As health professionals, we know the health risks and disadvantages of not breast feeding and we make time to discuss the topic with parents to be. New parents have a lot of information to absorb in the antenatal period and if their baby is born prematurely, they may not have had time to fully decide on the choice of feeding for their baby.

If you work in NNU you will be aware of the anxiety and concern that new parents are faced with following the birth of their preterm baby. Feeding choices may seem to be insignificant compared to other decisions that need to be made concerning their baby/ies especially if the infant also faces life threatening conditions.

It is always worthwhile to raise the discussion of feeding choice as early as possible after the birth (or beforehand if a preterm delivery is expected). It may be a relief for the parents to be able to talk about normal baby issues in the midst of the unfamiliar and often unplanned event of admission to NNU.

It helps if your NNU has:

• A positive ethos around breastmilk feeding.
• Regular and effective staff training on infant feeding including the use of donor milk where appropriate.
• This should be aimed at all levels of medical and nursing staff.
• An infant feeding policy which supports breastmilk feeding and includes the use of pasteurised donor breastmilk.
• Written information on the practical aspects of expressing mothers own breast milk.
• Written information about donor breastmilk and how it is used in your unit.
• Skilled breast feeding support for mothers in NNU.
• Enough breast pumps so mothers do not need to queue to express milk.
• Always be positive when starting a discussion on donor breastmilk but do not undermine the mother’s efforts to provide her own breast milk.

Include the following in your discussion:

• Pasteurised donor breastmilk is human milk which has undergone strict procedures making it a safe product. It is used in preference to formula/artificial baby milk when a mother doesn’t have enough or any of her own breastmilk.
• Donors are healthy breastfeeding mothers who choose to donate surplus milk for the benefit of sick and small babies
• Donors are rigorously selected and are excluded if taking long term medication, smoke or drink excessive amounts of alcohol
• Donors are screened for harmful viruses e.g. HIV, hepatitis B&C, syphilis and HTLV 1&2 and this is done at the time they become a donor.
• Donor breastmilk is tested for harmful bacteria before and after pasteurisation
• As an extra precaution donor breastmilk is heat treated to 62.5ºC for 30 minutes followed by rapid cooling
• UK milk banks follow strict guidelines recommended by NICE (The Operation of Donor Breast Milk Bank Services in the UK, 2010)

The above information should be the minimum Information discussed with the parents of the recipient baby. Always allow time for discussion and questions.

Provide the parents with written information if available or direct them to www.hmb.ph

Most hospitals require the written consent of parents prior to administration of donor milk. Some also require a signature from the healthcare worker who leads the discussion.

Ensure the signed document is filed into the baby/ies’ records.

Always record bottle / batch number of milk administered to baby.

Always remember that Human Milk Bank.ph are here to support and advise you. Do not hesitate to get in touch with us to discuss any aspect of the provision of donor breastmilk.

Neonatal units staff are amongst the highest users of Human Milk Bank.ph for advice and information. Your unit can take out an annual membership of Human Milk Bank.ph and so help to ensure that there is continued access to help available. With more income from membership, Human Milk Bank.ph will be able to provide more training opportunities for neonatal unit staff via the Milk Bank Forum meetings as well as continue to answer specific queries from health care professionals working with both parents and babies