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Tossing perfectly good breast milk

Posted

Specializes in NICU. Has 28 years experience.

I am angry. Seems our unit cannot let more than a month or two go by without changing some aspect of our "breast milk policies". The latest is that when a mom brings in EBM from home she has to put her initials on the label to verify that it's labeled with her infants name. Then when the RN receives the EBM she/he has to initial the label verifying that it's the correct label. Also if one pours two or more bottles together (say you've thawed bottles with little in them and want to combine and milk with other components) then two RN's are supposed to initial verifying that those bottles matched. Also some nurses (and this isn't policy yet but give them time) are having two RN's initial to verify they correctly calculated electrolytes they are adding to the EBM like KCl or NaCl.

Here's the part I'm mad about. One of the unit educators has made it her purpose in life to continuously change our breast milk policies. She had posted signs on the freezers saying bottles that didn't have two sets of initials would be thrown away. I guess I didn't believe her even though I was doing my part and slapping my initials on bottles left and right to make sure my bottles didn't get thrown away. I go into work Thursday and find out she had thrown away 8 bottles (I estimate each with about 50ml of EBM cause that's what the others had) of one of my babies frozen EBM. This left this baby with only about 2 days worth of EBM.

This is a former 25 weeker who is about a month old and has had feeding tolerance issues all along. What's gonna be tolerated better, EBM or PE 24?

I couldn't believe she did that!!!!!! Write someone up, hold the milk hostage until it can be verified, do anything but don't throw it away for pete's sake!!!

I am so angry about this :angryfire

This is the straw that broke the camel's back. I am starting to look around for other "opportunities" next day I have off. It's not just this, it's just the last straw.

KRVRN, BSN, RN

Specializes in NICU.

Wrong. Inappropriate. Inexcusable.

You know what? When she asks where all her bottles of EBM went (and I would estimate that 8 5oz bottles are several days' worth of feedings) I would tell that mom that a unit educator (that's probably far too many years removed from bedside care to remember what it's like) threw away a lot her breast milk because the nurses had trouble with hard-to-remember-and-follow-frequent policy changes. The nurses want all the best for her baby but we have trouble keeping up with the frequent changes. Then tell her that now her preemie will have to be started on Pe24 and will have a higher risk of NEC and DEATH and perhaps might even have to receive DONOR BM because someone threw out her perfectly good EBM. (ok, yes, I realize some moms would take this different than others and may not have the desired effect)

My God, such practice will moreso encourage nurses to forge initials just to avoid "liquid gold" from being thrown away than make things safer. I'm all for making things safer for EBM and avoiding milk errors, but no way should ANYONE be throwing away ANY milk unless it's expired. She could have at least had the mom verify her initials on it. Perhaps the mom could even be allowed to relabel HER milk with another label with HER baby's name on it so that ALL the proper initials were there and it could be saved from the trash.

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

I can think of several docs who could rearrange her priorities for her!!

Aww man! What an idiot! Would she throw out gold, because that's what it is.

It breaks my heart when I take out breast milk and there is no date and time.I have to toss it.

gauge14iv

Specializes in ICU, ER, HH, NICU, now FNP. Has 23 years experience.

ABSOLUTELY RIDICULOUS!!!!! :angryfire

We print labels for the mother (same labels we use on chart forms) and give them to her - the bottles come in ALREADY labeled with her infants name. As an added precaution we have the mother add a hand written label with name, date and time pumped and frozen as well. If both labels match we're in business. This is way we receive it.

2 nurses check the milk when it is drawn up, or before mixing multiple bottles but it's an eyeball check - not a sign your life away check.

We will be going to EMAR soon - which means we will be scanning the milk just like medication to verify who it belongs too.

Put the onus on labeling on the parent, double checking on the nurses - BUT NEVER THROW PERFECTLY GOOD BREASTMILK AWAY!!!!!!!!

If my baby missed getting EBM and got formula instead because some bozo threw out his milk I'd be looking at filing a serious complaint (a couple of lawsuits have been filed over this believe it or not - in cases where the parents had made clear to the staff they did not want formula and the baby was to be given EBM ONLY - now imagine if one of these infants had died of NEC) It's the same thing as someone saying they don't want a procedure done on their kid and then someone does it without their consent.

Id be calling that educator so SHE can explain to the parents what happened to the milk. (Even if you have to call her at home at 0300 hours)

AND I'd be getting an IBCLC involved so she can help this woman make decisions that are evidence based and appriopriate.

I know of some WONDERFUL resources you can call - including a few neonatologists who are IBCLC's - contact me privately if you would like to get in touch with them.

Here is how I feel about this......

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Whahahahahaha.......

that's so stupid...not like the milk was not labled at all...i feel terrible because i had to throw away about 3 oz of ebm for having no label on it at all. we have flats labled with the baby's name to but multipe bottles of breast milk in the freezer. This unlabled bottle was in this baby's box so I'm pretty sure it was his but I couldn't take that chance so i had to throw it away...there were about 25 other bottles in the freezer of other babies milk....i hated to do that.

TiffyRN, ADN, BSN, PhD

Specializes in NICU. Has 28 years experience.

I think I will be e-mailing the unit manager and the chief Neonatologist. The chief Neo is one of those docs that is nearly psycho (justifiably) about breastmilk. I'm sure she would love to know one of the micro-preemies in her unit had it's breastmilk thrown away. She manages the local donor milk bank, I'm sure she could "help" the educator understand the many values of EBM including what an equivilant bottle of donor milk would cost( I think we were told something like $75/3-4 ounces). I haven't been back to work since I initially posted.

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

Atta girl! Go get 'em! I think that's a great idea.

I think I will be e-mailing the unit manager and the chief Neonatologist. The chief Neo is one of those docs that is nearly psycho (justifiably) about breastmilk. I'm sure she would love to know one of the micro-preemies in her unit had it's breastmilk thrown away. She manages the local donor milk bank, I'm sure she could "help" the educator understand the many values of EBM including what an equivilant bottle of donor milk would cost( I think we were told something like $75/3-4 ounces). I haven't been back to work since I initially posted.

Do you think there is any chance that you can get through to this educator if you have this discussion with her yourself? I like to try to resolve issues with the person that I am having a problem with before going to someone else about it. If you have tried this and have had no hint of understanding from her then I suppose you have no choice but to report her actions. I can't help but feel that although her actions have shocked us maybe she just isn't aware of the true consequences of what she did?

BittyBabyGrower, MSN, RN

Specializes in NICU, PICU, educator.

Good lord...doesn't she have anything else to do? Was there a problem that precipitated all this? Even our nazi of a CNS only requires that mom label the bottles...we aren't allowed to combine bottles or add things like electrolyes to them, but we don't double check the mom. The only things we pitch are the ones with no labels or no date or time.

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