of support
  • Assess equity in access for non-birthing parents

Action

  • Offer pumping (<1 hour of birth)
  • Provide on-site lactation consults and mentorship
  • Supply hospital-grade pumps and refrigeration
  • Feeding plans in daily rounds
  • Normalize milk expression and breastfeeding in NICU culture

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Authors

Malathi Balasundaram, MD

Jessica Daigle, MD

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© 2026 Family-Centered Care Taskforce. Family-Centered Care Taskforce. All rights reserved. This toolkit may be reproduced and distributed freely for educational and non-commercial purposes with attribution. Any use of this content must acknowledge the Family-Centered Care Taskforce as the source. No portion of this toolkit may be altered or used for commercial purposes without prior written permission. Custom illustrations created for this project are for FCC Taskforce toolkit use only and may not be altered or reused separately.

DISCLAIMER
Readers are advised to adapt the guidelines and resources based on their local facility’s level of care and patient populations served and are also advised not to rely solely on the guidelines presented here.