Breastmilk for mouth care

[mlizhev]

Hello all,

I am looking for units that use colostrum or any breastmilk for oral care. I would like to start a PI project within my unit but would like feedback as to who else is doing this and how everythings is going.Thanks

[dawnebeth]

It's not really for mouth care, but to introduce 'friendly' bacteria into the mouth and gut to promote good flora and hopefully reduce the incidence of NEC, Our unit just started about two months ago. We swab 0.2 ml of colostrum into the baby's mouth (even a vented baby) on the cheeks and tongue every three hours. It's too soon to tell what effect this is having, but the nursing student who worked with me did an inservice for the unit on the practice. She made a nice brochure.

[mlizhev]

Thanks for the reply... can you tell me why your unit decided to start this practice? Was it received well from the Neo's and what do the parents and nurses think? Were there any concerns about doing this from the docs or nurses? Last question.... what region is your hospital?

[dawnebeth]

We're in Northern California. Swabbing the mouth with colostrum was started suddenly in late January. I came back from a vacation, and we were starting without any beforehand instruction. I believe that our nurse practitioner wanted to implement this practice, with the support of the doctors and the lactation specialists. The parents think it is great, because some think we are 'feeding' the babies. However, we nurses were not sure WHY it was being done, which is why I asked the nursing student to do a little teaching inservice.

Her brochure says that colostrum has anti-infective agents, macrophages and neutrophils to destroy harmful bacteria, IgA to protect mucosal surfaces against E. coli and many other bad bacteria and lysozyme, another anti-infective agent. Colostrum helps prevent NEC, sepsis, diarrheal disease, allergies and bacterial infections.

[mlizhev]

Thanks Dawn,

If you are looking for an article on the practice with good references it's on NANN this month. Colostrum and oral care in the NICU. I love the idea and want to start it in my NICU but am getting some hesitency from the docs. Thanks for the input.

[IronRN]

I've often wondered about the benefit of this, our unit routine is to cleans the mouth with sterile h20 after all feedings and with vented babes to moisten the MM's. I'll source that article, very interesting.

Thx

[nicu/nurse]

Breastmilk is great to use for oral care. Dawnebeth gave some really great reasons why to use breastmilk. To increase compliance our unit starting using oral care kits and our rate of NEC has gone down. Good luck!

http://trademarkmedical.com/pro/pro-critical-oralkits.html

[sui foon itea]

Would you perform colostrum oral care to an infant with stage I NEC?

[Jory, MSN, APRN, CNM]

Would you perform colostrum oral care to an infant with stage I NEC?

Yes, because it's not a feeding. You would still do oral care on a baby with NEC. You still do oral care even on an NPO baby.

We use an oral care kit on our ventilator babies UNLESS breast milk is available, then we have Mom to freeze it in very small amounts so that we are not thawing out a large amount and wasting it. We use it and swab the breast milk in the cheeks.

[NicuGal, MSN, RN]

We save the colostrum until priming feeds are started and use our usual method until m's milk changes over.

[mcco5665]

Do any if your units have a written protocol for colostrum care? If so would you be willing to share it?