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Best Milk

Interdisciplinary Guidelines 
and Recommendations for the




of Optimal Infant Feeding

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 National Association of Neonatal Therapists (NANT) 2024 Conference

Advocates for Best Milk Practices:

Neonatal Therapists as Breastfeeding Champions

Friday, April 12th    11:15 AM – 12:15 PM    Azalea Ballroom

Neonatal therapists are powerful advocates and champions of breastfeeding.

The first two weeks after birth are a critical time, during which the dyads learn to latch, build milk supply, establish feeding patterns, and communicate feeding cues of readiness and satiation. How breastfeeding challenges are managed can set the tone of feeding relationships.


This presentation aims to disseminate Best Milk Practices according to a recent literature review and future publications by the National Perinatal Association in the Journal of Perinatology. This presentation highlights recommendations from the third paper in the series, which provides an overview of best practices to optimize exclusive breastfeeding for neonates through the early post-partum period.


Six themes will be discussed based on a careful review of the literature, including (1) early postpartum care, including safe milk storage; (2) disparities in breastfeeding/chestfeeding, access to lactation care; (3) challenges of prematurity/medically fragile infants, (4) post-discharge outpatient breastfeeding support: providers, public health initiatives and community interfaces, (5) infant feeding factors and accommodations, and (6) considerations for special populations.


Neonatal therapists partner with parents to provide developmental support and anticipatory guidance for infants and their families. Recent studies have shown that intervention by a neonatal therapist in the mother-newborn dyad during the first hours of the newborn’s life positively affected breastfeeding establishment through improvements in latching and positioning (Medeiros et al., 2017) and that a lack of neonatal therapy involvement, especially in regard to determining oral feeding preparedness for premature newborns at the breast, can negatively influence health outcomes (Monti et al., 2013). Minimizing the conflicting messages parents receive and building cross-professional consensus on interventions can significantly improve breastfeeding rates in the US. Timely support and expertise in the management of these common situations are critical, along with the knowledge of where to refer the breastfeeding dyad for specialized support.

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Aleksandra Popkowska, MS, CCC-SLP, CNT, IBCLC, NTMTC   

Aleks is a Speech-Language Pathologist and Certified Neonatal Therapist with over 5 years of experience working with medically complex and challenging feeding cases in NJ/NYC/Brooklyn areas. She is an International Board Certified Lactation Consultant and Neonatal Touch and Massage Therapist Certified provider, who currently works in a Level III Neonatal Intensive Care Unit (NICU) and outpatient clinic focusing on feeding/swallowing disorders. As a full-time clinician working with premature, medically fragile infants and complex pediatric patients. Aleks works to facilitate comprehensive assessment and treatment of feeding and swallowing disorders, lactation support to mothers of nursing infants, fosters positive mealtimes with caregivers across a variety of social settings and facilitate whole body/holistic care strategies to promote bonding and development in the context of feeding. 


Maria Fisher, CNM, MSN, MPH, IBCLC  

Maria Fisher has been practicing full-scope midwifery since graduating from the University of Pennsylvania in 1999, where she won the Joyce E. Thompson Award in Women’s Health and the Undergraduate Nursing Research Award, and was a Hillman Graduate Fellow. After 10 years in private practice in NYC, she joined the team at Stony Brook Medicine on Long Island. In 2009, she added breastfeeding medicine to her practice. At Stony Brook, Maria established its first hospital-based outpatient breastfeeding service. This service provides lactation support to families with complex breastfeeding and lactation issues. In 2019, Maria was invited to join the Board of the National Perinatal Association and assumed the role of co-project manager of the Best Milk Project. This project, funded in part by the Kellogg Foundation, looks at evidence-based guidelines for best practices surrounding infant feeding in the prenatal, perinatal and postpartum period. It also identifies breastfeeding challenges, barriers, and best practices to address them. Maria left a career in hospital management to pursue her calling to become a midwife. She holds a master's in public health, health policy and management from Columbia University and a bachelor’s in classics from Union College. Maria also is an adjunct faculty member of the NYU Rory Meyers College of Nursing. Maria is a mother to 3 children, all born at home and breastfed beyond 2 years of life.


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