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Children’s Hospital Milk Techs Help NICU Babies Get ’Wonder Drug’

Mother's milk is a wonder drug.

Babies in the St. Louis Children's Hospital newborn intensive care unit routinely get a "wonder drug" — a miracle substance that helps them gain weight, strengthens their immune system, helps their organs develop, kills germs and reduces inflammation.

This medical marvel? Their mother's milk.

"Breast milk is treated just like a medicine. Doctors write orders for it. They prescribe the amount, prescribe calories needed and how often it's given," Rich Manley, RN, NICU assistant nurse manager, says.

Breast milk, loaded with substances important to the growth of any infant, is vital to the health of NICU babies, born desperately sick or breathtakingly early.

But unlike healthy babies for whom nursing is as simple as latching on, very sick or preterm babies, some weighing less than a pound, need help getting breast milk.

That's where a team of lactation consultants and milk technicians, as well as the NICU physicians and nurses, come in. After a baby arrives at the NICU, lactation consultants Mary Jo Butler, MSN, IBCLC; Tara Schneiderhahn, BSN, IBCLC; and Dora Downham, RN, IBCLC, work with the mother as soon as she arrives at the NICU.

"Our lactation consultants are passionate about the benefits of breastfeeding," says Manley. "They make it as easy as possible for moms to be successful breastfeeding."

In addition to educating mothers on breast milk's abundant benefits, Butler and Downham teach them the logistics of pumping, storing and transporting milk. Their efforts have resulted in a whopping 93 percent breastfeeding initiation rate.

"The more mothers know about all the health benefits of breast milk, the more likely they are to breastfeed," says Butler.

Breastfeeding can also help mothers connect to their baby. "It's a way for a mother to do something for her baby when she can't do anything else," Butler adds.

But sustaining breastfeeding throughout a patient's stay is just as important, and the entire NICU staff works to help moms continue feeding, encouraging them to use the four private lactation rooms in the NICU and troubleshooting for difficulties that might arise. "Knowledge equals initiation, but support equals duration," Butler says.

Dee Benardin and her fellow milk techs in the St. Louis Children's Hospital newborn intensive care unit prepare feeding for infants in the NICU and other nursing units.

After moms have produced milk, the babies need some help getting it. That's where Dee Benardin and her co-workers take over. Benardin is one of six milk techs at St. Louis Children's Hospital.

The milk techs work out of a small room lined with counters and specialized industrial refrigerators filled with pumped mother's milk and donor breast milk. Here, the techs prepare feedings for babies in the NICU and throughout the rest of the hospital as needed.

From 3-6 p.m., milk techs prepare breast milk feedings. NICU patients typically receive eight feedings over 24 hours, usually delivered through a nasal tube directly into the baby's stomach. The tiniest babies — some 400 grams, or less than a pound — might receive as little as 1 milliliter every 12 hours.

With an average of 35-40 patients in the unit, techs prepare about 250 "bottles" (actually small, disposable feeder tubes) each day, says Benardin.

Techs label bottles for each patient and fill them with their stored mother's milk. Each bottle is checked twice in the milk room and again at the bedside to make sure the patient is getting the correct milk, "like any medication," says Manley.

"We try to use fresh milk whenever possible," says Benardin. "Fresh milk can be kept refrigerated at least 48 hours." Milk is also frozen and thawed when needed.

Breast milk is considered so important for preterm and sick babies that SLCH began buying donated milk from the Mother's Milk Bank of Ohio two years ago. The practice is spreading rapidly throughout the country. The donor milk is pasteurized to kill any unhealthy bacteria, yet retains many beneficial nutrients, says Manley.

All together, the milk techs process about 300 ounces of breast milk per day, says Benardin.  In addition, SLCH keeps 10 specialty formulas on hand for babies who need additional nutrition.

Benefits of breast milk

Babies benefit from the active growth hormones, developmental enzymes, infection fighting and immunological factors found in breast milk. Research shows that breast milk helps preterm infants:

  • reach full feeds sooner and need fewer IVs
  • mature their intestines faster
  • spend fewer days in the hospital
  • reduce risk of necrotizing enterocolitis (a bowel disease)
  • reduce risk of sepsis (blood infection) and infections
  • experience long-term IQ advantages over formula-fed infants
  • be healthier as older children and adults

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