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From:
Sheila Waterstrat <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 23 Jan 2017 15:33:09 -0500
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Hi!
  We had been running into this issue more and more in our small hospital here in Olympia, WA. Many of the larger hospitals in the area have their own HDM from Milk banks and can offer this to their high risk newborns (although I hear more and more that in some hospitals it is getting offered to almost any mom who is deemed to have a supply issue or to term babies with weight or blood sugar issues). One of our first cases was an adoption in which the adoptive parents wanted to give baby the human donor milk they had obtained through a popular website.  It turned out the biological mom formula fed the baby while it was in the hospital, so I am sure the adoptive parents chose HDM when they were discharged. At this point I developed a policy (still in the process of being "approved" which had to include that a pediatrician's order was necessary and testing done on donor mother is "required" if obtained privately).  I also developed a realease form for the parents to sign stating they understand the risks of offering human donor milk to their baby, etc, etc. Our pediatricians vary in their opinions of HDM, so there is a big gray area on who may actually sign an order and who might choose not to regardless of testing.
  FORTUNATELY, the last experience we had was with a momma who had IDDM and supply issues with her first and had talked to her pediatrician, had a prescription written so that she could obtain HDM from the local Human Milk Bank, and came prepared with them to the hospital. (I talked to her about hand expressing her own colostrum before pregnancy but she had not thought to do this). Because it came from a Milk Bank, our on-call pediatrician had no problem with them giving it as a supplement (mom was able to BF and only needed to suppl the first few days d/t hypoglycemia in baby).
  My hope is that, as HDM from Milk Banks is getting easier to obtain, and moms are more educated about HDM and talking to the pediatrician or OB about it, that we will have moms coming in with "authorized" HDM from banks. As for the moms who come in with HDM from a sister, friend, website...it is most likely that a pediatrician will not approve of feeding baby this in the hospital if testing was not done and documented.
  I am curious what other experiences you all have had. I know I talked to an IBCLC in Australia who had said that, as long as mom signed a release, she could give her baby any HDM. All of the research I did lead to NICUs and VLBW/preterm babies and milk bank donations, which does not apply to our hospital.
Thanks so much
Sheila Waterstrat IBCLC, RN
Olympia, WA

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