Lactation promotion strategies among mothers of preterm infants experiencing mother-infant separation: a best evidence summary

Abstract Background Mother-infant separation is common among mothers of preterm infants requiring neonatal intensive care and may complicate the establishment and maintenance of lactation when direct breastfeeding is not feasible. Although various lactation promotion strategies have been reported, the evidence remains fragmented across different evidence sources. This study aimed to synthesize the best available evidence on strategies for promoting lactation among mothers of preterm infants experiencing mother-infant separation. Methods A systematic search guided by the 6 S evidence model was conducted across major international and Chinese databases and relevant professional websites from inception to February 17, 2026. Included literature types encompassed systematic reviews, guidelines, expert consensus statements, evidence summaries, and clinical decision support resources. Evidence was extracted, appraised, and synthesized using the Joanna Briggs Institute (JBI) Evidence Pre-grading and Recommendation System. Results A total of 32 evidence items were synthesized into 11 domains, covering professional lactation support, health education and skills, lactation assessment, lactation initiation, lactation monitoring, implementation considerations, breast pump, lactation promotion, galactagogues, herbal galactagogues and human milk management. However, uncertainty remained regarding several specific clinical parameters and adjunctive interventions. Conclusions This evidence summary provides a clinically relevant overview of strategies for promoting lactation among mothers of preterm infants experiencing mother-infant separation. Overall, the available evidence may support a comprehensive approach to lactation care, although certainty varies across interventions and specific clinical parameters. The findings may inform clinical practice, but should be interpreted in the context of individual maternal and infant circumstances and local healthcare resources. Further research is needed to strengthen population-specific evidence and clarify areas of continuing uncertainty.