Table 1

Components of the care bundle

Element DescriptionActions required for delivering this elementTime periodStaff involved
1Promotion of early expressing of breast milk
Promoting the use of maternal breast milk
  • Antenatal/postnatal: ▸   Discuss the benefits of maternal breast milk ▸   Provision of an information pack and supporting materials (syringes, labels, Small Wonders DVD, Bliss leaflets) to support expressing and breast feeding Postnatal: ▸   Support breast feeding and/or expressing within 4–6 h of delivery ▸   Consistent advice through ‘Top Tips’ ▸   Pump hire information ▸   Staff/maternal review of milk expressing and volumes

Ideally antenatally but if unachievable, within
4–6 h of delivery
Midwives, lactation specialists, maternity support workers, neonatologists, neonatal nurses, neonatal support workers, nursery nurses
2Ongoing support for expressing and breast feeding up to discharge
  • Staff/maternal review of milk expressing and volumes

  • Daily promotion of positive touch/supportive holding/kangaroo care

  • Pump hire information

  • Discussing maternal queries, for example, diet, rest/sleep

  • Facilitating transition to breast feeding as appropriate

Day 10 up to dischargeNeonatal nurses, neonatologists, lactation and breastfeeding specialists, dieticians, speech and language therapists
3Standardised enteral feeding guideline
  • Categorising infants ≤35 weeks according to risk for NEC ▸   Initiating and advancing enteral feeds by following the algorithm and feeding guideline

From birth to dischargeNeonatologists, neonatal nurses, dieticians
4Aseptic non-touch technique when preparing milk feeds
  • Following a double checking prompt which follows best practice for defrosting and storing human milk, reducing the risk of incorrect feed administration and avoiding contamination of feeds during preparation

When milk feeds are being stored and preparedAll staff involved in the storage and preparation of milk feeds
  • NEC, necrotising enterocolitis.