The lack of privacy -- if it causes mothers to miss feedings or makes them too timid to express milk -- is an even greater health risk for low-weight premature newborns, because milk enriched with the mother's antibodies helps ward off infection and gastrointestinal problems.

"The meaning of privacy might differ for mothers and the hospital. This calls for new ways to create privacy for these mothers who want to breastfeed," said Donna Dowling, the lead researcher from the CWRU nursing school. Dowling and Mary Ann Blatz, a doctorate of nurse practice student and lactation consultant, collaborated on the study reported in the journal Advances in Neonatal Care article, "Mothers' Experiences Expressing Breast Milk for their Preterm Infants."

The study surveyed 40 new mothers -- 15 in multiple-bed NICU rooms and 25 in single-family rooms.

Dowling, a Case Western Reserve professor and an advocate for breastfeeding, expected mothers in the single-family NICUs would find the process easier, quieter and more private than those in multi-family units.

But they didn't. The new moms overwhelmingly reported they would rather express breast milk at home, citing privacy and comfort concerns.

New mothers need to express milk eight to 10 times daily for 15 to 20 minutes in a newborn's first weeks, and six to eight times a day to maintain the milk supply after that.

The mothers said that possible interruptions while pumping kept them from starting pumping for fear of missing progress reports during a doctor's rounds. Missing the meeting might mean waiting hours before being able to meet with the doctor again. The respondents also felt uncomfortable expressing milk in front of the doctor or groups of doctors making rounds, Dowling reports.

Of the 40 mothers, 75 percent said before giving birth that they planned to breastfeed. But when their babies were discharged, only 45 percent breastfed their babies exclusively.

Interruptions and privacy weren't the only concerns, though. Mothers with newborns in NICU who must also juggle family, home and work responsibilities also found it difficult to meet their pre-birth aspirations to breastfeed their newborns exclusively.

The American Academy of Pediatrics recommends feeding babies breast milk exclusively for the first six months of life, with continued breastfeeding until at least 12 months.

Also contributing to this article was Gregory Graham, an instructor at CWRU's Frances Payne Bolton School of Nursing.