There is overwhelming evidence in the literature that human milk is superior to any form of nutrition for the neonate. It contains immunological, nutritional, and developmental properties that prevent infection, provide individualized nutrition, and optimize brain growth and visual development. Recent studies have proven that the protective factors in colostrum are even more concentrated in the colostrum of women who deliver low birth weight (LBW) infants. This population of patient in the Neonatal Intensive Care Unit (NICU) is most vulnerable to morbidities including Necrotizing Enteral Colitis (NEC) and nosocomial infections. Human milk decreases the incidence and severity of nosocomial infections and NEC. Is also has been proven to protect against gastrointestinal and respiratory infections. Its perfect combination of protein, carbohydrates, and plasma proteins improves gastric emptying which promotes feeding tolerance. The purpose of this project is to promote buccal care in LBW infants in the NICU using mothers’ colostrum.

Proposed change:

The nursing intervention of buccal application of mom’s colostrum potentially decreases the incidence of certain morbidities and decreases the length of stay of these fragile infants. The proposed change in practice is to institute a policy of buccal application of colostrum in the NICU. The infants are being followed longitudinally for outcomes related to this care.

Implementation, outcomes and evaluation:

A protocol for the buccal application of mother’s own colostrums as well as banked breast mill for all LBS infants (<1500 grams) was developed and implemented in January, 2011. Staff education was completed via power point presentation at staff meetings. The completed policy also includes an education sheet for parents in order to encourage their participation in this bedside practice.

Implications for nursing practice:

  Due to availability of colostrums in the early days, moms are being encouraged to begin pumping within 6 hours of delivery and pump on a prescribed schedule. We created syringe kits with detailed instructions for the collection of mom’s breast milk to avoid waste.

Ongoing education of staff and parents is imperative to the successful implementation of this policy.

Keywords:

Low Birth Weight Babies

Breastmilk

NICU

Buccal Care

In initial review of charts since the start of this policy revealed that access to colostrum takes several days and compliance with the policy is varied. Currently, longitudinal data is being collected on the infant outcomes post treatment.