Purpose for the Program
Preterm infants are at considerable risk of increased morbidity and mortality. They have a higher risk of learning disabilities, cerebral palsy, sensory deficits, respiratory illnesses, and gastrointestinal illnesses. Providing mother's own milk to the preterm infant has nutritional, gastrointestinal, immunological, developmental, and psychological benefits. Breastfed preterm infants have a lower rate of ear infections, respiratory infections, or infection-related events. They have lower rates of gastrointestinal infections, necrotizing enterocolitis, and mortality. Breastfed preterm infants are discharged earlier from the neonatal intensive care unit than formula-fed preterm infants. In this vulnerable preterm infant population, the rate of mothers who provide their own milk is less than mothers who delivered healthy newborns. When a mother's own milk is unavailable, the American Academy of Pediatrics recommends pasteurized human donor milk.
To provide premature infants with the access to pasteurized human donor milk when their mother's own milk is unavailable.
Implementation, Outcomes, and Evaluation
The pasteurized donor milk program was instituted in conjunction with other lactation support interventions to increase the amount of mother's own milk as the primary source of infant nutrition.
New York State requires a tissue license for infants to receive pasteurized human donor milk. The tissue bank compliance officer was contacted and the application form C, viewing section 405.25 organ and tissue donation, was submitted. Policies and procedures were implemented according to the regulations. A Human Milk Banking Association of North America was identified as donor human milk bank.
Informed consent is obtained from the parents. Frozen milk is shipped in dry ice. Upon arrival to the unit, the milk is inspected and placed in bins in the freezer. A donor milk utilization log with the patient's identification, number of bottles and ounces, batch number of donor milk, and signature/print of the nurse removing the milk from the freezer is initiated when milk is removed from the freezer. This information is kept for 7 years. To date 27 infants have received pasteurized human donor milk.
Implications for Nursing Practice
Mothers of premature infants in the neonatal intensive care unit are encouraged and supported with lactation interventions to provide their infants with their own milk. When a mother's own milk is unavailable pasteurized human donor milk is available.