Vital Human Milk: Implementing a Donor Milk Program

Purpose for the program:

Preterm infants are at considerable risk for 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 lower mortality rates. Breastfed preterm infants are discharged earlier from the Neonatal Intensive Care Unit than formula fed infants. In this vulnerable population the rates of mothers providing mother's own milk are decreased, when compared to healthy newborns. When mother’s own milk is unavailable The American Academy of Pediatrics recommends pasteurized human donor milk.

Proposed change:

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 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, donor human milk bank was identified.  

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 mother’s own milk is unavailable pasteurized human donor milk is available.   

Keywords:

Pasteurized human donor milk

Expressed human milk

Human Milk Banking of North America

Lactation support