Nutrition & Feeding

Dear colleagues, good day to all! Allow me to share with you some thoughts on non-nutritive feeding. We all know the important role of non-nutritive sucking, its significance in the formation of a healthy infant gut microbiota and psychological comfort for mother and child. But we rarely consider the differences in the structure of the nipple skin from the rest of the skin. The nipple skin is extremely resistant to mechanical and chemical stress, and the breastfeeding period is a case in point. Any other area of skin becomes malignant as a result of chronic mechanical and chemical trauma associated with breastfeeding. Any area, but not the nipple skin. And I thought about…

Dear Colleagues and Neonatology Experts, We are currently rewriting our internal protocols regarding bacteriological screening and CMV management of maternal milk (MOM) for hospitalized preterm infants. While our primary goal is maximum safety, we are guided by the principle of non-maleficence (Primum non nocere). This creates a complex clinical challenge: how do we protect the infant from potential pathogens (infection risk) without causing harm by destroying vital bioactive and immunological components through over-processing (nutritional/developmental risk)? Furthermore, we must avoid the harm of unnecessarily discarding precious breastmilk—a practice that exhausts res…

I’d love to hear from the 99NICU community about your go-to references. A few years ago, our team cared for a remarkable mother whose story reminded us how much nuance—and teamwork—breastfeeding counseling can require. She had undergone a liver transplant as a teenager and remained on lifelong anti-rejection medications. Years later, she delivered a healthy full-term baby and had a strong, heartfelt wish to breastfeed. As you can imagine, her medications raised questions about safety and infant exposure. Instead of defaulting to “no,” our team—neonatologist, clinical pharmacist, and the mother’s own transplant specialist—reviewed each drug carefully. We dove deep into pha…

Breastfeeding mothers having propofol sedation at surgery, may have green discoloration of the breast milk, I just read a short clinical pharma column in the Swedish Medical Journal. I found this longer case report from Canada about this, it seems propofol metabolites can discolour biological fluids other than urine. The authors advice no breast feeding until the color has normalised. Rare thing but still interesting to know and be aware of! https://pmc.ncbi.nlm.nih.gov/articles/PMC6306180/

Dear colleagues, I would love to read your thoughts on how you manage moderate/late preterm infants admitted in the NICU who do not have enough mother's milk. How do you feed them? Do you prefer to keep them on IV fluids/PN until MOM is available? Do you have unlimited donor milk to use for every baby? How is your level of concern about cow's milk allergy (CMA)? I work in a teaching hospital in South Brazil and I'm an enthusiast (aren't we all?) on improving breastfeeding rates in the NICU. How things work here: we have a limited resource of human donor milk, so we prioritize it to newborns under 32 weeks (when MOM is not available, of course). For babies older than that,…

Dear colleagues, We are a medium sized hospital in Germany with a donor milk bank. We are managing the procedures manually right now and are looking for a digital /software solution. Any suggestions for a usable software? Yours Nele Howold

Is there any good quality evidence around probiotics and reduction or increase in infections in neonates?

So thankful to Dandlelion Medical for this opportunity on May 8, 2025. Over 1500 NICU clinicians registered for this FREE live presentation and now it is available online for FREE CEU's at https://dandlelionmedical.com/webinars/

Do you use mct oil in feeding premature babies?

What I would like neonatologists to know about the Norwegian RCT on Immediate SSC for Very Preterm Neonates A recent randomized clinical trial published in JAMA Network Open challenges assumptions about the neurodevelopmental impact of immediate skin-to-skin contact (SSC) for very preterm infants (28–31 weeks’ gestation). Conducted across three Norwegian neonatal units (2014–2020), the study compared 2 hours of SSC in the delivery room versus standard incubator care, following 108 stable preterm neonates until age 2–3 years. While the primary outcome—neurodevelopmental scores on the Bayley-III—showed no difference between groups, the trial confirmed SSC’s significant ben…