Peer role in neonatal intensive care unit boosts exclusive breastfeeding

A breastfeeding peer counselor program in Sunnybrook’s neonatal intensive care unit (NICU) has supported mothers and helped to increase the number of women who begin to breastfeed, and continue to breastfeed after they are discharged from the hospital.

During the pilot program, rates of exclusive breastfeeding on the day of discharge rose from 71 per cent to 75 per cent. The Canadian average is only 40 per cent.

Made possible with funds provided by the Government of Ontario and the support of the Best Start Resource Centre at Health Nexus, the program provides one-on-one breastfeeding support to women who have babies in the NICU. The counselors, women who have also had a baby in Sunnybrook’s NICU, work with mothers and the health care team to address barriers to exclusive breastfeeding.

“We knew our rates of breastfeeding exclusivity for preterm infants were lower than those mothers of full-term babies,” says Dr. Jo Watson, Chair of Sunnybrook’s Breastfeeding Centre of Excellence. “Younger mothers and those with hypertension or diabetes have lower breastfeeding rates when their babies are discharged from the NICU.”

Sunnybrook’s NICU cares for 20 per cent of babies born in Ontario weighing less than 1500 grams. The benefits of breast milk for premature and ill babies include decreasing the risk of life threatening necrotizing enterocolitis (a serious intestinal disease in premature babies), as well as decreasing infections and reducing length of hospital stay. Longer term, breast milk contributes to improved motor outcomes, cognitive skills, neurobehavioral organization as well as decreased use of health care services later in life.

Ophelia Kwakye has worked as a peer counselor in the NICU for the last year. “I understand what parents are feeling, especially if it is their first child. I enjoy talking to the moms on what to do and how to balance their time between hospital and home. It is important to acknowledge that it can be challenging to pump breast milk,” says Ophelia.

Feedback from mothers has been very positive, with 91 per cent saying they felt they achieved their goals regarding feeding their baby. The social support benefits were also positive, with 68 per cent saying they felt less anxious after meeting with the breastfeeding peer counselors or attending a weekly mothers’ lunch.

“Hearing the feedback from mothers with babies in the NICU has been reassuring: they feel more supported and less anxious. Providing another source of support for mothers while their baby is in the NICU was our goal and seeing breastfeeding rates increase confirms the value of peer support,” says Dr. Watson.