Maternal educational support and practices to enhance breast milk flow among mothers of high-risk neonates in the neonatal intensive care unit: A quasi-experimental study

Introduction: Mothers of high-risk neonates are separated from their infants while lactation is being established, and low expressed milk volume in the first week often leads to early supplementation.Aim and Objectives: To evaluate the effect of a structured package of maternal educational support and lactation practices on expressed breast milk volume and to identify variables associated with the volume achieved.Materials and Methods: A quasi-experimental time-series non-equivalent control group study was carried out in a tertiary paediatric neonatal intensive care unit in Chennai, India. One hundred and twenty mothers were recruited by convenience sampling. The experimental group (n = 60) received a ten-component bedside teaching and practice package reinforced daily; controls (n = 60) received routine instruction. Volume expressed in 24 hours was recorded daily on days 1–7.Results: The groups were comparable at baseline (day 1: 35.6 ± 8.27 versus 35.1 ± 8.07 mL; p = 0.738). By day 7 the experimental group expressed 88.2 ± 12.50 mL against 62.1 ± 11.29 mL (t = 12.00, p < 0.001). The mean increase was 52.6 ± 13.02 mL (147.8%) versus 27.0 ± 11.44 mL (76.9%) (t = 11.44, p < 0.001), with a large group by time interaction (F = 67.91, p < 0.001, η²p = 0.365). Day 7 volume was associated with maternal education, previous breastfeeding experience, gestational age and regularity of antenatal care (all p < 0.05).Conclusion: A structured, nurse-delivered package of educational support and lactation practices produced a substantially steeper rise in expressed milk volume during the first week than routine teaching alone, and requires no additional resources.