The Baby Friendly Program here at UCSD Medical Center has created the opportunity for us to support all mothers that wish to breastfeed their newborns, including premature infants.  Providing breast milk is one of the most important physiologic benefits a mother can give her premature infant.  Breast milk provides the infant with all the nutrition necessary for growth, conveys anti-infective properties, supplies enzymes to assist with digestion, and decreases the incidence of NEC.  Breastfeeding is an experience that increases mother-infant bonding in a stressed environment, the NICU.   The mother also benefits by supplying breast milk with decreased rates of anemia, cancer and better bone mineralization.
There are many challenges to providing human milk for premature infants.  These infants are small, immature, and may not be able to feed by mouth for several months.  To provide human milk for her sick baby or premature babies, a mother has to pump her breast 8-10 times a day and bring the milk into the hospital regularly.  Being successful at this requires the right equipment, strong support and a lot of effort and dedication on the part on the whole family.  Even the most dedicated mother may tire of her goal to pump milk for her premie as the months pass. 
Bedside nurses continually support the mother in her effort to supply milk for her infant but we created a program to help mothers and NICU staff in this endeavor.  This program utilized a multidisciplinary approach to create consistent protocols to help teach and support the NICU staff and the mother in her pumping efforts.  This collaborative effort is striving to reach a goal of 80% human milk provision for our premature infants, to assure the first “gut-priming” feedings are human milk (either mother’s own or donor milk), that every premature infant receives human milk throughout the hospital stay, and that the nutritional plan is tailored to each mother/infant dyad utilizing breast milk and nutritional analysis.    
The program consists of parent, nursing, physician, nurse practitioner, dietary, lactation and social work education to promote the production of human milk for premature infants.  We purchased a milk analyzer that after further research will enable better nutritional analysis of supplied breast milk.  We created specific policies and protocols to ensure consistency across the board.  There was mandatory staff education to teach the NICU nurses and providers how to best support mothers.  We have monthly SPIN meeting and weekly SPIN rounds to keep updated.
The SPIN program is an ongoing process and we hope to continue to learn and grow.  We are currently in the process of collecting data to analyze how successful we have been.