330 R.M. Shaw and M. Morgan
as alcohol or nicotine. Staff also make clear to the donor mother that
her own baby is her priority, and while the unit will accept as much
milk as the mother wants to gift, she can stop donating at any time.
A discussion then takes place to ensure correct hygiene around the col-
lection, storage, and transporting of EBM, as well as the cleaning of
expressing equipment. As the donor milk within the neonatal unit is
often from mothers with premature babies, it enables the unit to gesta-
tionally match the milk to the baby. This occurs in the majority of cases.
When milk is available from more than one donor; that is, a premature
baby mother and a term mother, options to provide infants with the
appropriate milk are enhanced. When a mother has mastitis, skin infec-
tions or diarrhoea and vomiting, it is advised that she refrain from pro-
viding donor milk during that period. However, she is able to continue
providing her milk for her own baby. Bacterial screening does not take
place, as the neonatal unit only accepts frozen breastmilk from screened
mothers with babies in the unit and these mothers are already follow-
ing the hospital guidelines. All donor milk is frozen prior to use. The
mother is given appropriate labels for her donor milk and places the
milk she wants to gift in a tray made available to her.
For a prospective recipient mother, a conversation is undertaken by
a neonatologist on the need for donor milk, the most common reason
being that the mother is unable to produce enough milk herself for the
baby. Once this conversation has taken place, information sheets are
provided and any questions are answered by the lactation consultant
or senior staff. Consent is formalised, and a signed copy of the consent
form is kept in the baby’s notes and by the lactation consultant. A sheet
with the donor number, but no name, is then placed in the baby’s file to
receive the donor milk. A tracking sheet is commenced which records
the donor number, date expressed, and times given. A record is also
kept on a database that tracks the donor information and the recipient
baby’s information.
A range of practices are thus undertaken by staff working with breast-
milk in the NICU. Principally, donated breastmilk is treated as a precious
substance in short supply. Staff who work at NICUs may wear gloves
when handling babies, drawing up medications, putting in IV lines, and
when handling blood and milk. The main reason for this is to reduce
http://www.ebook3000.com