A couple of days ago there was a letter from a lactnetter, who said that
there were BFHI guidelines about preterm babies' readiness to begin
breastfeeding: 33 weeks and a certain weight. I assume that these
guidelines must be local, as the BFHI program does not specify anything
about preterm infants. If so, which country/countries have developed BFHI
guidelines for preterm infants? In my country, Sweden, a working group has
just started preparing a BFHI re-evaluation (I hope you all know that 100%
of Swedish hospitals are baby-friendly), and will also formulate a BFHI
policy for neonatal units and child health services.

Furthermore, I was very surprised to see guidelines about a certain
gestational week or weight as requirements for initiation of breastfeeding.
There is no scientific evidence behind such general guidelines, although
they appear to be rather common all over the world. In a study about the
development of preterm infants' breastfeeding behavior, I myself have made
a prospective study of preterm infants' progress at their mother's breast,
and am presently analyzing the data. As a preliminary finding, I would only
like to mention that the most immature infant I have observed during
brastfeeding was 27 weeks. This baby girl latched on and sucked in short
sucking bursts, and maintained an excellent oxygen saturation. At 33 weeks,
most babies in my study were well on their way in their "breastfeeding
career".

Kerstin Hedberg Nyqvist, University Children's Hospital, Uppsala, Sweden

P.S. Those of you who met me in New Orleans during the ILCA conference and
got my card: The e-mail address was incorrect: Please use this one:
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In our setting, the only guideline for initiation of breastfeeding is that
the baby does not need ventilator/CPAP and is not considered fragile.