Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Newborn Care

Breastfeeding Support




The Lactation team

Bronwyn Bernerius, Andrea Laidler, Jean Paterson, Heather Taylor

The RPA Newborn Care team recognises that breast milk is the optimal food for babies, particularly the sick and preterm. The neonatal intensive care and special care nurseries at RPA have provided a specialist high risk lactation service since 1983 and the service when commenced was probably the first of its kind in Australia.

The lactation team consists of four registered nurses with graduate qualifications in midwifery and / or neonatal nursing and child health. All lactation consultants have extensive experience in neonatal  care and are certified with the International Board of Lactation Consultants (IBLC). The team has presented its work at both national and international lactation forums and provides a resource for many midwives and nurses working with high risk families and infants.

In collaboration with the medical / nursing team in the neonatal intensive care unit the lactation service is committed to supporting mothers in their goal to initiate and establish a milk supply for their high risk infant. The lactation team provides support and guidance for the mothers and infants in the neonatal nurseries and also provides a referral and consultation service for the medical / nursing team seven days per week.

This service uses an inter professional approach that includes the provision of evidence based information, education and emotional support for mothers.The team also works closely with the postnatal midwives while mothers are inpatients and also provides ongoing lactation support and advice after mothers are discharged home. With this consistent support and education mothers are able to consolidate their lactation skills and confidence before discharge of their infants from the neonatal nursery.

Following discharge families and infants are usually visited and followed up at home by our family support nurses. If needed, the family support nurses are able to consult with and discuss possible management options with the lactation service. The service also provides a resource for the neonatologists in their outpatient clinics.

A unit based donor breast milk programme was initiated in 2005 and was maintained by the lactation service. The Australian Red Cross took over the provision of Donor Milk  to all NICUS in NSW in 2018. The RPA programme facilitates the supply of donor breast milk to those infants whose mothers are unable to supply their own milk usually due to illness. Use of donor milk follows discussion between the family and senior medical / nursing personnel and informed consent. Infants who may benefit from donor breast milk include those at high risk of necrotising enterocolitis regardless of gestational age and infants less than 30 weeks gestation where mother's own milk is not available.

Donor milk is often donated by mothers with babies in our nursery who have a supply of milk in excess of their own infant's requirements. These mothers' efforts and generosity are acknowledged as the donor process is complex and includes informed consent before agreeing to the strict screening criteria that is required fo the programme.

The lactation team provides inter professional and ongoing education and clinical advice in the nurseries. This commitment has facilitated the development of a culture and standard of best practice that strongly advocates the important role of breast milk in the optimal management of the high risk infant and family.