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Peer-reviewedCC BYCureus

Operationalising a Comprehensive Lactation Management Centre in a Tertiary NICU in North India: A Retrospective Implementation Study With Before-After Comparison of Breastfeeding and Counselling Coverage

  • Anu Sharma1
  • Aishwarya Kashyap2
  • Vaishnavi Pandey3
  • Alok Kumar Singh4
  • Muskan Sharma2
  • Ashok Kumar5
5 affiliations
  1. 1Pediatrics/Neonatology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
  2. 2Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
  3. 3Public Health Research, Community Empowerment Lab (CEL), Varanasi, IND
  4. 4Pediatrics and Child Health, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
  5. 5Pediatrics, Heritage Institute of Medical Sciences, Varanasi, IND
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Abstract

Background: Feeding practices in neonatal intensive care units (NICUs) are often compromised by limited lactation support and mother-infant separation. A Comprehensive Lactation Management Centre (CLMC) integrates counselling, bedside lactation assistance and donor human milk banking within the NICU. Evidence on the real-world operationalisation of such centres in tertiary care institutions in India remains limited. This study describes the operationalisation of a CLMC in a tertiary NICU and evaluates its effect on exclusive breastfeeding and structured counselling coverage through a before-after comparison.

Methodology: This retrospective implementation study was conducted in the NICU and CLMC of a public-sector tertiary centre with 4,200-4,500 deliveries annually. Baseline feeding and counselling practices (April-June 2024) were compared with those in the post-implementation period (July 2024-July 2025). Core components included structured lactation counselling, bedside milk expression support, a functional donor human milk pathway, daily multidisciplinary rounds and WhatsApp-based coordination. Feeding and counselling indicators during the baseline and post-implementation periods, monthly operational trends and donor profiles were analysed.

Results: The proportion of mothers receiving structured breastfeeding counselling rose from 87/353 (25%) to 1,613/1,841 (88%). Exclusive breastfeeding at discharge increased from 25/56 (45%) to 436/534 (82%). Over the implementation period, 541 neonates received pasteurised donor human milk (PDHM), and the peak monthly donation volume reached 30,009 ml. Early initiation of milk expression, together with hands-on demonstration and lactation counselling, appeared to drive the change. Mother-infant separation and perceived low milk supply remained persistent barriers.

Conclusions: CLMC establishment was associated with improved exclusive breastfeeding and structured breastfeeding counselling coverage. As a retrospective analysis, these findings reflect associations rather than causal effects. Sustaining these gains requires ongoing lactation support and system-level coordination.

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Cite

BibTeXRIS
BibTeX
@article{sharma2026operationalising,
  title = {{Operationalising a Comprehensive Lactation Management Centre in a Tertiary NICU in North India: A Retrospective Implementation Study With Before-After Comparison of Breastfeeding and Counselling Coverage}},
  author = {Anu Sharma and Aishwarya Kashyap and Vaishnavi Pandey and Alok Kumar Singh and Muskan Sharma and Ashok Kumar},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.118825},
  url = {https://europepmc.org/article/PMC/PMC13721027},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Operationalising a Comprehensive Lactation Management Centre in a Tertiary NICU in North India: A Retrospective Implementation Study With Before-After Comparison of Breastfeeding and Counselling Coverage
AU  - Anu Sharma
AU  - Aishwarya Kashyap
AU  - Vaishnavi Pandey
AU  - Alok Kumar Singh
AU  - Muskan Sharma
AU  - Ashok Kumar
PY  - 2026
DA  - 2026/10/30
JO  - Cureus
DO  - 10.7759/cureus.118825
UR  - https://europepmc.org/article/PMC/PMC13721027
AB  - Background: Feeding practices in neonatal intensive care units (NICUs) are often compromised by limited lactation support and mother-infant separation. A Comprehensive Lactation Management Centre (CLMC) integrates counselling, bedside lactation assistance and donor human milk banking within the NICU. Evidence on the real-world operationalisation of such centres in tertiary care institutions in India remains limited. This study describes the operationalisation of a CLMC in a tertiary NICU and evaluates its effect on exclusive breastfeeding and structured counselling coverage through a before-after comparison.  Methodology: This retrospective implementation study was conducted in the NICU and CLMC of a public-sector tertiary centre with 4,200-4,500 deliveries annually. Baseline feeding and counselling practices (April-June 2024) were compared with those in the post-implementation period (July 2024-July 2025). Core components included structured lactation counselling, bedside milk expression support, a functional donor human milk pathway, daily multidisciplinary rounds and WhatsApp-based coordination. Feeding and counselling indicators during the baseline and post-implementation periods, monthly operational trends and donor profiles were analysed.  Results: The proportion of mothers receiving structured breastfeeding counselling rose from 87/353 (25%) to 1,613/1,841 (88%). Exclusive breastfeeding at discharge increased from 25/56 (45%) to 436/534 (82%). Over the implementation period, 541 neonates received pasteurised donor human milk (PDHM), and the peak monthly donation volume reached 30,009 ml. Early initiation of milk expression, together with hands-on demonstration and lactation counselling, appeared to drive the change. Mother-infant separation and perceived low milk supply remained persistent barriers.  Conclusions: CLMC establishment was associated with improved exclusive breastfeeding and structured breastfeeding counselling coverage. As a retrospective analysis, these findings reflect associations rather than causal effects. Sustaining these gains requires ongoing lactation support and system-level coordination.
SN  - 2168-8184
ER  -