Ten steps for promoting and protecting breastfeeding for vulnerable infants.

Human milk is the preferred food for infants, including ill and preterm infants. Ensuring skilled and comprehensive breastfeeding support for these vulnerable infants requires a specialized approach. The author outlines 10 steps for promoting and protecting breastfeeding in vulnerable infants. The steps include providing the parents with information necessary to make an informed decision to breastfeed; assisting the mother with the establishment and maintenance of a milk supply; ensuring correct breast milk management (storage and handling) techniques; developing procedures and approaches to feeding the infant breast milk; providing skin-to-skin care (kangaroo care) and opportunities for non-nutritive sucking at the breast; managing the transition to the breast; measuring milk transfer; preparing the infant and the family for infant hospital discharge; and providing appropriate follow-up care. Material and examples are drawn from the author's research and clinical work at the Children's Hospital of Philadelphia. Current research is utilized, and the role of the nurse is emphasized throughout.