Professional Documents
Culture Documents
Secondary Drivers
2.
A. Promote and use mothers milk as the preferred nutritional substrate for infants 1. Assess feeding intention and establish expectations related to premature birth upon admission
2. Provide early and continuous support to obtain mothers colostrum and milk
a. Inform all mothers at time of birth of benefits of their milk for their baby including mothers milk as medicine b. Use language that distinguishes providing milk from breastfeeding c. Encourage early initial visit to facilitate communication and assistance to obtain colostrum and milk a. Provide mother with access to appropriate pump (hospital-grade with double pumping kit) and provide necessary supplies b. Teach breast massage and relaxation techniques c. Teach hand expression & pumping techniques using mechanical pump d. Provide support from lactation consultant or other breastfeeding expert e. Provide daily review of mothers records of pumping and volume expressed a. Provide staff & parent education to promote skin to skin b. Encourage early maternal visits to include touch and skin to skin as soon as possible c. Encourage breast pumping immediately after each skin to skin interaction with mom d. Encourage non-nutritive sucking at the breast
C. Safety in the use of expressed human milk 1. Labeling, storage and administration of breast milk
e. Provide appropriate chairs and privacy screens for skin to skin and breastfeeding opportunities Actions: a. Provide early small volume feeds using moms colostrum every chance you get as soon as you get it b. Consider using pasteurized donor milk until moms milk is available c. Develop unit specific systematic feeding advancement guidelines including but not limited to volume, fortification, use of additional protein and an algorithm for residuals Actions: a. Adopt and follow national guidelines to include, but not be limited to type of containers, labeling protocols, and refrigerator/freezer temperatures b. Develop policies for the administration of breast milk to include, but not be limited to recipes and policies for fortification, warming, bolus feedings, and assuring correct milk for each baby a. Use only screened pasteurized milk b. Consider strategies to optimize growth in babies receiving donor milk c. Track batch number of milk given to infant Actions: a. Identify one senior administrative leaders briefed, updated and actively supporting the project a. Establish aim (s) b. Review current status of human milk use in the NICU c. Develop methods to communicate project aim and regularly report initiative progress to staff d. Identify methods to collect data on initiation, duration of feedings, exclusivity and patient experience e. Meet as a leadership team monthly to discuss project execution and results a. Consider whether NICU Lactation Consultant staffing is adequate to support nursing staff and mothers b. Offer breastfeeding support groups and peer support for in-patients and c. Refrain from accepting and distributing any infant formula marketing materials