We use a lot of donor milk at Boulder Community Hospital in Boulder, Colorado. We went from just about never using it to using almost 700 ounces in May. We are in our fourth year of using it. In the first couple years the milk bank would bring us milk and we would have the family pay out of pocket. They either provided a CC number and the milk bank would bill them or wrote a check to the milk bank or (our least favorite) gave us cash. There was a lot of paperwork involved and it was a big fat pain. Then the milk bank said they were no longer going to bill patients directly, but rather the hospital. The rationale was we asked no other patient to pay for their food. Our director said, okay, we will pay for it. So now we just have the family sign an information sheet, so much less paperwork. We have a standing order for it on the baby's chart. If they have been using donor milk we send them home with one 4 ounce bottle and they can take home anything that was already open as well. We have refrigerators in our pt rooms. so we they are given a 4 oz bottle at a time. If you have a central nursery (we don't, babies room in 24 hours a day) you could theoretically use one bottle for multiple patients. After discharge if they want to continue using donor milk they have to contact the milk bank and arrange it and arrange payment. We do not give any milk out after discharge. When we charged the pt we did do this and it was another big fat pain because people would show up and want more milk, sometimes repeatedly, instead of calling the milk bank. Our patients are very happy with this option. Our nurse have gone from "You can use donor milk if you want to" with that funny expression on their face, to now saying it's better for the baby.

I handle the ordering and call when we get to 20 bottles in our freezer. Sometimes we go through a lot and we have to pay to have it couriered. The milk bank sends me the invoices and I send them on to accounts payable.

Happy to answer any other questions.

Andrea Tran RN, IBCLC
Boulder/Erie, Colorado

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