We live in the Arizona desert. The vast majority of our patients are low
income. If they have cars, many are without air conditioning. Some come in
taxis or on the city bus, borrowed cars, or are driven in by a
friend/relative. Some drive 1 to 3 hours one way to get here from the
Reservation and other rural areas. Even though we do teach them to use
insulated bags, styrofoam coolers, or even provide them with these bags and
packages of freezer gel, some still show up with 3-4 volufeeds of
(defrosted?) milk swimming in water that used to be ice, in a zip top
plastic bag. We don't know how long it's been in that condition. We need an
interpreter to explain what freezer gel or "Blue Ice" is. So instead of
judging the EBM of each individual mom, we have a general policy that all
EBM brought in must still be frozen, or no more than 50% defrosted. We do
encourage pumping on site as often as they wish. Sometimes that's the only
time they get to use an electric pump.

Our NICU does have an excellent reputation in the community, and we often
get babies transferred in from the "high rent district". You can see the
faces of the well-educated, high income parents looking uncomfortably at
our lack of amenities and soothing decor, but once they see we have
excellent staff and equipment, they feel better and have more confidence in
our facility. But our frozen EBM rules apply equally to them.


> Phyllis, why would frozen be allowed and not fresh, if brought from home?
I
> would assume they wouldn't allow any milk for fear that it wouldn't be
> sterile.  Would freezing sterilize and negate any non-sterile conditions
or
> would all germs be eliminated by the freezing process?
>
> thanks.
> ellen shein, ibclc,
> tel aviv


--- Phyllis Adamson, IBCLC
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