Nurse-Driven Initiative to Increase Exclusive Human Milk Feeding by Using Pasteurized Donor Human Milk to Treat Hypoglycemic Term Neonates.
Nurse-Driven Initiative to Increase Exclusive Human Milk Feeding by Using Pasteurized Donor Human Milk to Treat Hypoglycemic Term Neonates.
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DOI：
10.1016/j.nwh.2019.05.001
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发表时间：
2019-08-01
影响因子：
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通讯作者：
Anca, Raluca
中科院分区：
文献类型：
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作者：
Ferrarello, Debi;Schumacher, Aida;Anca, Raluca
目的：为了增加纯母乳喂养，提供巴氏灭菌的捐助者母乳（PDHM）新生儿低血糖症。设计：质量改进project.SETTING/EQUIPMENT问题：一个婴儿友好医院倡议指定的城市学术医疗中心在美国东北部服务于不同的人口，根据政策，几乎所有的新生儿低血糖症补充婴儿配方奶粉。大约85%的妇女在这个中心照顾开始母乳喂养，但许多斗争与纯母乳喂养在hospitalstay.Participants：所有工作人员在劳动和交付单位和母亲/婴儿单位，包括注册护士，单位办事员，病人护理技术人员，和哺乳顾问。长期，母乳喂养的新生儿被确定为低血糖，根据我们的指南有资格接受PDHM.INTERVENTION/MEASUREMENTS：注册护士提供有关PDHM的新生儿低血糖的父母教育，获得同意，并启动了该命令。根据我们的低血糖指南，当母亲自己的乳汁量不足时，我们提供PDHM而不是婴儿配方奶粉。我们测量了新生儿的血糖水平，并监测母乳喂养的结果，包括继续母乳喂养。结果：在4个月的试验中，83名新生儿符合PDHM。其中，76%的父母选择PDHM而不是配方奶粉。大多数新生儿在这两个群体仍然母乳喂养出院时，和53%的那些谁收到PDHM喂养母乳完全在其hospitalstay.CONCLUSION：护士驱动的协议，提供PDHM，否则健康的新生儿低血糖是一个可行的选择，增加纯母乳喂养在住院期间。
OBJECTIVE: To increase exclusive breastfeeding by offering pasteurized donor human milk (PDHM) to newborns with hypoglycemia.DESIGN: Quality improvement project.SETTING/LOCAL PROBLEM: A Baby-Friendly Hospital Initiative-designated urban academic medical center in the northeastern United States serving a diverse population where, by policy, virtually all newborns with hypoglycemia received supplemental infant formula. Approximately 85%of women cared for at this center initiate breastfeeding, but many struggle with exclusive breastfeeding during the hospital stay.PARTICIPANTS: All staff members in the labor and delivery unit and the mother/baby unit, including registered nurses, unit clerks, patient care technicians, and lactation consultants. Term, breastfed newborns identified as being hypoglycemic per our guidelines were eligible to receive PDHM.INTERVENTION/MEASUREMENTS: Registered nurses provided education about PDHM to parents of newborns who were hypoglycemic, obtained consent, and initiated the order. We offered PDHM instead of infant formula when mother's own milk was not available in sufficient quantity per our hypoglycemia guidelines. We measured newborns' glucose levels and monitored breastfeeding outcomes, including continued breastfeeding.RESULTS: During the 4-month trial, 83 newborns were eligible for PDHM. Of those, 76%of parents opted for PDHM rather than formula. Most newborns in both groups were still breastfeeding at discharge, and 53%of those who received PDHM were fed human milk exclusively during their hospital stays.CONCLUSION: A nurse-driven protocol offering PDHM to otherwise healthy newborns with hypoglycemia is a viable option for increasing exclusive breast milk feeding during the hospital stay.