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!
That is crazy I am a nurse and a mother who supports and teaches breastfeeding. The hospitol should have been suporting the adoptive mother wanting to breast feed even if it was not her own milk. It is ok to feed a baby formula which is made of who knows what but not ok to feed what is naturally ment for a baby even if it is donated milk. I have had to breast feed my nephew before when his mother was unable to due to a short illness and I would do it again if that what it takes. I am a strong beliver in breastfeeding even if the milk is donated or from a wet nurse.
I'm not trying to hijack this thread, but when I had my daughter I declined the HIV test because I had it with my son and was confident I didn't need another one. The doc didn't bat an eye. It must be different for different states, I'm in Nebraska.
As far as the mom producing milk herself, I wonder if she could have. Since she was adopting she may never have been pregnant before. If that was the case it would be unlikely she could have produced.
Specializes in Med/Surge, Psych, LTC, Home Health.
Please, I wish you all weren't making this into a breastfeeding vs. formula issue. Hospitals, in my opinion, tend to go overboard sometimes with the whole infection control issue. If the OP is from NY state, which I suspect she is if her mothers were required to have HIV tests?... well, I seem to remember a news story a few years back that hospitals in NY state were actually looking at banning formula? Like, I guess a mom could bring it in to feed her baby, but hospitals would no longer be giving away the "goodie bags" with cans and bottles of formula in them. The hospitals were trying very hard to push breastfeeding.
I have my own belief that this country's hospitals are far more supportive of moms who choose to breastfeed than a lot of people seem to think. Heck, I live in backwards Kentucky, and I never received anything short of full support and encouragement from my nurses when I breastfed. Double heck =), I never had a problem breastfeeding when I went out and about with the babies, either.
Someone just freaked out that this breastmilk, which can carry HIV, was brought into the hospital and that nurse didn't know exactly where it came from. Again, it really should have been the adoptive mom's business, and only her business, where that milk came from.
Specializes in Nurse Leader specializing in Labor & Delivery.
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.
Yes, of course her milk would be ideal for her babies. But for babies who are early and don't suck very well, they aren't able to access it. And in the first few days, for many women it's impossible to pump more than a few mls of colostrum. If a baby is needing 10-15 ml of supplementation after feedings, the likelihood that the mother would be able to pump anything, let alone 10 ml (and that would be x 2 babies, remember) is pretty slim. So barring being able to provide her own milk (and she was pumping after feedings), donor breastmilk is the next best thing. Certainly not formula, which is what most babies in that situation would get, without a second thought from most people about whether or not it's the most appropriate thing.
To Klone: I am impressed....what a great friend you are!
I am also interested about the milk bank....how are patients charged for the donor milk when it comes from a milk bank? Do you know if insurance covers this? I know that our NICU utilizes donor milk, but I had never thought about it for term babies until this situation occurred. The other frustrating thing about this is that our hospital, in the past, has allowed adoptive moms to breastfeed their adopted babies while in the hospital and didn't mind this, so it seemed to me a double standard when they wouldn't let this mom (who could not breast feed or produce milk b/c of prior medical issues) use her friends' milk. The other adoptive moms were not asked to verify their HIV/Hep B status.
Needless to say, I was very disappointed in the hospital's response to this situation.
I'm really disappointed in the hospital's response to this. With such a push lately in America to breastfeed babies you would think the hospital would consider it a victory that another baby born was going to get the benefits of breastmilk.
I understand where the hospital was coming from but the uproar probably had more to do with covering their own butts from possible legal action than the welfare of the children. You know how us nurses and administrators freak out when there is no policy and procedure guiding us :) I live in NY and when I was told that I needed an HIV test I told them I had already had a negative HIV test with employee health (I work and delivered my baby at the same hospital) because of a needle stick I got while working, the nurse and doctor both said ok and I never heard another thing about it, and I breastfed in the hospital. I never had to sign anything and to my knowledge no one ever contacted employee health for the result.
Kudos to the donors of the breastmilk who came in without a fight for the HIV tests.
I'm thinking back, and I remember when we had a pair of twins at the hospital. Mom was feeding and doing a lot of pumping (babies had RSV so weren't eating a whole lot). We had to make sure we did half and half on ID stickers because one of the nurses threw a fit when Baby B needed to eat and we only had milk with Baby A's stickers on it. Because mom created TOTALLY DIFFERENT milk for Baby A and Baby B.
I live in NY and when I was told that I needed an HIV test I told them I had already had a negative HIV test with employee health (I work and delivered my baby at the same hospital) because of a needle stick I got while working, the nurse and doctor both said ok and I never heard another thing about it, and I breastfed in the hospital. I never had to sign anything and to my knowledge no one ever contacted employee health for the result.
Kudos to the donors of the breastmilk who came in without a fight for the HIV tests.
With one of my pregnancies I was told I needed to take an HIV test, and if I didn't agree the baby would be taken away from me after birth and I wouldn't be allowed to nurse until the baby was tested for HIV. Unfortunately I allowed myself to be bullied that time... but my next four births were at home!
When people bring in their own breastmilk from home (longterm baby in the nursery) I have no idea if it's been stored correctly, if anything's been added to it, or what. I have to trust that the mother has her baby's best interest in mind and has followed the instructions we've given.
Why should this case be any different, and why shouldn't parents be allowed to feed their baby what they want?
I have never heard of a situation like this happening. My thought is make sure you educate the patient that pathogens like HIV can be transmitted through breast milk. If they know that it can and are still confident of the source and want to give it to the baby, then more power to them. I would also offer the possibility of testing the donors for peace of mind.
I am always a fan of patient education over strict rules and regs that patients have to follow "because we said so," as opposed to giving the real reason for concern. I think the hospital was trying to protect the baby (and their own butts), but they did it in the most reactionary and scary way possible.
This is a great thread, one of the most interesting in a long time.
I can understand that there may be infection control issues if the milk wasn't stored properly. I can also understand that if there would be 'leftover' milk, there may be a question of taking an outside container and storing it, um, where? Generally not in the med fridge, and not in the staff fridge. So where?
And how do we know what is in that container? I am playing devil's advocate here - I actually think it is beyond wonderful that this woman was getting help from her 'village'. But I also understand that the hospital has issues with this.
I can also understand that if there would be 'leftover' milk, there may be a question of taking an outside container and storing it, um, where? Generally not in the med fridge, and not in the staff fridge. So where?
Any unit that has babies on it, L&D, PP, Peds, NICU, PICU, etc... is going to have a fridge for breastmilk. It has to be kept at certain temps that are a bit different from med/staff fridges. And the rules are always stricter than home rules, and generally a bit on the ridiculous side like most hospital P&Ps.
The mandatory HIV testing is absolutely ridiculous to me. I can understand the sentiment, finding out early saves baby's lives. But not letting them breastfeed until testing is done, contacting DFACS, that kind of stuff is just crazy.
I know there's the occasional case where it won't be true, but the hospital should not care more about a child than the parents. Education may be needed. But if mom is ok with the milk, then I should be ok with it. I should not be more worried about the baby than the mom.
Boonce1
143 Posts
That is crazy I am a nurse and a mother who supports and teaches breastfeeding. The hospitol should have been suporting the adoptive mother wanting to breast feed even if it was not her own milk. It is ok to feed a baby formula which is made of who knows what but not ok to feed what is naturally ment for a baby even if it is donated milk. I have had to breast feed my nephew before when his mother was unable to due to a short illness and I would do it again if that what it takes. I am a strong beliver in breastfeeding even if the milk is donated or from a wet nurse.