Implementing Use of Donor Breast Milk in the Well Baby Population: It's Not Just for the NICU Any More

Abstract

Newborn Care Paper Presentation Purpose for the Program Donor breast milk has been used in neonatal intensive care units (NICUs) since the 1990s and has been proved to increase infant survival rates. Since our hospital instituted the use of human donor milk in our NICU in 2011, we have seen a significant improvement in the incidence of necrotizing enterocolitis and survival rates. Exclusive breast milk feeding is now recognized as a Perinatal Core measure by the Joint Commission and defined as feeding infants no other nutrition besides breast milk (breast milk includes human donor milk). Therefore, to provide the best evidence-based feeding practices, UT Southwestern has begun the process of making pasteurized donor milk available to our well newborn population of infants who require medical supplementation of breastfeeding. Proposed Change Implementing the use of donor milk in our well infant population was a result of best practices research and education of staff and patients. Ethical considerations for the use of a limited resource and cultural practices that involved the use of donor milk also were explored, discussed, and adopted. Implementation, Outcomes, and Evaluation By applying ethical and evidenced-based best practice principles to the process, our staff implemented the controlled use of donor breast milk on the well infant unit. Innovative practices for this change included the creation of consent and information for parents, criteria for use, cost versus benefit analysis, procurement donor milk from sources approved by the Human Milk Bank Association of North America, and implementation of proper storage for the donor milk supplied. Implications for Nursing Practice Exclusive breast milk feeding is known to be the best practice for all infants. Infants in the well newborn population also may need supplementation of breastfeeding because of hypoglycemia, excessive weight loss, hyperbilirubinemia, and other associated factors. By offering donor milk as a means of supplementing these infants, we preserve the health benefits associated with exclusive breastfeeding and decrease the risk of readmission and potentially preventing an extended length of hospital stay.