Use of Donor Milk to Improve Exclusive Breast-Milk Feeding Rates for Newborns on the Mother–Baby Unit

Abstract

Important health organizations, including the Joint Commission, the American Academy of Pediatrics, and Healthy People 2020, are in agreement with the recommendation that infants exclusively receive breast milk for the first 6 months. Even when mothers intend to exclusively breastfeed, many experience milk-supply challenges in the first few days and are faced with a temporary need to provide supplemental nutrition. The purpose of this program is to provide an option for continued human-milk feeding as an alternative to formula supplementation and to support exclusive breast-milk feeding. In addition to standard breastfeeding support, we suggested offering pasteurized donor human milk (PDHM) on the mother–baby unit to families who wished to exclusively breastfeed but medically needed to supplement. A proposal was made to hospital administrators to purchase a supply of PDHM from a milk bank for a trial period. A policy was developed using the Academy of Breastfeeding Medicine’s appropriate volumes for supplementation; the policy outlined a practice to support newborns who met medical indications for up to 96 hr while mothers worked on building their own milk supply. After education of the nursing staff, the PDHM program was implemented in April 2018. Data were collected according to the Joint Commission’s Perinatal Care (PC)-05 Exclusive Breast Milk Feeding criteria before and after program initiation; rates of mothers’ intentions to exclusively breastfeed on admission to the hospital were also determined. Within 2 months of program implementation, exclusive breast-milk feeding rates exceeded the 70% goal for the first time in 3 years. This sustained increase occurred although the rate of mothers’ intentions to exclusively breastfeed remained the same. Having donor milk available for early supplementation helps families meet their breastfeeding goals and supports current infant-feeding recommendations. This, in turn, leads to improved health outcomes for both newborns and mothers. A program such as this demonstrates the power of collaborative efforts among nurses, lactation consultants, physicians, and hospital administration.