Using Donor Milk in the NICU
Mother’s own milk will always be the preferred choice for the initiation and maintenance of feedings for all babies.
The current eligibility criteria to receive donor milk is:
- Medically fragile hospitalized babies who are < 2250g in weight or less than 36 weeks gestation at birth.
- Some babies requiring gastrointestinal or cardiac surgery may be eligible as determined by their health-care team.
For babies that meet the eligibility criteria, the requirements are:
- Discussion between parent(s) or guardian(s) and the physician, nurse practitioner or dietitian about the risks and benefits of using pasteurized donor milk for their baby.
- Written parental or guardian consent for donor milk will be obtained by a member of the health care team prior to the milk being dispensed.
- Consent for donor milk will be filed in the patient chart.
- The order for the initiation of donor milk feeds must be documented by a prescription in the Doctor’s Order section of the patient chart.
- The donor milk can be thawed and aliquoted for multiple pre-consented babies in the neonatal intensive care unit as pasteurized donor milk is not mother-baby specific.
- Donor milk should be prepared according to policies in your unit for mother’s own milk. Growth should be closely monitored and additional nutrient fortification should be considered if growth gains do not approach intrauterine rates.
When feeding the baby with donor milk:
- Nutrient fortification can commence according to your unit policy for mother’s own milk.
- Additional protein fortification may be required for donor milk.
- The duration of eligibility for donor milk is according to the gestational age at birth. Any baby who has received donor milk will require weaning from donor milk in the final three days of use or prior to discharge home. Mother’s own milk should be provided as available, during the weaning, the remainder of the feeds should consist of donor milk and preterm formula alternated using a ratio of 1:1. This regime will continue for 2 – 3 days, after which any required supplement to mothers own milk will be changed to preterm baby formula.
- Donor milk for multiple births – only the baby(s) that meet the criteria will be given donor milk.
- Each batch number of donor milk, along with the date, must be recorded in the patient’s permanent hospital chart.