Mothers of newborns in neonatal ICUs (NICUs) must express breast milk as often as 10 times a day. Yet they have difficulty finding private places in hospitals to pump milk. Single-family rooms offer some advantages over traditional multiple-bed rooms, but do they encourage longer feeding with breast milk?

Researchers at Case Western Reserve University and Rainbow Babies and Children's Hospital at University Hospitals Case Medical Center, both in Cleveland, Ohio, surveyed 40 new mothers-15 in multiple-bed NICU rooms and 25 in single-family rooms. Slightly more than half (55%) preferred to pump breast milk in their own homes, where they had more control over privacy and their environment. Surprisingly, women in single-family rooms favored home as much as women in multiple-bed rooms did.

Private single-family rooms don't ensure that mothers won't be interrupted while pumping, which, presumably, makes them uncomfortable. One woman told the researchers, "There are people constantly coming into the hospital room, and I don't want to miss talking to doctors-if they saw I was pumping and said they'd come back, it would be hours before they did." The study's authors believe this to be a strong indication that mothers and health care providers define privacy differently.

Seventy-five percent of mothers said before giving birth that they planned to breastfeed. However, only 45% exclusively breastfed when their babies were discharged, suggesting that NICU staff need to provide ongoing support and reassurance, even to women who seem to be doing well.

Offering hands-on breastfeeding classes for mothers and newborns while they're in the hospital makes mothers feel more confident, and breastfeeding support must continue through and even after discharge-with telephone follow-up, for instance, says Eileen DiFrisco, manager of perinatal support services at New York University's Langone Medical Center. DiFrisco adds that because NICU nurses often focus on the health of the baby, it isn't only new mothers but also NICU nurses who could benefit from additional breastfeeding training. A class with a certified lactation counselor, says DiFrisco, can make nurses "feel more confident about supporting new mothers."-Carol Potera

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