Use in the Hospital
Mother’s own breast milk is the preferred choice for all babies. According to the AAP, the next choice is pasteurized donor human milk (PDHM). PDHM should be used according to the unit policy for mother’s own milk. Additional fortification may be required based on the nutritional needs of the patient(s). Hospitals should follow established criteria for use of PDHM in patients. Medically fragile babies who are hospitalized, as well as low birth weight babies, should receive donor human milk. Some post-surgical babies and other babies as determined by the medical team may also require PDHM. Consent form requirements are hospital based. Documentation in the baby’s medical record should include the batch number, the type of milk used, and the volume consumed.
Ordering by Hospital
There are several ways that pasteurized donor human milk can be purchased for use in the hospital. Most hospitals have protocols and policies for ordering. These policies include the need for a prescription, the type of milk being requested, the specific amount in ounces per day and the period of time the milk is for. The order for use of PDHM is usually documented in the patient chart. Milk ordered by 1pm will be packaged and sent for next day delivery by Monday – Thursday.
One cost model used by the milk bank in Texas found that the NICU saved between $11-37 for every dollar the NICU spent on PDHM for vulnerable NICU babies. Decreased length of stays and lower incidence of NEC have been documented saving between $128,000 and $238,000 per patient cost to the hospital. Additional benefits and cost savings for hospitals are seen in reductions of sepsis, ROP, and other complications.