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Guidelines for the Preparation and Handling of Expressed and Donor

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Guidelines for the Preparation and Handling of Expressed and Donor Guidelines for the Preparation and Handling of Expressed and Donor Breast Milk and Specialist Feeds for Infants and Children in Neonatal and Paediatric Health Care Settings 1 Contents Contributors and Acknowledgements ...................................................................................................... 5 Contributors ............................................................................................................................................ 5 Acknowledgements ................................................................................................................................. 5 Foreword ................................................................................................................................................. 5 Frequently Used Abbreviations ............................................................................................................... 6 Frequently Used Definitions .................................................................................................................... 6 Section One ............................................................................................................................................ 7 Introduction ......................................................................................................................................... 7 Section Two ............................................................................................................................................ 8 Physical Facilities ................................................................................................................................ 8 2.1 The Special Feed Unit .................................................................................................................. 8 2.2 Facilities without a Separate Feed Preparation Room .................................................................. 9 Section Three ......................................................................................................................................... 9 Equipment and Supplies ...................................................................................................................... 9 3.1 Equipment .................................................................................................................................... 9 3.2 Supplies ..................................................................................................................................... 10 3.3 Facilities without a Feed Preparation Room ............................................................................... 10 Section Four ......................................................................................................................................... 11 Personnel .......................................................................................................................................... 11 4.1 Personal Hygiene and Clothing .................................................................................................. 11 4.2 Training ...................................................................................................................................... 11 4.3 Personnel in Facilities without a Feed Preparation Room ........................................................... 12 Section Five .......................................................................................................................................... 12 Feed Preparation and Handling ......................................................................................................... 12 5.1 WHO Guidelines for safe Preparation, Storage and Handling of Powdered Infant ...................... 12 5.2 Aseptic Technique ...................................................................................................................... 12 5.3 Feed Recipes and Labels ........................................................................................................... 13 5.4 Ingredient Water ......................................................................................................................... 13 5.5 Formula Mixing ........................................................................................................................... 13 5.6 Pasteurisation............................................................................................................................. 15 5.7 Chilling and Storage of Feeds in the SFU ................................................................................... 15 5.8 Care and Maintenance of Facilities and Equipment .................................................................... 15 5.9 Feeds Made Up Outside of SFU Hours of Operation .................................................................. 15 5.10 Irregularities in Feed Preparation and Storage ........................................................................... 16 Section Six ............................................................................................................................................ 16 Storage, Collection and Handling of Maternal Expressed Breast Milk (MEBM) and Pasteurised Donor Breast Milk (PDBM) ........................................................................................................................... 16 6.1 Expressing Breast Milk ............................................................................................................... 16 6.2 Breast Milk Storage .................................................................................................................... 19 6.3 Storing Breast Milk Prior to Arrival at the Hospital ...................................................................... 20 2 6.4 Transporting Breast Milk ............................................................................................................. 21 6.5 Appearance of Breast Milk.......................................................................................................... 22 6.6 Storage and Use of Breast Milk in Hospital ................................................................................. 22 6.7 Thawing and Warming Feed ....................................................................................................... 24 6.8 Continuous Feeds ...................................................................................................................... 25 6.9 Additives to Breast Milk .............................................................................................................. 25 6.10 Medications and Mother’s Milk ................................................................................................... 26 6.11 Maternal Illness and Breast Milk ................................................................................................. 26 6.12 Ante-natally Expressed Colostrum .............................................................................................. 26 6.13 Breast Milk Error ........................................................................................................................ 27 6.14 Donor Breast Milk ....................................................................................................................... 27 6.15 Storage Times for MEBM and PDBM ......................................................................................... 29 Section Seven ....................................................................................................................................... 30 Delivery of Feeds and Storage at Ward/Unit Level ............................................................................ 30 7.1 Delivery of Feeds ....................................................................................................................... 30 7.2 Discarding Formula .................................................................................................................... 30 7.3 Feed Storage ............................................................................................................................. 30 Section Eight ......................................................................................................................................... 30 Feeding the Child and Feed Management at Ward/Unit Level ........................................................... 30 8.1 Feed Handling ............................................................................................................................ 30 8.2 Warming Feeds .......................................................................................................................... 31 8.3 Feed Administration.................................................................................................................... 31 8.4 Discharge Planning .................................................................................................................... 31 Section Nine ......................................................................................................................................... 31 Infection Prevention and Control........................................................................................................ 31 9.1 Hazard Analysis Critical and Control Point Plan ......................................................................... 32 9.2 Microbiological Sampling ...........................................................................................................
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