Adoptive mom brings in pumped breastmilk to feed baby: what are your thoughts?

[redbeads]

I am going to describe a very unique scenario and I am interested in other nurses thoughts and opinions.

An adoptive mom came in with a birth mom. Before delivery, adoptive mom explained that she had brought in pumped breast milk (from 2 of her very close friends who were nursing there own children) to feed the baby during the hospital stay. (For certain medical reasons, this mom could not produce her own breast milk, or she would have nursed the baby herself). The birth mom gave her verbal and written consent for this...included in the birth plan that she came in with. I, as the L&D nurse, did not have a problem with this plan. So, after delivery, adoptive mom fed baby the pumped breast milk.

When I went to visit both moms and the baby the next day, adoptive mom informed me that the entire postpartum floor was in an uproar, infection control had been notified, risk management involved, and she had been told that she could no longer feed the baby any of the pumped breast milk. After some time, staff allowed that if the 2 sources of breastmilk could come in and be HIV tested, they would allow adoptive mom to feed baby the pumped milk...maybe. The two friends did come in right away and since both had recently delivered at this very hospital, offered to have the staff look up their medical records (which included HIV results). By this time, moms and baby were ready to go home. Yes, they chose to leave after 24 hours. Home to a happy home with plenty of love and a freezer stocked full of donated breastmilk.

What would You have done.....and what would your hospital have done? Oh yeah.....someone is now researching this and coming up with a protocol.....like this scenario will ever happen again!

[JeanettePNP, MSN, RN, NP]

Interesting question.

What are the rules if the parents want to feed the baby anything else brought in from home? Do those things also have to be vetted by infection control?

[netglow, ASN, RN]

IDK, your hospital is going to get some bad word of mouth from that family.

[sunkissed75, CNA]

I think it's interesting! In fact, just like there are blood banks there are also breast milk banks where a mother can donate her breast milk. Of course, there is a screeing process and it is pastuerized but milk is milk! If someone is able to give this precious liquid instead of it being wasted who would want to deny a baby something so healthy and beneficial? Really, it's no ones business where the milk comes from especially after the two donating women were deemed healthy. My guess is a couple of people thought it very unusual and gross and went with that.

[wooh, BSN, RN]

I work at a peds hospital. People bring in breast milk. Now we make them put all sorts of stickers and stuff on it, but if it comes from home, do I REALLY know where it came from? If it's pumped in the room, I don't watch mom pump it, so I don't see it from source to bottle to freezer. But we still give it to the kids. Unless they're a suspected Munchausen by proxy, they aren't on camera, they could be putting ANYTHING into those bottles!

Sheesh. The things that will get nurses into an uproar. I personally would use the common sense that if a woman's going through all the trouble it is to adopt a child, and find breast milk for this child, that she's not going to ask the IV drug using prostitute down the street to be the baby's wet nurse.

I think it's fabulous that this baby is lucky enough to have a family that loves her, with a "village" of people so happy she's come into this world that they're pumping extra milk for her to eat.

[redbeads]

I think it's fabulous that this baby is lucky enough to have a family that loves her, with a "village" of people so happy she's come into this world that they're pumping extra milk for her to eat.

Thank you! These were my thoughts exactly.

[klone, MSN, RN]

Something very similar happened to a good friend of mine. She came in to give birth to twins. Knowing she was O bloodtype and her first baby had to go under bili lights, and knowing that her babies were 36 weeks at birth, she came prepared with frozen breastmilk from a friend of hers for supplementation. One of the nursery nurses made a stink about it, and infection control and risk management also got involved.

The parents (who are both employees at the hospital), said that if they were prevented from feeding the babies what THEY, the parents, wanted them to eat, they would contact their attorney. The director of our department talked to risk management, and it was agreed that if the parents were to sign a waiver, absolving the hospital of liability should the babies get sick from the donor breastmilk, they would drop the matter. Nothing was mentioned again, and the waiver never materialized.

As a result of that incident, our hospital is now in the process of hooking up to receive donor breastmilk from one of the milk banks.

I was ready to fight on behalf of my friend, but luckily I didnt need to. Her donor milk came from someone she and I know VERY well. In fact, I know the donor probably better than anyone else in the world, except perhaps my husband ('nuff said).

[TabithaB]

Liquid gold!!!!

[mochamonster]

I swear, Americans are so uptight about breastfeeding and breastmilk. This was clearly a parenting issue and not a medical issue. Women are not required to take HIV tests when they are pregnant, they are offered it. If they don't take it they aren't threatened to not breastfeed their babies because it may make them sick. The likelihood that either of those mothers were HIV positive was probably quite remote.

I agree, that baby is so lucky to have a mother care about him/her so much. The more women breastfeed in this country the more commonplace it will become so things like this won't happen (as often). Perhaps by the time my 8 month old baby girl (yes I nurse her) is a mother, people won't be so uptight about this sort of thing. I would have expected better behavior from hospital staff though.

[JeanettePNP, MSN, RN, NP]

I swear, Americans are so uptight about breastfeeding and breastmilk. This was clearly a parenting issue and not a medical issue. Women are not required to take HIV tests when they are pregnant, they are offered it. If they don't take it they aren't threatened to not breastfeed their babies because it may make them sick. The likelihood that either of those mothers were HIV positive was probably quite remote.

Actually, in NYS that is the case. If you are pregnant and decline to take the HIV test, the hospital can take your baby from you and prevent you from breastfeeding until the baby's HIV status is determined.

[mochamonster]

Wow, I find that surprising. You learn something new everyday.

[jen1500]

Yeah, at our hospital an HIV test in the third trimester or when mom comes in to L&D is actually required, not optional. I don't know what happens if they refuse, I haven't heard of that happening/I don't think they are specifically asked if they will allow the test, I would think it's covered under the general consent they sign upon admission since it's a mandated test. As for the mom who brought in another mom's frozen milk because she was delivering the twins early and worried about possible jaundice- I can kind of understand that, but wouldn't it have been better for her to pump her own milk for the babies? The benefit of breastmilk to preventing jaundice is because colostrom (the first milk) has a laxative effect which helps clear bilirubin, right? But the milk from her friend would have been mature milk, not colostrum, so would it be as helpful? And we know that moms are able to produce milk by the end of the first trimester, so it's not like she wouldn't be producing milk for her babies even if they were a few weeks early. On top of that, studies have found that breast milk composition varies by the age of the baby, so the milk a mom produces for a baby that delivers prematurely is actually different from the milk she will produce at the time the baby reaches full term, and the early milk is more tailored to the preemie's needs (higher levels of fatty acids, etc), so wouldn't her pumped milk really be better for the babies than her friend's? Unless she is physiologically unable to produce sufficient milk, of course, but that is pretty rare. It seemed like she would be dedicated to the babies' health/nutrition if she was bringing in milk before her delivery, so I would think she would be pretty good at consistently pumping and establishing a good milk supply fairly quickly for the babies. Just some thoughts.