The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants.

Objective: Human milk has well-established health benefits for preterm infants. We conducted a multidisciplinary quality improvement effort aimed at providing at least 500 mL of human milk/kg in the first 14 days of life to very low birth weight (VLBW) (< 1,500 g) infants in the neonatal intensive care unit.

Subjects And Methods: Improvement activities included antenatal consults with at-risk mothers, staff and parent education, a breast pump loaner program for uninsured/underinsured mothers, pump logs, establishment of a donor milk program, and twice-daily physician evaluation of infants' ability to tolerate feedings.

Launching evidence-based nursing practice.

In one institution's effort to develop nursing staff to use evidence in practice, formation of the Evidence-Based Practice Council was instrumental. This Evidence-Based Practice Council developed its members to support the development of others. Programming strategies included keynote speakers during Nurses Day followed by breakout sessions and programs throughout the year.

Alterations in the host defense properties of human milk following prolonged storage or pasteurization.

Objectives: Preterm infants are often fed pasteurized donor milk or mother's milk that has been stored frozen for up to 4 weeks. Our objectives were to assess the impact of pasteurization or prolonged storage at -20 degrees C on the immunologic components of human milk and the capability of the different forms of human milk to support bacterial proliferation.

Materials And Methods: The concentrations and activities of major host defense proteins in the whey fractions of mother's milk stored for 4 weeks at -20 degrees C or pasteurized human donor milk were compared with freshly expressed human milk.

Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad.

Objective: Ankyloglossia in breastfeeding infants can cause ineffective latch, inadequate milk transfer, and maternal nipple pain, resulting in untimely weaning. The question of whether the performance of a frenuloplasty benefits the breastfeeding dyad in such a situation remains controversial. We wished to 1) define significant ankyloglossia, 2) determine the incidence in breastfeeding infants, and 3) measure the effectiveness of the frenuloplasty procedure with respect to solving specific breastfeeding problems in mother-infant dyads who served as their own controls.