RE: NICU formula preparation policy

[Guest guest]

Thanks Sandi!

" 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@...

________________________________

From: rd-usa [mailto:rd-usa ] On Behalf Of Sandi

Birch

Sent: Tuesday, February 15, 2011 10:07 AM

To: rd-usa

Subject: Re: NICU formula preparation policy

Many NICUs have policies against the use of any powdered formulas (including

powdered HMF) becuase of bacterial contamination. Search for this - lots has

been published.

________________________________

From: Vajda

<jennyvajda@...<mailto:jennyvajda%40sbcglobal.net>>

To: rd-usa <mailto:rd-usa%40yahoogroups.com>;

" cnm-bounces@...<mailto:cnm-bounces%40lists.my180.net> "

<cnm-bounces@...<mailto:cnm-bounces%40lists.my180.net>>

Cc: " Norlin, Sally " <snorlin@...<mailto:snorlin%40meriter.com>>

Sent: Fri, February 11, 2011 11:37:23 AM

Subject: Re: NICU formula preparation policy

My input is from the discharge side, in WIC I had a real problem getting the

expensive packets ordered let alone approved, I would try to get the doctor to

agree to Neosure in the prper ratio to boost the 20 cal breast milk to 22 cal or

24 cal depending on order at the time. I don't remember the ratios but I would

teach the caregiver to measure carefully with a teaspoon - I think it was a 1/4

tsp per 2 oz breast milk and mix as needed in the exp. milk. The packets might

be convenient in the NICU but sending people home on it is expensive.

R Vajda, R.D.

________________________________

From: " Boehme, " <kboehme@...<mailto:kboehme%40meriter.com>>

To: " rd-usa <mailto:rd-usa%40yahoogroups.com> "

<rd-usa <mailto:rd-usa%40yahoogroups.com>>;

" cnm-bounces@...<mailto:cnm-bounces%40lists.my180.net> "

<cnm-bounces@...<mailto:cnm-bounces%40lists.my180.net>>

Cc: " Norlin, Sally " <snorlin@...<mailto:snorlin%40meriter.com>>

Sent: Fri, February 11, 2011 10:59:08 AM

Subject: NICU formula preparation policy

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@...<mailto:kboehme%40meriter.com><m\

ailto:kboehme@...<mailto:kboehme%40meriter.com>>