Introducing donor human milk to the NICU: Lessons for Australia
There is an increased use of pasteurised donor human milk (PDHM) in North American neonatal intensive care units (NICU) in order to achieve exclusive human milk (EHM) feeding for preterm infants. Australia, on the other hand, is relatively new to reintroducing PDHM to NICUs. Very little is known about the perception of multidisciplinary NICU teams toward PDHM. This article reports on a survey of 89 NICU clinicians that was implemented during the first weeks of PDHM use in an American NICU, and was repeated 6 months later. Their knowledge and opinions of PDHM in addition to their inclination to recommend its use were evaluated using thematic coding and descriptive statistics. We found that after a 6-month trial, preparedness to recommend PDHM increased to 93%. We found that NICU clinicians' support for PDHM exceeded their knowledge about its risks and benefits and clinicians requested education about various aspects of PDHM. This research in this article aims to assist clinical staff educators as they go about introducing PDHM in NICUs.
Available from: Katherine E Carroll
- "In Australia there are five HMBs, but unlike the in U.K. and the U.S.A., there is no national advocacy association that co-ordinates the ideal operating guidelines for HMBs in Australia. Instead, Australian HMBs operate within a confluence of regulatory systems recommended by the NICE and HMBANA guidelines, Hazard Analysis and Critical Control Points (HACCP) system safety procedures, and relevant state and federal governmental legislations (Hartmann et al. 2007; Carroll and Herrmann 2012). "
Available from: Catherine Ruth Mackenzie
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ABSTRACT: ARTICLE AT: http://jhl.sagepub.com/content/29/2/222.short
BACKGROUND: The beneficial effects of breastfeeding for mothers and babies are well recognized. When maternal breast milk is not available in sufficient quantity, donor breast milk is recommended as an alternate source of nutrition, particularly in preterm and other high-risk infants. Australia lags behind the rest of the developed world in establishing and promoting human milk banks; there is no human milk bank in South Australia and little is known concerning mothers' perceptions of using human milk banks in that state.Objective:This study explored mothers' knowledge of and attitudes toward human milk banks, to inform the development of human milk banking policies and guidelines in South Australia should a milk bank be established.
METHODS: In-depth semistructured interviews were conducted with 12 mothers who were breastfeeding and/or had preterm or sick babies. In addition, 2 focus groups were conducted-1 with breastfeeding mothers as potential donors (n = 5) and the other with mothers of preterm or high-risk infants (n = 4) - to answer questions raised by early analysis of the individual interview data.
RESULTS:Breastfeeding mothers, as potential donors, unanimously supported donating their breast milk to a human milk bank, provided it would be easy (especially if required to drop off milk) and not overly time consuming. Mothers of preterm or sick infants would use a human milk bank if they were assured the milk was safe and appropriate for their babies.
CONCLUSION:Study participants would welcome having access to a human milk bank for both donating and receiving milk in South Australia.
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ABSTRACT: Numerous short and long-term benefits of breastfeeding the full-term infant have been acknowledged. The use of human milk in the neonatal intensive care unit (NICU) is emerging as the beneficial effects are being realized. Challenges facing the practitioners today include providing optimal storage and processing strategies for mother's own milk (MOM), as well as offering an alternative when MOM is unavailable or supply is insufficient. We review the health benefits of human milk for the ELBW infant and the strategies for optimal use of the milk in the NICU.
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