Attitudes of NICU professionals regarding feeding blood-tinged colostrum or milk

Objective: Mothers of neonatal intensive care unit (NICU) patients sometimes bring expressed milk that is blood tinged to the NICU. In certain instances, the blood contamination appears minimal, whereas in others, the milk is quite dark pink. We have observed inconsistencies in practice regarding wh...

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Bibliographic Details
Published in:	Journal of Perinatology Vol. 29; no. 2; pp. 119 - 123
Main Authors:	Phelps, M M, Bedard, W S, Henry, E, Christensen, S S, Gardner, R W, Karp, T, Wiedmeier, S E, Christensen, R D
Format:	Journal Article
Language:	English
Published:	New York Nature Publishing Group US 01-02-2009 Nature Publishing Group
Subjects:	Adult Attitude of Health Personnel Attitudes Best practice Blood Breast Feeding Breast milk Breastfeeding & lactation Colostrum Consultants Contamination Feeding Female Food contamination Food contamination & poisoning Health aspects Humans Intensive care Intensive Care Units, Neonatal Intolerance Lactation Male Management Medical personnel Medicine Medicine & Public Health Milk Neonatal care Neonatal intensive care Neonatal nursing Neonates Nurse practitioners Nurses original-article Patients Pediatric Surgery Pediatrics Polls & surveys Practice Privacy Professional Practice Surveys United States United States > US NICU colostrums human milk blood-tinged milk attitudes feeding
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Summary:	Objective: Mothers of neonatal intensive care unit (NICU) patients sometimes bring expressed milk that is blood tinged to the NICU. In certain instances, the blood contamination appears minimal, whereas in others, the milk is quite dark pink. We have observed inconsistencies in practice regarding whether or not to feed blood-tinged colostrum or milk to NICU patients. We know of no evidence that establishes best practice in this area, and thus we sought to determine attitudes of NICU professionals on which to base a potentially best practice. Study Design: We conducted a web-based anonymous survey of attitudes of NICU professionals at Intermountain Healthcare regarding feeding blood-tinged expressed milk to NICU patients. These professionals included neonatologists, neonatal nurse practitioners, NICU nurses, NICU dieticians and lactation consultants. Result: Survey results were returned from 64% (426 of 667) of those to whom it was sent. A total of 75% of respondents reported that their practice was NOT to feed the blood-tinged milk illustrated in the figure as sample 2, and nearly all respondents (98%) reported that they would NOT feed the milk illustrated as sample 3. The majority of the neonatologists (56%) and the lactation consultants (58%) recommended feeding moderately bloody milk (sample 2), whereas only 22% of the neonatal nurse practitioners (NNPs), NICU nurses and NICU dieticians recommended feeding such samples (<0.001). The most frequently selected reason for NOT feeding blood-tinged milk was that it would likely cause gastrointestinal upset and feeding intolerance (selected by 77%). The majority (87%) overestimated the amount of blood contaminating a milk sample (sample 3). Conclusion: As colostrum and human milk feedings can be of value to NICU patients, evidence should be assembled to document whether feeding blood-tinged samples indeed have the problems listed by the survey respondents. Such evidence is needed to enable informed decisions involving the benefits vs risks of feeding blood-tinged expressed milk to NICU patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0743-8346 1476-5543
DOI:	10.1038/jp.2008.188