DesignA quasi experimental design was used to meet the objectives of this study. Settings: The setting for this study involvedtwo university hospitals with tertiary level NICUs in Beirut-Lebanon. Each unit consisted of 20–25 beds with a neonatologiston site. The NICU environments in both hospitals did not have any protocols related to cluster care or developmental care andthere was no policy for noise or light levels control. Heel-sticks are performed every 4 h, as a routine policy in both hospitals.Mothers are encouraged to breastfeed as soon as the infant was able to suck and to express their milk in a designated roomwith an electrical breast pump