The Use of Human Milk in the Neonatal Intensive Care Unit: Practices in Belgium and Luxembourg

Abstract

Routines for handling of human milk differ widely among NICUs in Belgium and Luxembourg. An assessment of current issues through a structured survey is a useful tool in the development of best practice guidelines.

Improving the Process of Enteral Nutrition Preparation With Milk Technicians

“…Inconsistencies in the handling, storage, and preparation of enteral nutrition were identified in 19 NICUs across Belgium and Luxembourg. 5 While the published data are lacking on enteral feed preparation practices in US NICUs, the potential for variation by bedside nurses in the United States is likely due to the lack of standardized practice recommendations for neonatal enteral feeding preparation.…”

“…6 In the neonatal setting, there is reported variability in the equipment used for milk expression and collection, milk storage, bacteriological surveillance, pasteurization of mother's own milk, use of donor milk, and the preparation of enteral feedings. 5 Despite established safety and practice guidelines, there is reported variability in the practices of refrigeration, freezing, thawing, and use of fresh breast milk in neonatal units. 5 While the exact nature of the variations in clinical practice in the United States is unclear, given the known use of a variety of products to fortify enteral feedings, additional problems with preparation may include inaccurate amounts of additives and variable nutrient content between preparers.…”

“…5 Despite established safety and practice guidelines, there is reported variability in the practices of refrigeration, freezing, thawing, and use of fresh breast milk in neonatal units. 5 While the exact nature of the variations in clinical practice in the United States is unclear, given the known use of a variety of products to fortify enteral feedings, additional problems with preparation may include inaccurate amounts of additives and variable nutrient content between preparers. 7 These types of errors could contribute to feeding intolerance, delayed attainment of full enteral feeds, and other sentinel events.…”

Management of Mother's Own Milk for Very Preterm Infants in Tertiary-Level Neonatal Units in the Ile-de-France Region in France

“…[5][6][7] Variations in practices among neonatal units in Ile-de-France may be due to the fact that the guidelines did not always give the same recommendations, like, for instance, for storage time for refrigerated fresh milk. These differences also relate to units' interpretation of regulations and guidelines.…”

Essential trace element analysis of human breast milk

“…In these cases pasteurised donor human milk is the preferred alternative over formula milk. Milk banks are becoming increasingly common worldwide and allow women to donate milk if they met certain inclusion criteria (202,207). Pasteurised donor human milk is now widely accepted as life saving for many preterm infants and has been associated with a reduction in certain disease of prematurity including necrotising enterocolitis (208).…”