Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 I sent out this email last Friday and basically got one response. I thought I would try it again. Unfortunately it doesn't have any political ties but I hope people will respond regardless. :-) My NICU RD has been asked to update the policy for fortification of Human Milk. The current policy states: Fortification of Human Milk: Fortification may be utilized to meet calorie, protein, vitamin, and mineral needs of the premature or sick infant. Breast milk may be fortified with human milk fortifier in premeasured packets or powdered/liquid formulas. An open can of powdered formula is intended for single patient use and good for one month. Preparation of fortified milk can be done a feeding at a time or up to 24 hours in advance. All containers must be labeled (see labeling). All fortified human milk should be used within 24 hours. Contamination and osmolality increase faster in fortified human milk. Gently swirl the milk to mix. Avoid breaking the fat globules which will cause fat to adhere to the container and reduce the calories of the milk. Our NICU has large private rooms that have their own sinks, fridge, counter space + pull out counter intended for formula prep. The RN's currently fortify the breast milk at the bedside. We are fairly new to the NICU world and would like to know: * Is the ADA manual: Infant Feedings : Guidelines for Preparation of Formula and Breast milk in Health Care Facilities considered the gold standard in the industry, and if not, what other resources are used? * How many other NICU 's have : designated formula rooms, immersion blenders, gram scales? * if you fortify milk at the bedside, do you use teaspoons for powder or use disposables? * how do they sanitize the reusable items; ie autoclave, 3 sink sanitize, dishwasher, etc? * Is anyone is able to share their written policy guidelines? Thanks so much in advance, " There cannot be a crisis next week. My schedule is already full. " ---Henry Kissinger Boehme RD, CD Manager, Clinical Nutrition Meriter Health Services Phone: <file://kboehmemeriter/>kboehme@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 , Get onto pedi-rd listserv and ask. You will get tons of replies. to join: go to listserv@... leave the subject line blank type Subscribe Pedi-RD and then your name in the body of the e-mail Ro From: Gilpin Sent: Wednesday, February 16, 2011 1:40 PM To: rd-usa Subject: Re: NICU policy guidelines , I am not a neonatal/pediatric expert, but if you don't find anymore answers on rd-usa, you might try Dietitian Central. Just go to Dietitiancentral.com or type Dietitian Central into Google search and it comes up. You do have to set up a login and password to participate in their message boards, but there are lots of clincal experts that are good at answering questions like this one. Very little political chat. Mostly clinical and professional information. From: Boehme, <mailto:kboehme%40meriter.com> Subject: NICU policy guidelines To: " mailto:%27rd-usa%40yahoogroups.com' " <mailto:rd-usa%40yahoogroups.com>, " mailto:cnm-bounces%40lists.my180.net " <mailto:cnm-bounces%40lists.my180.net> Date: Wednesday, February 16, 2011, 9:44 AM I sent out this email last Friday and basically got one response. I thought I would try it again. Unfortunately it doesn't have any political ties but I hope people will respond regardless. :-) My NICU RD has been asked to update the policy for fortification of Human Milk. The current policy states: Fortification of Human Milk: Fortification may be utilized to meet calorie, protein, vitamin, and mineral needs of the premature or sick infant. Breast milk may be fortified with human milk fortifier in premeasured packets or powdered/liquid formulas. An open can of powdered formula is intended for single patient use and good for one month. Preparation of fortified milk can be done a feeding at a time or up to 24 hours in advance. All containers must be labeled (see labeling). All fortified human milk should be used within 24 hours. Contamination and osmolality increase faster in fortified human milk. Gently swirl the milk to mix. Avoid breaking the fat globules which will cause fat to adhere to the container and reduce the calories of the milk. Our NICU has large private rooms that have their own sinks, fridge, counter space + pull out counter intended for formula prep. The RN's currently fortify the breast milk at the bedside. We are fairly new to the NICU world and would like to know: * Is the ADA manual: Infant Feedings : Guidelines for Preparation of Formula and Breast milk in Health Care Facilities considered the gold standard in the industry, and if not, what other resources are used? * How many other NICU 's have : designated formula rooms, immersion blenders, gram scales? * if you fortify milk at the bedside, do you use teaspoons for powder or use disposables? * how do they sanitize the reusable items; ie autoclave, 3 sink sanitize, dishwasher, etc? * Is anyone is able to share their written policy guidelines? Thanks so much in advance, " There cannot be a crisis next week. My schedule is already full. " ---Henry Kissinger Boehme RD, CD Manager, Clinical Nutrition Meriter Health Services Phone: <file://kboehmemeriter/>mailto:kboehme%40meriter.com<mailto:mailto:kboehme%\ 40meriter.com> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 , Are you a member of the pediatric practice group (PNPG)? They've got some fantastic NICU RDs who can give advice. The pediatric-specific list serve, pedi-rd that mentioned, I believe it's run by the NICU RD at the University of Iowa; she's recognized nationally as an expert in NICU nutrition issues. You can't go wrong with that level of expertise on board. To the best of my knowledge, the ADA guidelines are still considered the gold standard; I think they might be either due for an update or in the process of being updated at this time. Good luck, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney@... http://www.linkedin.com/in/pamcharney > , > Get onto pedi-rd listserv and ask. You will get tons of replies. > to join: > go to listserv@... > leave the subject line blank > type Subscribe Pedi-RD and then your name in the body of the e-mail > Ro > From: Gilpin > Sent: Wednesday, February 16, 2011 1:40 PM > To: rd-usa > Subject: Re: NICU policy guidelines > > , > I am not a neonatal/pediatric expert, but if you don't find anymore > answers on rd-usa, you might try Dietitian Central. Just go to > Dietitiancentral.com or type Dietitian Central into Google search > and it comes up. You do have to set up a login and password to > participate in their message boards, but there are lots of clincal > experts that are good at answering questions like this one. > Very little political chat. Mostly clinical and professional > information. > > > > > From: Boehme, <mailto:kboehme%40meriter.com> > Subject: NICU policy guidelines > To: " mailto:%27rd-usa%40yahoogroups.com' " <mailto:rd-usa%40yahoogroups.com > >, " mailto:cnm-bounces%40lists.my180.net " <mailto:cnm-bounces%40lists.my180.net > > > Date: Wednesday, February 16, 2011, 9:44 AM > > I sent out this email last Friday and basically got one response. I > thought I would try it again. > Unfortunately it doesn't have any political ties but I hope people > will respond regardless. :-) > > My NICU RD has been asked to update the policy for fortification of > Human Milk. > The current policy states: > > Fortification of Human Milk: > Fortification may be utilized to meet calorie, protein, vitamin, and > mineral needs of the premature or sick infant. Breast milk may be > fortified with human milk fortifier in premeasured packets or > powdered/liquid formulas. An open can of powdered formula is > intended for single patient use and good for one month. > Preparation of fortified milk can be done a feeding at a time or up > to 24 hours in advance. All containers must be labeled (see labeling). > All fortified human milk should be used within 24 hours. > Contamination and osmolality increase faster in fortified human > milk. Gently swirl the milk to mix. Avoid breaking the fat globules > which will cause fat to adhere to the container and reduce the > calories of the milk. > > Our NICU has large private rooms that have their own sinks, fridge, > counter space + pull out counter intended for formula prep. The RN's > currently fortify the breast milk at the bedside. > > We are fairly new to the NICU world and would like to know: > > * Is the ADA manual: Infant Feedings : Guidelines for Preparation of > Formula and Breast milk in Health Care Facilities considered the > gold standard in the industry, and if not, what other resources are > used? > * How many other NICU 's have : designated formula rooms, immersion > blenders, gram scales? > * if you fortify milk at the bedside, do you use teaspoons for > powder or use disposables? > * how do they sanitize the reusable items; ie autoclave, 3 sink > sanitize, dishwasher, etc? > * Is anyone is able to share their written policy guidelines? > > Thanks so much in advance, > > > " There cannot be a crisis next week. My schedule is already full. " > ---Henry Kissinger > > > > Boehme RD, CD > > Manager, Clinical Nutrition > Meriter Health Services > Phone: > <file://kboehmemeriter/>mailto:kboehme%40meriter.com<mailto:mailto:kboehme%\ 40meriter.com > > > > Quote Link to comment Share on other sites More sharing options...
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