Breast Milk Policies: MIX UP!

[VgsNrs]

Here is my concern, I am a nursing student and I need to create a policy on my peds floor regarding standards or a protocol when administering breast milk to the infants. It was suggested to me to go to our NICU to see what standards they went by regarding this issue, because there have been mix up's in the past, BUT there is nothing in writing. The NICU nurses just have their own way of doing it. But I still need help on where to start because I have to make this from scratch. If you have a set of standards that you use in your NICU could you please share some? (ie- 2 RN's check names, checking expire date, organization within fridge, etc.) Thanks for any feedback!

[fergus51]

We have 2 nurses check the name on the breast milk and expiry AT THE BEDSIDE (not at the frisge since they could be getting two babies milk there and mix it up walking back to the bedside), then each sign that they did so on the flow sheet. Similar or same named babies have to have their names highlighted, our milk fridge is organized like a med cart (we have letters for the bedspaces, so the baby in bed A will have the milk in the A space in the fridge).

[BittyBabyGrower, MSN, RN]

Same here...we treat it like a blood product...check name and unit number and 2 RN's signatures on the flowsheet.

In our policy, the mom is the only one who is allowed to label the container, we cannot accept any container that doesn't have a label on it. You have to take it out and you check it with the other RN, ideally, that RN is supposed to watch you draw up what you need.

[VgsNrs]

Thanks so much for some good ideas...

[nursechick182, BSN, RN]

At my hospital, we have EMAR which is basically giving and checking meds all on the computer. We treat breast milk just as a medication and print out breast milk labels for each baby. The mom's then pump and label their bottles with our labels. If there are twins or triplets, a label for each baby has to be on the bottle. (it gets really tricky if you have quads!) Pharmacy times the medication to give breast milk every 3 hours-which is how often we feed usually-and we scan the bottle and then the patient's armband. I know it sounds like a lot of work, but it's supposed to decrease medication errors.

[nursechick182, BSN, RN]

At my hospital, we have EMAR which is basically giving and checking meds all on the computer. We treat breast milk just as a medication and print out breast milk labels for each baby. The mom's then pump and label their bottles with our labels. If there are twins or triplets, a label for each baby has to be on the bottle. (it gets really tricky if you have quads!) Pharmacy times the medication to give breast milk every 3 hours-which is how often we feed usually-and we scan the bottle and then the patient's armband. I know it sounds like a lot of work, but it's supposed to decrease medication errors.

[prmenrs, RN]

Now, THAT sounds like a system, Nursechick!! Excellent.

I think the double signature (like blood) seems like it is "standard of care" right now.

[prmenrs, RN]

Now, THAT sounds like a system, Nursechick!! Excellent.

I think the double signature (like blood) seems like it is "standard of care" right now.

[Mithrah]

I have heard breastmilk called white blood before. It should be treated like blood because having a breastmilk error is unacceptable. I would never want my child drinking some stranger's breastmilk. Yuck!

[Kerrirn]

We use a system where the moms label milk with the babies id sticker but each mom is also assigned a set of colored labels (the colored dots you use for labelling garage sale items!) each baby has his own combo of colors that are placed on the top of the bottles. This is an easy way to see if any one's milk is in the wrong bin without having to read every label. Of course all the names are double checked before ever using the bottle. Just another thought....

[dansamy]

I would never want my child drinking some stranger's breastmilk.

It's not really any different than you receiving some stranger's blood after a trauma or surgery. There are a few milk banks around for infants unable to digest formulas. There are some dedicated women who pump milk for those banks.

[rainbows4me]

It's not really any different than you receiving some stranger's blood after a trauma or surgery. There are a few milk banks around for infants unable to digest formulas. There are some dedicated women who pump milk for those banks.

I agree with what you're saying about blood products and the amazing value of breast milk and breast milk banks. Blood products (and milk), however, are thoroughly screened before they are given to any baby. I wouldn't want my baby getting either one without the screening - or without my consent, for that matter.