Can we talk about breastfeeding and breastmilk please?

Specialties NICU

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I am a NEW NICU nurse... Not gonna lie... I don't know squat about NICU nursing. I was an ICU nurse for the big babies (adults) for many years before I made the transition to heaven... errrr the NICU.. :)

I love it. I love it so much. I am so happy to be here!! Any way. I am also a mom. I am a breastfeeding mom. I am a La Leche League member. I have done extensive research on breastfeeding. This is really what made me transfer. I want to help all the moms breastfeed the babies. I don't force anyone to do anything. But I am knowledgeable about it and have been able to help my moms successfully breastfeed my patients. I learn more and more about these precious babies every day.

I work in a level 2 nursery so most of out babies are not that sick. But there is so much resistance that I have noticed with the senior staff and breastfeeding. Moms that want to breastfeed get on their nerves.. They don't understand why they don't want their babies to have formula. They think these moms are dumb. I came into the NICU not telling any of my coworkers my back ground and opinion with breastfeeding so I really know how they feel about it. Honestly from one anonymous NICU nurse to another; what is the deal? Am I clueless? Dumb? Too eager? I don't think every baby needs supplemental formula. I encourage them to try to latch their baby... why am I the weird one?

Specializes in NICU, PICU, PACU.

I wish we used more donor EBM but we don't get reimbursement for it, right now the amount we do use on our little ones is costing our unit $55,000 a year. We have some kids on a study which is reimbursed, but many insurance companies balk at paying for it. So we supplement with formula.

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Specializes in NICU.

Most nicu nurses are not trained to give infants cups or syringes...I certainly wouldn't want aspiration on my license and that is what would terrify me if my facility did it.

i am a huge advocate for breastmilk/feeding though. It's one of the best things we do for babies. I also feel that we aren't generally strongly educated in assisting babies to breast so many nurses feel uncomfortable with it.

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In my unit breast feeding is promoted. There are lactation specialists available to moms who need assistance. Formula is used when ebm is unavailable. Fortunately care partners work in the unit who are able to collect vital signs. The nurse is freed up to support the moms.The baby is always first. Nurses should support moms to breastfeed even if they disagree with it. If there is not time, notify the charge nurse or write an incident report stating you were too pushed for time to assist a mom. If entitlements are cut, there may be less formula distributed to families in need. So many good reasons to promote breast feeding!

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Specializes in LTC/MDS.

My twins were in the NICU for 2.5 weeks when they were born and I was strongly encouraged to bf. I made it very clear that I had to go back to work very soon and so I didn't want to bf but was willing to pump and bottle feed, which I did to the best of my ability. However, come to find out I have IGT and just couldn't produce much milk at all so I did end up formula feeding. The NICU was very supportive of whatever my decision was. I was not swayed or made to feel guilty about what I chose.

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Specializes in NICU, PICU, PACU.

We promote it too, but we have limited lactation help and sometimes our assignments are busy. And as a former charge nurse, I had other responsibilities to tend to and really couldn't have gone around and helped all the moms. We tried writing incident reports and it never got anywhere. We do need more lactation people but budget constraints put the cabash on that. And now we have to send one of our nurses to work in L/D every shift as the dedicated baby nurse to help with the transition phase to help the Moms kangaroo care and start breastfeeding. Too bad our own unit doesn't have a dedicated person like this to help in our own unit!

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I wish we used more donor EBM but we don't get reimbursement for it, right now the amount we do use on our little ones is costing our unit $55,000 a year. We have some kids on a study which is reimbursed, but many insurance companies balk at paying for it. So we supplement with formula.

There's advocacy opportunities for this cause: Reimbursement for Donor Human Milk for Preterm Infants | agenda

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Specializes in NICU, PICU, PACU.

Our team has done petitions. Sad that it all comes down to dollars and cents.

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Specializes in Nurse Scientist-Research.
Our team has done petitions. Sad that it all comes down to dollars and cents.

Yes, it is sad. But unfortunately sometimes money is the only language that some speak. For them, we have this. . .

How much does one medical case of NEC cost? $74,000

How much does one surgical case of NEC cost? $198,040

How many days can you shorten the average LOS for an extremely premature infant if you feed them exclusively human milk? 3.9 days (average cost savings: $8167.17).

This study and a few others was the basis our unit used to justify eliminating the use of cow milk for infants under 1500g, including using a human-based milk fortifier (at $6.25/ml !) and donor human milk at least until they are around 34 weeks adjusted.

http://online.liebertpub.com/doi/abs/10.1089/BFM.2011.0002

Not only is there a wealth of evidence for this practice, I have anecdotally seen a dramatic drop in the rate of NEC in our unit. It used to be common that everyone had experience caring for ostomy bags because every other former micro had one. Now (thankfully!), we get them so infrequently most of us struggle to build those skills, and you know what? I'm okay with that.

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