Nurse-Driven Initiative to Increase Exclusive Human Milk Feeding by Using Pasteurized Donor Human Milk to Treat Hypoglycemic Term Neonates

Abstract

ObjectiveTo increase exclusive breastfeeding by offering pasteurized donor human milk (PDHM) to newborns with hypoglycemia. DesignQuality improvement project. Setting/Local ProblemA Baby-Friendly Hospital Initiative–designated urban academic medical center in the northeastern United States serving a diverse population where, by policy, virtually all newborns with hypoglycemia received supplemental infant formula. Approximately 85% of women cared for at this center initiate breastfeeding, but many struggle with exclusive breastfeeding during the hospital stay. ParticipantsAll staff members in the labor and delivery unit and the mother/baby unit, including registered nurses, unit clerks, patient care technicians, and lactation consultants. Term, breastfed newborns identified as being hypoglycemic per our guidelines were eligible to receive PDHM. Intervention/MeasurementsRegistered nurses provided education about PDHM to parents of newborns who were hypoglycemic, obtained consent, and initiated the order. We offered PDHM instead of infant formula when mother’s own milk was not available in sufficient quantity per our hypoglycemia guidelines. We measured newborns’ glucose levels and monitored breastfeeding outcomes, including continued breastfeeding. ResultsDuring the 4-month trial, 83 newborns were eligible for PDHM. Of those, 76% of parents opted for PDHM rather than formula. Most newborns in both groups were still breastfeeding at discharge, and 53% of those who received PDHM were fed human milk exclusively during their hospital stays. ConclusionA nurse-driven protocol offering PDHM to otherwise healthy newborns with hypoglycemia is a viable option for increasing exclusive breast milk feeding during the hospital stay.