Breastfeeding Plan of Care for the Late Preterm Infant From Birth Through Discharge

The focus of this clinical practice case is on the initiation of successful breastfeeding in the late preterm infant. The exploration of a case of a late preterm infant born at 36(0)/(7) weeks' gestation, delivered via cesarean section, at risk for breastfeeding challenges. Common difficulties encountered in the late preterm, defined as 34(0)/(7) to 36(6)/(7) weeks' gestation, include delayed lactogenesis, decreased milk transfer, and ineffective suck and swallow. This may lead to hospital readmission due to inadequate weight gain, dehydration, and/or hyperbilirubinemia. These difficulties often result in premature breastfeeding cessation. A management strategy incorporating an individualized mother's breastfeeding plan of care across 2 care continuums is a unique feature in this case presentation. Assessment of the mother-infant dyad provides the foundation to develop clinical strategies to initiate prompt individualized lactation support for the late preterm infant. Interventions focus on establishing maternal milk supply, facilitating milk transfer, and providing breast milk to the newborn. This case illustrates how developing an individualized in-hospital breastfeeding plan for the late preterm infant, followed by comprehensive primary care follow-up at discharge, can reduce the risk factors that lead to readmission in the late preterm birth and promote breastfeeding success.