An analysis by researchers at Children’s Hospital of Philadelphia suggests that providing enhanced postpartum support directly in the neonatal intensive care unit (NICU) may help parents of very preterm infants continue to give breastmilk for longer. The findings were reported in the Journal of Perinatology.
The single-center PeliCaN trial, conducted at the Hospital of the University of Pennsylvania with CHOP neonatologists from November 29, 2022, to November 7, 2023, embedded trained doulas and a certified nurse‑midwife (CNM) in the NICU to provide emotional support, breastfeeding education, latch and pumping help, and coordination with the infant’s care team. Thirty‑seven parents of infants born before 34 weeks’ gestation were enrolled within about two weeks of delivery and randomized to receive either the enhanced in‑unit postpartum support (doulas and CNM) or standard NICU support which includes lactation services.
Mother’s milk gives preterm and medically fragile infants vital protection from infection and support for brain development. Breastfeeding also benefits mothers’ long‑term heart and cancer health. Yet many new NICU mothers face barriers – stress of a NICU stay, logistical challenges, and systemic disparities – that make it difficult to continue exclusive breastfeeding for the recommended six months.
A prior analysis published last year in the American Journal of Obstetrics & Gynecology MFM reported that the intervention improved access to timely, essential postpartum health services during a critical period. For this secondary analysis, researchers followed the subgroup who had already initiated lactation at enrollment to six months using a standardized breastfeeding survey as a marker of intent to breastfeed.
There was strong follow‑up among the participants – 34 of 37 completed the six‑month survey. Among the 29 who began expressing milk before enrollment, half (7 of 14) in the intervention group were still providing breastmilk at six months versus just 2 of 15 in the control group.
“We attribute the successful outcomes to combining practical help with emotional support,” said Heather H. Burris, MD, MPH, the study’s corresponding author and an attending neonatologist at CHOP. “Doulas assisted with logistics such as milk transport and pumping, and ensured mothers stayed hydrated and nourished. The midwife worked closely with the maternal and neonatal medical teams to clarify breastfeeding safety during maternal medication use. We think these efforts maximized mothers’ capacity and willingness to continue to provide milk for their babies.”
The authors said the study’s findings are encouraging. They recommend additional research to confirm the effect in larger, multicenter trials, to explore which components of the intervention matter most and to assess cost and feasibility for broader implementation.
Funding for this study was provided by grants from Optum and the March of Dimes Research Center to Advance Maternal Health Equity.
Baumann et al. “Breastfeeding Continuation at 6 Months among Mother-Infant Dyads Participating in the Postpartum Care in the NICU (PeliCaN) Pilot Trial. J Perinatol. Online March 6, 2026. DOI:10.1038/s41372-026-02616-x.
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An analysis by researchers at Children’s Hospital of Philadelphia suggests that providing enhanced postpartum support directly in the neonatal intensive care unit (NICU) may help parents of very preterm infants continue to give breastmilk for longer. The findings were reported in the Journal of Perinatology.
The single-center PeliCaN trial, conducted at the Hospital of the University of Pennsylvania with CHOP neonatologists from November 29, 2022, to November 7, 2023, embedded trained doulas and a certified nurse‑midwife (CNM) in the NICU to provide emotional support, breastfeeding education, latch and pumping help, and coordination with the infant’s care team. Thirty‑seven parents of infants born before 34 weeks’ gestation were enrolled within about two weeks of delivery and randomized to receive either the enhanced in‑unit postpartum support (doulas and CNM) or standard NICU support which includes lactation services.
Mother’s milk gives preterm and medically fragile infants vital protection from infection and support for brain development. Breastfeeding also benefits mothers’ long‑term heart and cancer health. Yet many new NICU mothers face barriers – stress of a NICU stay, logistical challenges, and systemic disparities – that make it difficult to continue exclusive breastfeeding for the recommended six months.
A prior analysis published last year in the American Journal of Obstetrics & Gynecology MFM reported that the intervention improved access to timely, essential postpartum health services during a critical period. For this secondary analysis, researchers followed the subgroup who had already initiated lactation at enrollment to six months using a standardized breastfeeding survey as a marker of intent to breastfeed.
There was strong follow‑up among the participants – 34 of 37 completed the six‑month survey. Among the 29 who began expressing milk before enrollment, half (7 of 14) in the intervention group were still providing breastmilk at six months versus just 2 of 15 in the control group.
“We attribute the successful outcomes to combining practical help with emotional support,” said Heather H. Burris, MD, MPH, the study’s corresponding author and an attending neonatologist at CHOP. “Doulas assisted with logistics such as milk transport and pumping, and ensured mothers stayed hydrated and nourished. The midwife worked closely with the maternal and neonatal medical teams to clarify breastfeeding safety during maternal medication use. We think these efforts maximized mothers’ capacity and willingness to continue to provide milk for their babies.”
The authors said the study’s findings are encouraging. They recommend additional research to confirm the effect in larger, multicenter trials, to explore which components of the intervention matter most and to assess cost and feasibility for broader implementation.
Funding for this study was provided by grants from Optum and the March of Dimes Research Center to Advance Maternal Health Equity.
Baumann et al. “Breastfeeding Continuation at 6 Months among Mother-Infant Dyads Participating in the Postpartum Care in the NICU (PeliCaN) Pilot Trial. J Perinatol. Online March 6, 2026. DOI:10.1038/s41372-026-02616-x.
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