PURPOSE: To assess the effectiveness of an educational intervention aimed at staff and parents in changing breastfeeding practices in the NICU. DESIGN: The breastfeeding education initiative consisted of three parts: breastfeeding training for NICU staff, issuance of complementary breastfeeding materials to mothers of infants in the NICU, and addition of a breastfeeding pathway to the individualized care plan. Infants admitted before and after the initiative were compared to evaluate for changes in breastfeeding practices. SAMPLE: The study sample included very low birth weight (VLBW) infants hospitalized in the NICU for more than seven days and born weighing <1,500 g. Infants were grouped based on whether they were admitted before (pre-intervention) or after (post-intervention) implementation of the education initiative. MAIN OUTCOME VARIABLES: Health care professional (HCP) knowledge of breastfeeding interventions in the NICU was measured using a posttest following training. Breast milk feeding initiation rates, breastfeeding rates, and rates of breast milk feeding at discharge were measured via retrospective chart review among pre- and post-intervention infant groups. RESULTS: The post-intervention group demonstrated significant improvement in rates of breastfeeding (infants being put directly to the breast) in the NICU compared with the pre-intervention group. General positive trends in breast milk feeding initiation (up 11 percent) and breast milk feeding at discharge (up 5 percent) were observed, but these increases failed to reach significance.