Dear Zena, Most of the hospitals where I live do a pretty good job telling 
moms to get an electric pump for their NICU babies but it ends there. 
Rarely, do they mention they have a pump in the NICU for those moms to use 
when visiting their baby. Most of the hospitals will open the bottle of 
human milk and keep reusing it until it is gone, some throw away. (I believe 
the HMBANA says one closure after putting the milk into the container and 
one opening to feed the baby -- this is for infection control.)

What our WIC is trying right now is a handout in English and Spanish about 
the state's breast pump loaner program for NICU babies. We recently changed 
it to where it lists all the WICs in the area and their contact phone number 
for a loaner breast pump for NICU situations (not just our local agency). 
When I do the actual pump loan, I go over all the things mom needs to know, 
how often to pump, how to wash the collection kit, how to store the milk, 
and I have her use the pump in front of me so I know she knows what to do 
and the flanges fit right. This takes me about 45 minutes per client 
(including doing the contract).

We have given these fliers to hospitals and asked them to hand them out. We 
are also going to some of our low income maternity clinics and giving the 
staff these fliers. The best thing is to have WIC staff give the flier out 
to the PG women, so they know what to do in advance. Hopefully they will 
remember!

We are either having a huge NICU boom, or our outreach is working. I have 
double the amount of breast pumps out on loan than I did a year or two ago. 
I also call the moms every week or two to encourage them and give 
information. (But due to our hospital situation, I don't have more mothers 
breastfeeding after the baby comes home. We try!)

About fortifier. Almost all the babies are on fortifier at most of our 
hospitals. Many come home being told to pump and bottle feed so they can 
have formula added to their breast milk to increase the calories. I do not 
believe our WIC moms can get HMF from WIC, I think they all are told to use 
a little bit of regular formula added to the breast milk. My understanding 
is the HMF is only available to hospitals. Or, they are told to quit using 
human milk entirely and use a special premie formula.

Kathy Eng, BSW, IBCLC 

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