NICU Breastmilk Support Groups

[Samscar]

I am an ANM in a level III, 69 bed NICU. With the recent increase in central line blood stream infections we have turned our attention to how we do EVERYTHING in our unit (dressing changes, accessing hubs for meds/blood, wiping down everything in the entire unit, etc). We haven't seen any decrease with infection numbers and so are turning our attention to moms and the breastmilk they bring to our unit. We would like to develop a Breastmilk Support Group to inform and encourage moms how to pump/clean/store etc.

Does anyone have any tips and suggestions to how to get this going. We do have a breastmilk committee already in place.

[NicuGal, MSN, RN]

We went thru something similar a bit back and that is when we totally rolled out a central line bundle with hours of re-education. We have a lactation team that deals with all the moms and the pumping, etc. The only time we culture anything is if the kid grows something odd.

The other thing we found was that many of the kids that were getting septic had moms with artificial nails, we now have a letter we give all moms that ask them to have their artificial nails removed (they hand it out in the the ob offices and give it to them on antepartum also) and if they choose not to then they will be required to wear gloves, esp if they have a micronate. We did this after we had 5 kids come down septic and we asked the moms if we could swab their nails, after scrubbing in. They came back with the same bug their kids had We also don't allow any stuffed animals in the beds...those were harboring also.

We also found many, many people not accessing lines properly...we did blind audits and ones where we stood there and watched. We included everyone that would access a line, docs, RT, etc. It was amazing to watch how some people just swiped the hub, waved it in the air and then accessed it. Same with line changes....many didn't follow proper procedure. Re-education and follow up are a must.

We have had zero umbilical line sepsis in several years and only a handful of central line, the majority of those were kids with femoral lines or gut problems.

Good luck!

[dawnebeth]

We had our line infections drop dramatically when we started doing sterile line set ups (sterile gloves, hats and using a sterile field to lay out the IV tubing), as well wiping the hubs 15 seconds with alcohol with every new med and flush and--as the poster said above--lots of re-education to make sure all were doing the IV set ups the same way.