Pregnant Mothers with Risk Factors for
Premature Delivery on the Antenatal Unit


Mothers of preterm infants decide to provide milk for their infants for different reasons than those of healthy term infants, usually related to the infant’s vulnerable medical condition (Sisk PM, 2006). Mothers who had not intended to breastfeed are not made to feel guilty, when asked to provide milk. In fact, they feel resentful if not fully informed of the advantages of their own milk for the infant (Miracle DJ, 2002).

Newly delivered mothers of preterm infants are typically unprepared and medically compromised for the task of pumping. Yet, initiating pumping within the first 6 hours and maintaining a schedule of >5 sessions/day is critical for the establishment of lactation (Furman, 2003). Therefore, the ideal time to approach any mother with risk factors for delivering prematurely is before delivery. The most successful approach involves all healthcare members taking an active supportive role. (Powers, 2003).

Suggested Measures

  1. With chart and physician input, assess patient for risk of preterm delivery and desire to care for a viable infant (i.e. no plans to adopt or abort infant).
  2. Discuss importance of breastmilk for all babies, but especially preterm infants, who get out of the hospital sooner and healthier if they receive mother’s milk.
  3. Offer to have her watch the video, "A Premie Needs his Mother" on closed circuit TV, and encourage her to have her family take a copy home for viewing, as the family will need to understand the importance of providing breastmilk and how to help.
  4. Show her: a) what a breast pump looks like, b) what a 1cc syringe looks like (the normal amount to be given to the baby right after birth), and c) what a pumping diary looks like.
  5. Discuss how we make every effort to help her begin expression immediately after delivery, and how her colostrum will be used right away for his/her baby’s “first immunization”.

Suggested Script

We encourage all of our mothers who have even a small chance of delivering prematurely to learn about the life-saving importance of breastmilk for small and sick babies. Because there is so much to learn, would you be willing to watch an award winning educational video, which was filmed here at Stanford? Many of our staff and families participated in this video.

If you do deliver prematurely, we would like to help you collect your babies “first immunization” (your colostrum) in the delivery room, just after your baby is born. Just as a healthy baby nurses right after birth, your colostrum can then be taken straight to the NICU for your baby. Once you’re back to your room, we’ll help you start pumping and recording each session in a diary.