Tag: breastfeeding

Human Milk is Magical- What Donor Mothers Should Know About Milk Banks

There is no doubt that human milk provides species specific nutrition for the optimal growth and development of all infants, including the vulnerable hospitalized preterm infant. 1,2 Since time began, mothers have supported mothers in providing this optimal source of nutrition but evidence is strong that human milk contains much more than nutrition for the infant’s well-being.3 Despite global efforts to provide infants worldwide with this basic human right resource, no country on earth meets the minimum support for breastfeeding.4  In 2004, Labbock et al., cited a key issue limiting the global acceptance of human milk- social and commercial pressures- that still holds true today and is relevant to current donor milk donation and utilization.5

When a mother is unable to provide enough milk for her own infant’s needs, then donor milk is the next best option. There are basically two business models for human donor milk bank operations; not-for-profit and for-profit. Both models provide safe, processed donor milk for infant consumption. One of the differences lies in the human species-specific properties retained post-processing procedures. The Human Milk Banking Association of North America (HMBANA) is a professional association that supports non profit milk banks by  providing its members with standardized guidelines to screen donors, and process and distribute human milk.6 The for-profit milk banks utilize different, but safe, milk processing procedures, yet the end milk product produced by each contains significantly different human bioactive milk immune and metabolic components. HMBANA milk banks utilize holder pasteurization (milk is heated to 62.5°C for 30 minutes then rapidly cooled to 4°C) whereas for-profit milk banks utilize high vat pasteurization (milk is heated to 63°C ≥ 30 minutes), and  sterilization (milk is heated to 121°C for 5 minutes at 15 pounds per square inch). This sterilization process renders significantly less human species concentrations of protein, fat, immune components, and oligosaccharides.7 Donor mothers will benefit from knowing  this information to make informed decisions about where to donate their milk.

Another social and commercial pressure is the monetary compensation for donating milk . Donor mothers should know the differences in processing fees between non-profit and for-profit milk banks. A mission of HMBANA milk banks is to contain processing costs so that donor milk can be equitably distributed. One mechanism to contain costs is to not offer monetary compensation for milk donations.  For-profit milk banks offer monetary compensation which is then passed on to the consumer resulting in higher prices for donor milk. Guiding principles to determine whether or not a donor of a biological product can be offered compensation is outlined in an international statement developed by the convention of the Council of Europe   ; only those products created using patents can be distributed for commercial profit.8 This guidance protects for-profit milk banking companies. Donor mothers have the right to know how their milk will be processed and sold.

Lastly, for-profit milk banking companies have abundant resources to promote their product using sophisticated, provocative ad campaigns. Donor mothers have the right to receive informed healthcare data regarding the value of donor milk that retains 50-90% of human milk properties post-processing-the milk provided by non-profit human milk banks- which benefits  optimal infant growth and development.

HMBANA mentors those who are developing milk banks in areas where improvement in breastfeeding support is needed. To learn more about how to become a HMBANA- developing milk bank  visit www.hmbana.org . The Mothers’ Milk Bank of Louisiana, a developing milk bank member of HMBANA, would like to express sincere gratitude for the guidance of our mentor bank, the Mothers’ Milk Bank at Austin under the leadership of Kim Updegrove, Executive Director, as well as HMBANA guidance documents. August is National Breastfeeding Month. Let’s join together to honor all donor mothers for their lifesaving donation of miracle milk and pledge to inform and enlighten them of the invaluable impact of their milk donation decisions.

References

1.            American Academy of Pediatrics Committee on Nutrition SoB, Committee on Fetus and Newborn. Donor Human Milk for the High-Risk Infant: Preparation, Safety, and Usage Options in the United States. Pediatrics. 2017;139(1):e20163440.

2.            Medicine AoB. ABM Position on Breastfeeding – Revised 2015. Breastfeeding Medicine. 2015;10(9):407-411.

3.            Agarwal S, Karmaus, W., Davis, S., & Gangur, V. Immune markers in breast milk and fetal and maternal body fluids: A systematic review of perinatal concentrations. Journal of Human Lactation. 2011;27(2):171-186.

4.            UNICEF. #breatfeeding- Breastfeeding A Smart Investment. 2017; https://www.unicef.org/breastfeeding/. Accessed August 5, 2017, 2017.

5.            Labbock ML, Clark, D. & Goldman, A. Breastfeeding: maintaning and irreplaceable immunological resource. Nature Reviews Immunology. 2004;4(7):565-572.

6.            Human Milk Banking Association of North America. Guidelines for the establishment and operation of a donor milk bank. Forth Worth, Texas: Human Milk Banking Association of North America; 2016.

7.            Meredith-Dennis L, Xu, G., Goonatilleke, E., Lebrilla, C., Underwood, M. . Composition and variation of macronutrients, immune proteins, and human milk oligosaccharides in human milk from nonprofit and commercial milk banks. Journal of Human Lactation. 2017.

8.            Council of Europe. Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. Treaty No.164. 1997; http://conventions.coe.int/Treaty/en/Treaties/html/164.htm. Accessed July 27th, 2017.

 

 

Shelley Thibeau, PhD, RNC, is the Director of the developing Mothers’ Milk Bank of Louisiana. As a NICU nurse for 38 years, her interest in breastmilk has expanded to exploring breastmilk immunology associated with preterm infant health.

5 Ways to Be More Baby-Friendly (Without Becoming a ‘Baby-Friendly Hospital’)

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By Deirdre Wilson

There are many great reasons why hospitals choose to work toward and achieve Baby-Friendly hospital status. There are also plenty of ways to encourage breastfeeding in line with the World Health Organization’s (WHO) guidelines without having that official Baby-Friendly Hospital designation. In fact, research has shown that implementing Baby Friendly practices such as early breastfeeding after birth, skin-to-skin care , and rooming-in,  in hospitals that do not have this designation, resulted in higher rates of breastfeeding initiation and duration.

Whether or not you’re pursuing Baby-Friendly status, your hospital can effectively support and promote breastfeeding among staff, mothers, and their families. Here are just 5 of many ways to go about it:

1. Start educating women about breastfeeding early.

Setting expectations and goals early in the care process that a mother will achieve desired health objectives. This is true of breastfeeding, as well.

  • Educating mothers about the benefits of breastfeeding is most successful when it starts during pregnancy. Indeed, Step 3 of WHO’s 10 Steps to Successful Breastfeeding—the key criteria for formal Baby-Friendly hospital status—requires that hospitals “inform all pregnant women about the benefits and management of breastfeeding.”
  • Educating parents proactively, rather than waiting for them to request information, ensures they have the education they need when they need it.
  • Educating parents electronically means the information can be shared in small, consistent pieces that don’t feel overwhelming. It’s also a time savings for staff and providers who would otherwise need to use medical appointments for breastfeeding education.

2. Incorporate breastfeeding education into your ongoing staff training.

Keeping your staff updated on supportive breastfeeding practices doesn’t have to be time-consuming or require organized training classes. Consider providing electronic breastfeeding education for staff to access anywhere and at their own convenience. Choose a solution that lets you track their progress, so you know when they’ve read the required information.

3. Stay in touch with women and their families about breastfeeding support opportunities, even after they’ve returned home.

In the U.S., 74% of babies have breastfed at least once, but only 23% are still breastfeeding by 1 year of age, according to the CDC’s Breastfeeding Report Card. Once new mothers are discharged, a strong connection with your hospital can encourage them to take advantage of available support, overcome challenges and stick with breastfeeding.

When following up with women who’ve recently had babies invite them to schedule a session with a lactation consultant or attend a  breastfeeding support group at your hospital. These opportunities not only provide additional revenue sources,  but also nurture relationships with women and their families, who will be more likely to return to your hospital in the future—whether for obstetric or other medical care.

4. Ask new moms for feedback about your hospital’s breastfeeding support practices.

Breastfeeding is an emotional topic for new mothers. With patient experience and satisfaction so important to a hospital’s bottom line these days, you want to know where you stand in patients’ minds.

Surveys are a great way to measure patient satisfaction with your breastfeeding education practice and policy. Send a quick survey by email or text message, asking new moms specifically about how your breastfeeding support has helped them and where you can improve.

5. Collect data on how many women who had their babies at your hospital continue breastfeeding.

Healthy People 2020, the population health measures created by the federal Office of Disease Prevention and Health Promotion, set goals for how many infants are breastfed by the year 2020, including 34% of infants breastfeed at 1 year and 26% breastfed exclusively through 6 months.

If you want to work toward or even surpass this goal, you need to measure how your patients are doing after they leave the hospital. Providing patients education in a digital format, i.e. on their mobile device, combined with data collection technology can help you gain insight.

Baby-Friendly status remains the gold standard for many hospitals encouraging breastfeeding. But if your facility has limited resources, these 5 strategies can help your hospital successfully support and encourage breastfeeding.

For additional information on becoming a Baby-Friendly hospital, visit www.babyfriendlyusa.org

AWHONN Resources

Deirdre Wilson, Senior Editor for UbiCare, is an award-winning writer and editor with 30 years’ experience researching and writing on a wide range of health, wellness and education topics for newspapers, magazines and a news wire service.

Nurses’ Critical Role in Preventing Infant Sleep-Related Deaths: A Call to Action

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by, Sharon C. Hitchcock

Did you know most infant sleep-related deaths are considered preventable? This is good news worth sharing! Because most babies are born in a hospital or birthing center, nurses are uniquely positioned to interact with virtually every new parent. This means nurses play a critical role in helping prevent these deaths. We know that parents trust us (we are the most trusted profession!), watch us, and listen to us. We have a responsibility to make sure we give parents safe sleep recommendations along with the evidence behind them. We have a responsibility to problem-solve with parents about accomplishing safe sleep situations, all while simultaneously respecting their right to decide what is best for their family. The bad news is too many babies are still dying. October is SIDS Awareness month and a perfect time for nurses to spread the good news and advocate for our smallest patients! Continue reading →

Beginning Breastfeeding, Breaking Down Barriers

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by, Summer Hunt

You’ve heard it time and again: Breast is the best. But many moms-to-be express concerns over breastfeeding, from doubts about their abilities, to time constraints, and everything in between. However, moms who have experienced challenges and broken down breastfeeding barriers will tell you this—it’s worth it.

Same goal, different struggles

Erin Lee and her family

Pictured above: Erin and Hung Lee with Emersyn, Paxten and Mylo

Pictured above: Erin and Hung Lee with Emersyn, Paxten and Mylo

“Just because something is natural doesn’t always equal easy,” says Erin Lee, RN, BSN, IBCLC, mother of three. As a registered nurse (and now a board-certified lactation consultant), she was fully aware of all the benefits and knew that she would breastfeed. What she couldn’t predict, though, was how many bumps in the road she would encounter.

“I had a long intense labor, and they had to use some suction to get my daughter out,” she explains. “She had a strong oral aversion, and I had flat nipples, which made latching almost impossible. On top of everything else, she was extremely jaundiced. I wanted and needed to breastfeed her, and I was determined to—but it wasn’t easy to get started.”

Lindsey Grissett knew before her daughter was born that she would breastfeed. “It was just something that made enough sense to me not to question,” she says. “I was further encouraged to educate myself on it by both my doctor and my husband.” Birthing at a Baby-Friendly® hospital meant Lindsey had a lot of support. “I was signed up for breastfeeding classes well in advance, and I don’t think I had a single question go unanswered,” she says. “I felt both mentally and physically prepared.” Shortly after giving birth, baby Emma latched right on as both mom and baby got the hang of things.

Breastfeeding wasn’t without its challenges for Lindsey, though. “There were times when I would stand in the shower, stare at the wall, and wonder how it was possible for an individual to function on so little sleep,” she recalls. It felt like the baby was hungry all the time… I was exhausted.” Lindsey learned a lesson in patience and teamwork as mom and baby found their rhythm. “It’s a process—you have to use different hand movements, massaging your breast to get the milk flowing while trying to get her mouth in the right place… or else all that hard work literally just leaks away.”

Finding help when you need it

For Erin, having the support of an International Board Certified Lactation Consultant® (IBCLC) made it easier to focus on one thing at a time. “Even though I’m a nurse, she saw things I couldn’t see,” Erin says. “She realized my daughter was jaundiced. She also helped me establish smaller goals instead of worrying about getting her to latch. I pumped my milk so we could focus on feeding her and getting her to gain weight. Then we worked on overcoming her oral aversion, and then… she latched!”

Lindsey Grissett

Pictured above: Lindsey and Raymond Grissett with Emma

Lindsey agrees that a lactation consultant was a huge help. “They called a few days after being discharged, asking if everything was going okay. They set up appointments for me to come in, show them my progress, and make sure she was taking in enough.” It was a lactation consultant who recognized that Lindsey’s baby girl was also jaundiced, she adds. “Several months after I had Emma, I still received phone calls to see how I was doing. I was so well taken care of!”

An indescribable feeling

While you can read a bundle on the benefits of breast milk, there’s one thing that you can’t find in a class or a book—the physical and emotional closeness that develops between mom and baby. “The bond you feel while you’re feeding your baby… it’s incredible,” Erin says. “Until you experience it, you can’t know how powerful it is.”

“The most valuable thing about breastfeeding was definitely how close it brought me to Emma,” Lindsey says. “There so many times when I just wanted to sleep, or eat, or shower in peace… but even when I was at the end of my rope, it was such a great feeling knowing that she needed me. That was my motivation to keep going.”

Turning lemons into… breast milk?

After a difficult breastfeeding journey, Erin knew she could use her experience to help other women. “I was working in pediatrician’s office, and I shadowed the IBCLC there, seeing the moms and babies come in, some of them having the same issues I did. I wanted to help them overcome it—I became very passionate about it.” She became an IBCLC in 2013, and in 2015 she cofounded a private practice lactation business.

“Most people will encounter some sort of struggle,” she says. “For some it might be a few days or weeks, others might take months to get the hang of it. Just because the baby doesn’t latch right away, or you have a little discomfort at first doesn’t mean it’s the end. With the right support system, you can do it. It’s so empowering—being able to provide this essential need for your baby.”

For first-time moms (or first-time breastfeeding moms), Erin offers up this advice:

Educate yourself. Not just about the basics of breastfeeding, but also on normal infant development. The more you know, the more prepared you’ll be for what’s to come.

Build a support system. Find a health care provider that’s supportive of breastfeeding and understands that it’s something you want. Find an IBCLC, and attend La Leche League meetings even before you give birth. Talk to your mom if she breastfed, or your friends who did – these are the people you’ll be texting at 1am when you’re at your wit’s end and you need someone to tell you it’s going to be okay.

Be gentle with yourself. Your only job right now is to nourish your baby. The rest of it, cleaning the house, putting dinner on the table, losing baby weight… it can wait. You take care of your baby—everything else will fall into place.

 

Summer Hunt

 

Summer Hunt is the editorial coordinator for publications at AWHONN.

 

 

 

Resources for Moms

Ask Our Nurses: How Will My Baby and I Begin Breastfeeding? (video)
Ask Our Nurses: How Do I Prepare For Breastfeeding? (video)
How to Overcome the Challenges of Breastfeeding (article)
Breastfeeding Fixes (article)
Download our brand-new Breastfeeding Parent Pages here.

Erin Lee, RN, BSN, IBCLC has worked as a registered nurse in the Pediatric Intensive Care Unit at Boston Children’s Hospital, Georgetown University Hospital and All Children’s Hospital, among others. She is the cofounder of Suncoast Lactation Consultants in Bradenton, FL, where she lives with her husband and three children.

Lindsey Grissett is a mental health community court liaison in Anniston, AL, where she lives with her husband and daughter. She enjoys working out, traveling and hanging out with her family,  and watching her little girl grow.