Hello all,
My name is Maureen Allen and I am an LC in the Level III NICU at
Brigham and Women's Hospital in Boston. We are trying to begin doing
creamatocrits in our NICU and need to get it approved by the lab (as a
bedside test) and okayed by nutrition, neonatologists and God know who else,
before we can start. I know all about Paula Meier and Nancy Hurst's
work--I've done a pretty exhaustive lit search, as well as communicated with
both of them. We do have some ideas on how we'd like to utilize
creamatocrits, but I'd love some input. What I'd like to find out from all
of you is:
1. What avenues did you need to go through to get creamatocrits approved?
2. What type of crit spinner are you using? What brand--do you like it or
not?
3. Who does them--LCs, nurses, mothers? Any quality control issues?
4. Do you have a formal policy and procedure? Or do you use Paula's handout?
5. Do you do them for all babies--or what are your guidelines for initiating
them?
6. Do you see increased weight gain, head circumferences, lengths when baby
starts on hindmilk feedings? Or just weight gain? How long do you usually
need to do this for a baby?
Anything else you can think of would be appreciated. If you think you need
to contact just me, please do. If it's OK and you feel comfortable sharing,
though, I think there are alot of people out there who may be interested in
hearing about this--respond to the group, please.
We know that there are many NICUs who are doing this with Paula's procedure
in hand, along with an old crit spinner from the basement or someone's
office. I'd really like to hear from you, too--your information is valuable
in helping us convince others "it's a good thing". Most of the neos think
this will be great, but I'd like as much ammunition as possible before we go
in to present this to everyone.
I' m discovering that the bigger the hospital, the more hoops to jump
through. I can understand some of this, as we did have one person who had
heard about hindmilk and began splitting foremilk and hindmilk and giving one
baby hindmilk(he wasn't growing well) and the other two foremilk--not for
long, thankfully. With so many people involved in the care of our babies, it
is probably better to have a strong policy, as to avoid as many of these
kinds of issues as possible. Our mantra is "Change is slow"--but at least
it's changing. Please respond ASAP--we have 180 NICU nurses breathing down
our backs who want to stop putting all of that &##%!! in mother's
milk--their words, not just mine. See, change is slow, but it does happen!
Thanks everyone.
Maureen Allen RN,
BSN, IBCLC
Lactation Consultant,
NICU
Brigham and Women's
Hospital
Boston, MA
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