What is the Milk Drop Method?
The Milk Drop Method is an evidence-based practice that improves feeding outcomes and has significantly shortened the length of stay for very premature infants. This intervention actively engages infants by placing droplets of milk on their lips, and based on the infant’s response, additional milk is offered.
As the infant begins to associate hunger with the enjoyment of eating, they are also practicing sucking, swallowing, and breathing – the adaptive motor skills critical for successful oral feeding.
Initially designed to support the neurodevelopment of oral feeding readiness in preterm infants, the Milk Drop Method has since been adopted for older infants in both neonatal and pediatric care settings.
Milk Drop Steps
1. A few droplets of milk are placed on the infant’s lip so he can smell and taste the milk.
2. A swab or pacifier is offered by gently stroking the infant’s lips.
3. If the infant accepts the swab or pacifier by opening their mouth...we will offer more milk a droplet at a time...pacing the infant as they suck.
4. If the infant sticks out their tongue or just licks the milk...we will offer more milk a droplet at a time...pacing the infant as they lick the milk.
5. If the infant doesn’t respond, we’ll let them rest and try again at their next feeding.
Key Components: Milk Drop Method
Micro-Dose Tasting
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Droplets of milk are offered to the infant
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Provides enjoyable experiences of taste and smell
Cue-Based Pre-Feeding
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More milk is offered based on the infant’s cues and response.
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Promotes and reinforces positive feeding behaviors.
Gut and Immune System Support
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Even tiny amounts of milk help prime and engage the digestive system.
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Provides nutrients and antibodies that help strengthen immunity.
Neurodevelopmental Benefits
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Provides sensory-motor experiences normally learned in the womb.
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Infants practice sucking, swallowing, and breathing with droplets of milk.
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Helps stimulate and develop upper airway protection.
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Socially engages the infant as the caregiver spends time gently touching, talking, and offering milk drop.
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Positive oral experiences help buffer the negative oral experiences of routine NICU care
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Consistency helps wire the association of hunger to the enjoyment of eating.
Improved Parent Bonding and Satisfaction
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Promotes parental involvement from birth with scent-heart bonding.
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Encourages breastfeeding and skin to skin holding
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Parents often offer milk drops to their infant.
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Parents learn to understand their infant’s cues and responses
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Parents are more confident when breast or bottle feeding starts
Shortened Hospital Stays & Cost Savings
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Accelerates e transition to full oral feeding, leading to shorter hospital stays.
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Reduces healthcare costs while improving long-term outcomes.
Articles & Citations
Bingham, Peter M. “Deprivation and Dysphagia in Premature Infants.” Journal of Child Neurology, vol. 24, no. 6, 1 June 2009, pp. 743–749, https://doi.org/10.1177/0883073808329530.
Pickler, R. H., McGrath, J. M., Reyna, B. A., McCain, N., Lewis, M., Cone, S., Wetzel, P., Best, A. (2010). A model of neurodevelopmental risk and protection for preterm infants. The Journal of perinatal & neonatal nursing, 24(4), 356– 365.doi:10.1097/JPN.0b013e3181fb1e7
Shubert, T. R., et al. “Effects of Pacifier and Taste on Swallowing, Esophageal Motility, Transit, and Respiratory Rhythm in Human
Neonates.” Neurogastroenterology & Motility, vol. 28, no. 4, 4 Jan. 2016, pp. 532–542, https://doi.org/10.1111/nmo.12748.
O’Rourke, B., Fuller, K., Parker, L., Moore, T. (2022). Provision of positive oral experiences for premature infants by offering milk drops: A clinical practice change initiative. Journal of Neonatal Nursing. 10.1016/j.jnn.2022.11.014.
Séassau, Alexia, et al. “Neonatal Care Unit Interventions on Preterm Development.” Children (Basel), vol. 10, no. 6, 2 June 2023, pp. 999–999, https://doi.org/10.3390/children10060999.
Selman, R., &; Aleksandra Popkowska. (2024). Optimizing Neonatal Prefeeding Habilitation: A Holistic Approach Integrating Neonatal
Learning Behaviors, Motor Development, and Evidence-Based Interventions. Neonatal Network the Journal of Neonatal Nursing, 43(4), 199–211. https://doi.org/10.1891/nn-2024-0004