ABSTRACT
A mother who wishes to breast-feed a baby of very low birthweight on a neonatal intensive care unit faces a range of difficulties which do not apply to the mother with a healthy term infant. An intensive care unit is a place of intense activity orientated towards measuring and controlling physiological variables and intervening to deal with recurrent crises. The staff are under continuous stress. Successful breast feeding under these conditions would be difficult even for a mother with a healthy responsive term infant. It is therefore important that one member of the staff, preferably a midwife, should take special responsibility for the mother who is attempting to establish lactation and has a very low birth weight baby. She should be carefully taught to express her milk in order to establish and maintain her lactation. She can express at times convenient to the hospital routine, usually 3-5 hourly, except perhaps at night.
