Vol. 25 No. 3 neonatal May-June 2012 INTENSIVE CARE SPECIAL SUPPLEMENT In-HospItal Breast FeedIng WarmIng Human Milk FIttIng Breast Shields Breast pumpIng HygIene HmBANA guIdelInes Human Milk storage Editorial Advisory Board Arie L. Alkalay, MD Ivan Frantz, III, MD Rahmi Ors, MD Clinical Professor of Pediatrics Professor of Pediatrics Chief, Division of Neonatology UCLA School of Medicine Chief, Division of Newborn Medicine Ataturk School of Medicine ISSN 1062-2454 Los Angeles, CA Tufts University School of Medicine Erzurum, Turkey Boston, MA Published seven times each year by M. A. Arif, TableMD of Contents T. Michael O’Shea, MD, MPH Professor of Pediatrics & Head, Neonatology Philippe S. Friedlich, MD Chief, Neonatology Division Goldstein and National Institutes3 ofImproving Child Health In-HospitalAssistant Professor Breastfeeding of Pediatrics ManagementWake Forest University for the School of Medicine Associates, Inc. Karachi, Pakistan Keck School of Medicine Winston-Salem, NC Late Preterm University of Southern California Muhammad Aslam, MD G. Battisita Parigi, MD Los Angeles, CA 10940 Wilshire Blvd., Suite 600 Instructor in Pediatrics,Maria Harvard Lennon, Medical RN, MSN, CNM, IBCLC Associate Professor of Pediatric Surgery Los Angeles CA 90024 School It is essential forG. a Paolo mother Gancia, and MD her family toUniversity be educated of Pavia, Italy on the Neonatologist & Director of Education Neonatologist, Terapia Intensiva Richard Paul, MD Phone: 310-443-4109 Neonatology and Newbornimportance Medicine Unit of breastmilkNeonatale-Neonatologia and how it provides not only optimal Chief, Maternal & Fetal Medicine Department of Pediatrics Cuneo, Italy Fax: 310-443-4110 nutrition for her late preterm infant but alsoDepartment helps protectof Obstetrics from & Gynecology Massachusetts General Hospital for Children George A. Gregory, MD University of Southern California E-mail: [email protected] Boston, MA disease and improved developmental outcomes. Professor of Pediatrics and Anesthesia Los Angeles, CA Web: www.nicmag.ca Edward Austin, MD University of California Max Perlman, MD Assistant Clinical Professor San Francisco, CA 7 Best Practices for Warming Human Milk in Professora Hospital of Pediatrics Setting Publisher Pediatric Surgery Jean Rhodes, PhD, CNM,William IBCLCR. Halliburton, RRT, RCP The Hospital for Sick Children Steve Goldstein University of California-San Francisco Neonatal Respiratory Care Coordinator Toronto, Ontario, Canada San Francisco, CA Human milk feedings in the hospital setting involve a complex Department of Respiratory Care Boris Petrikovsky, MD Editor Richard L. Auten,matrix MD of issuesHillcrest related Baptist to Medical the intricateCenter nature of human milk Professor of Obstetrics and Gynecology Les Plesko Assistant Professor of Pediatrics Waco, TX and the potential hazards of milk storage andNassau preparation. Health Care Corporation Duke University Medical Center Mary Catherine Harris, MD East Meadow, NY Durham, NC Through the use of innovative technology, and with effective Senior Editor Associate Professor of Pediatrics Arun Pramanik, MD Laszlo Sandor Bruce G. Bateman,clinical MD implementation,Division of Neonatology the Medela Waterless Milk Warmer Professor of Pediatrics Department of Obstetrics & Gynecology University of Pennsylvania School of may help maintain the optimal integrity of humanSection of Neonatology milk feeds University of Virginia Medicine Associate Editor Louisiana State University Charlottesville, VA for hospitalized Theinfants. Children’s Hospital of Medicine Jordana Hammeke Health Sciences Center, Shreveport, LA Philadelphia, PA David D. Berry, MD Benamanahalli K. Rajegowda, MD Design, Typography, Prepress and Wake Forest University School of Medicine David J. Hoffman, MD 10 Correctly Fitting Breast Shields: A Guide forChief Clinicians of Neonatology Winston-Salem, NC Clinical Associate Professor of Pediatrics Production Management Lincoln Medical and Mental Health Center Irene Murphy Zoppi,Penn RN, State MSN, College IBCLC of Medicine D. Spencer Brudno, MD Professor of Clinical Pediatrics http://accugraphics.net Staff Neonatologist Associate Professor ofClinicians Pediatrics need to know how the pump componentsWeill Medical Collegework of Cornell University, NY The Reading Hospital and Medical Center Medical Director, Pediatric Therapy Circulation, Coverage, Advertising together and howWest to Reading, ensure PA mothers are usingKoravangattu correctly Sankaran, sized FRCP(C), Medical College of Georgia Complete details regarding FAAP, FCCM Rates: Augusta, GA breast shields… MichaelClinicians R. Jackson, should RRT know specific breast shield Professor of Pediatrics and Director of circulation, coverage, advertising Newborn Intensive Care Unit Curtis D. Caldwell,sizing NNP criteria that are straightforward and Neonatologycan be easilyand Neonatal Research Beth Israel Hospital rates, space sizes, and similar infor- UNM School of Medicine Department of Pediatrics interpreted and Boston,taught MA to mothers. mation are available to prospective Department of Pediatrics Royal University Hospital advertisers. Closing date is 45 days Albuquerque, NM Chang-Ryul Kim, MD University of Saskatchewan Associate Professor of Pediatrics Saskatoon, Saskatchewan, Canada preceding date of issue. Ed Coombs,13 MA, Evidence-BasedRRT Recommendations for Breast Pumping College of Medicine Sr. Marketing ManagerHygiene – Ventilation Istvan Seri, MD, PhD Hanyang University Kuri Hospital Change of Address notices should Draeger Medical, Telford, PA Professor of Pediatrics Jean Rhodes, PhD, CNM,Seoul, South IBCLC Korea Head, USC Division of Neonatal Medicine be sent promptly to Circulation Jonathan H. Cronin, M.D. Expressing humanDavid milk M. Kissin as BS,hygienically RRT as possibleUniversity of Southernwill California, Assistant Professor of Pediatrics, Harvard Department: provide old mailing Perinatal/Pediatric Specialist Los Angeles, CA Medical School diminish the risk of pathogenic contamination and decrease label as well as new address: include Maine Medical Center, Portiand, ME Chief, Neonatology andmicrobial Newborn Medicine growth in stored human milk; however,Tushar A. the Shah, process MD, MPH zip code or postal code. Allow two Unit Sheldon Korones, MD Division of Neonatology months for change. Department of Pediatricsis fragile and anyDirector break of Newborn in technique Center can leadCincinnati to undesired Children’s Hospital Medical Center Massachusetts Generalresults. Hospital for Children College of Medicine Cincinnati, OH Editorial Contributions may be Boston, MA Memphis, TN Dave Swift, RRT sent by e-mail and will be handled Michael P. Czervinske, RRT Scott E. Leonard, MBA, BA, RRT Ottawa Hospital – Civic Site with reasonable care: however, Neonatal and16 Pediatric Current Critical Care Breast PumpChief Administrative Recommendations Director forCampus NICU Coordinator Mothers: (Professional Practice) publishers assume no responsibility University of Kansas 2011Medical CenterHMBANA GuidelinesDepartment of Respiratory – an Care Essential Services Resource& Special Care Nursery Charge Therapist Kansas City, KS Jean Rhodes, PhD, CNM,UMass Memorial IBCLC Medical Center Respiratory Therapy Team Lead for safety of art work, photographs, Worcester, MA National Office of the Health Care Professor Adekunle H. Dawodu or manuscripts. Every precaution Current best practice standards continue to Emergencyrecommend Response theTeam (NOHERT) Chairman of Pediatrics Raymond Malloy, BS, RRT Subject Matter Expert is taken to ensure accuracy, but Faculty of Medicine anduse Health of hospital-gradeSciences Director ofelectric Pulmonary Carepumps when infants cannot go to Health Canada the publishers cannot accept United Arab Emiratesbreast University or when theyThomas cannot Jefferson University breastfeed Hospital effectively. responsibility for the correctness Al Anin, UAE Philadelphia, PA Otwell D. Timmons, MD Assistant Professor of Pediatrics or accuracy of informa tion supplied Jayant Deodhar, MD Paul J. Mathews, PhD, RRT, FCCM, University of Utah Medical Center Associate Professor20 ofHuman Clinical Pediatrics Milk StorageFCCP, FAARC in the NICU – Summarizing the Research herein or for any opinion expressed. Salt Lake City, UT Editorial closing date is the first day Children’s Hospital Center– What You ShouldAssociate Know Professor of Respiratory Care Cincinnati, OH Amy O’Malley, RN, UniversityMSN of Kansas Medical Center Maya Vazirani, MD, FAAP of the month preceding month of Kansas City, KS Board Certified Neonatology and Pediatrics, Leonard Eisenfeld, MD To decide which storage guidelines are appropriate,Lancaster, CA the issue. Associate Professor of Pediatrics William Meadow, MD University of Connecticutage School and of healthMedicine ofAssociate the infant Professor as well as other factorsMax Vento, must MD be ©2012 by Goldstein & Associates, Division of Neonatologyconsidered. WithDepartment high-risk of Pediatrics infants, the safestAssociate approach Professor isof Pediatrics Inc. All rights reserved. Connecticut Children’s Medical Center The University of Chicago Chief, Pediatric Services Reproduction in whole or in part Hartford, CT to minimize contaminationChicago, IL and use appropriateNeonatologia storage Hospital Virgin del Consuelo Valencia, Spain without written permission is Sami Elhassani, MDconditions for theDavid shortest G. Oelberg, storage MD time possible. strictly prohibited. Neonatologist Center for Pediatric Research Dharmapuri Vidyasagar,