Breastfeeding the high risk infant: Implications for midwifery management

The mother of a high risk infant is confronted with numerous parenting chal lenges, not the least of which is the decision about how to nourish her vul nerable newborn. Successful breastfeeding depends on overcoming obstacles p osed by infant condition, maternal health, and the neonatal intensive care environment. These obstacles include maternal separation from the nursing i nfant during hospitalization, delayed initiation of the expression of breas t milk due to maternal illness and/or surgery, the inability to suckle her infant or feed on demand, and the lack of sufficient maternal follow-up aft er discharge. This article reviews the benefits of providing breast milk to high risk infants, problems that may be encountered by mothers of high ris k infants, and the interventions that may be used by the midwife to facilit ate the breastfeeding process. (C) 2000 by the American College of Nurse-Mi dwives.