Benefits of Breastfeeding

Mother_Breast_feedingBREAST MILK BENEFITS FOR MOM AND BABY
“Breast milk is the ideal food for babies. It has the vitamins, protein and fat that a baby needs to grow. It’s easy to digest, contains antibodies that help the baby fight off illnesses and lowers the baby’s risk for having asthma, allergies and becoming obese,” says Dr. Bixby, CHOC’s medical director of lactation services. Babies exclusively breastfed for the first six months also tend to have fewer ear infections, respiratory illnesses and diarrhea, Dr. Bixby says. Plus, breastfeeding helps mom and baby bond. The American
Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the World Health Organization all strongly recommend breastfeeding. And, it’s free!

BENEFITS OF DONOR MILK
In the case where a mom can’t produce or sustain her own milk supply, for whatever reason, donor human milk is an excellent alternative to a mother’s breast milk or formula, says Dr. Bixby. “Donor milk isn’t as good as the mother’s own milk but it’s way better than formula, especially for preterm babies or those with gastrointestinal or digestive issues that make it harder for the baby to digest food. Breast milk is designed to help move the gut better. It is a limited resource so at CHOC, we mostly use donor milk for preterm babies under 32 weeks old and also at times for some of our surgical patients.”

LACTATION SERVICES AT CHOC
CHOC’s Clinical Nutrition and Lactation Services department seeks to be a helpful source of nutrition and lactation information for patients, their families and the community. Individualized, family-centered and culturally sensitive lactation care is part of CHOC’s interdisciplinary approach to healthcare and wellness. CHOC has board-certified lactation consultants on hand to help patients who are breastfeeding or receiving donor breast milk. For information about inpatient lactation services at CHOC, call (714) 509-8455.

FAST FACTS

  • Percentage of infants in California who were breastfed in 2013: 91.6
  • Percentage of infants nationwide breastfed at 6 months (infants born in 2010) – up from 35% of infants born in 2000: 49%

View the full feature on Babies and Breastfeeding

Dr. Bixby
Dr. Christine Bixby
CHOC Neonatologist

PHYSICIAN FOCUS: DR. CHRISTINE E. BIXBY

Dr. Bixby is CHOC’s medical director of lactation services. Dr. Bixby completed her fellowship in neonatology at Harbor UCLA Medical Center and also completed her residency and internship training in pediatrics at Harbor UCLA Medical Center. She completed a fellowship in neonatology in a joint program between CHOC and Harbor UCLA Medical Center. Dr. Bixby specializes in caring for premature infants and is involved in research studies focusing on issues related to breast milk, establishing a milk supply and using breast milk for premature babies.

Dr. Bixby’s philosophy of care: “My philosophy of care is to bring in the parents and family as part of the healthcare team and making sure they are educated and  comfortable with the care we are giving their children.”

EDUCATION:
University of California, Davis, School of Medicine

BOARD CERTIFICATIONS:
Neonatal-Perinatal Medicine

More about Dr. Christine Bixby

This article was featured in the Orange County Register on July 7, 2014, and was written by Amy Bentley.

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Nutrition for Breastfeeding Moms

Nursing mothers are providing their babies with nutrients to help ensure their growth – but what about mom’s diet?

In the latest CHOC Radio podcast, CHOC Children’s clinical dietitians Sue Freck and Gina O’Toole address many questions that breastfeeding moms may have about their own nutrition.

Listen in to hear the dietitians, who both work in CHOC’s neonatal intensive care unit, discuss how many extra calories a nursing mother should eat, what foods to be mindful about, and much more.

Breastfeeding Premature Infants

breastfeeding_preemiesParents of premature infants face many new challenges as they help their special infant grow and flourish, and breastfeeding is often one of them.

“Breastfeeding a preemie is possible but the exclusive breastfeeding of a baby, especially the earlier premature babies, is not always nutritionally appropriate,” says Dr. Christine Bixby, a CHOC Children’s neonatologist who specializes in caring for premature infants.

There’s rarely a case where a premature baby can’t get some breast milk, she says. For example, in CHOC’s neonatal intensive care unit (NICU), nurses add powdered formula to breast milk to increase the nutrient levels.

“The breast milk is the best base, so we add some nutrients and that helps the baby grow,” says Dr. Bixby, who is involved in research studies focusing on issues related to breast milk, establishing a milk supply and using breast milk for premature babies.

Mothers of premature babies often have difficulty producing milk or sustaining production, Dr. Bixby says.

“Oftentimes moms are unable to make milk early in the process or sustain it, which given the prematurity of their baby, isn’t surprising,” Dr. Bixby says.

So, while the baby is at CHOC, lactation consultants and other specialists are available to help and encourage a mother to pump, if possible. The best way for a mother of a premature baby to establish a milk supply is to begin pumping as early as possible, ideally within six hours of delivery, she says. The mother should attempt to pump regularly, which physicians understand can be challenging when her baby is in the NICU.

For early feedings, donor human milk is an excellent alternative to a mother’s breast milk. CHOC purchases breast milk from a milk bank to offer babies whose mothers cannot produce milk, Dr. Bixby says. Milk donors are tested and the banked milk is completely safe, she adds.

Specialized formulas are also available for later feedings and following discharge. These both provide extra nutrients to help older premature babies grow, Dr. Bixby says.

“If the milk doesn’t come, regardless of why, it’s not worth dwelling on it,” she says. “Parents should ask their doctor about the best formula available and focus on creating a nurturing and loving environment for their baby.”

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New Process Leads to Safer Breast Milk Handling

20130423_0279 CHOC Children’s is seeing fewer breast milk feeding errors after a more than two-year initiative to redesign the process for safer and more efficient handling.

With very few government regulations in place, hospitals across the country struggle to establish best practices in handling breast milk, and CHOC is no different. Busy nurses are often tasked with collecting, labeling, inventorying and distributing dozens of bottles during a shift, amidst other critical responsibilities.

“Our nurses are doing a multitude of highly important things, often being pulled in many directions at once,” said Caroline Steele, director of CHOC’s Clinical Nutrition & Lactation Services. “Without good support and a better system in place, there was potential for interruptions and errors.”

In June 2011, CHOC’s Joint Leadership Committee formed a process improvement team, including a physician co-chair and representatives from each inpatient nursing unit, Clinical Nutrition and Lactation, Quality and Transport. The team reviewed data from the previous 12 months and identified possible handling errors, such as storage problems, incorrect labels and instances of patients receiving the wrong milk.

Breast milk errors can spread diseases and20130423_0293 infections and, in some cases, are reportable events to the California Department of Public Health. If the wrong milk is handed to a mother who then views a patient’s private information on the label, that event would be a reportable breach of the Healthcare Insurance Portability and Accountability Act (HIPAA) as well.

A New Method

In January 2013, the team moved milk preparation to a centralized location. The existing formula room was repurposed to accommodate both formula and breast milk preparation. Now referred to as the Nutrition Lab, it houses a breast milk freezer and a commercial dishwasher and is staffed with registered dietetic technicians. CHOC also operates a satellite nutrition lab in the CHOC Children’s Neonatal Intensive Care Unit (NICU) at St. Joseph Hospital.

CHOC then secured a $190,000 grant from UniHealth to purchase the Timeless™ Breast milk Tracking system. The software uses unique barcode identifiers to ensure babies are matched with the correct milk, and that the milk has not expired. The system launched in November 2013 in the NICU, medical and surgical units, neuroscience unit, oncology unit, pediatric intensive care unit (PICU) and cardiovascular intensive care unit (CVICU) at the hospital’s Orange campus.

Nurses previously fortified and prepared milk themselves at the bedside – a contamination risk – and then had to ask a second nurse to verify the accuracy of it at every step. That accuracy check is now done automatically.

“It used to take at least an hour to make your shift’s worth of milk,” NICU nurse Jenn Landman said. “That’s an hour you can spend with a baby’s family or do extra things, like bath time or a ‘spa day’ with a baby. It’s much more meaningful work.”

Now, when a mother checks in with her baby, a nurse prints labels for the breast milk expressed during their stay and scans the baby’s armband to verify the labels are correct. The mother attaches a label to a filled bottle, which is transferred to the Nutrition Lab for inventorying and storage. The lab’s technicians fortify the milk per doctor’s orders and deliver 12 hours worth of feedings back to the units twice a day.20130423_0267

All information about the milk is documented in the baby’s medical record.

In the first two months of the barcode program, 11,232 breast milk feedings were prepared by the Nutrition Lab, with 100 percent compliance to scanning in the lab and 97 percent compliance on the units.

“This gives moms that sense of security that human error has been taken out of the equation,” Landman said.

Next Steps

CHOC’s efforts have been noticed. The California Department of Public Health has commended the program and has asked Steele to train registered dietitian surveyors across the state on proper breast milk handling.

Meanwhile, plans are being made to implement the barcode system at CHOC Children’s at Mission Hospital, and the team hopes to purchase software to track formula, as well. They are seeking additional grant funding.

Starting this month, CHOC will also conduct a study that uses a new analyzer to identify the components of a mother’s milk, rather than assuming it contains generalized amounts of nutrients. That will make the fortification process more accurate, making sure babies are getting exactly what they need.

“We are always looking at ways that we can make our hospital safer and ultimately a better experience for the patient and family,” Steele said.

Related articles:

  • Meet Dr. Christine Bixby
    CHOC Children’s wants its patients and families to get to know its specialists. Today, meet Dr. Christine Bixby, a neonatologist. She completed a fellowship in neonatology, as well as her ...
  • World Breastfeeding Week is Aug. 1-7
    By Joanne DeMarchi, MA, RD, IBCLC, lactation consultant at CHOC Children’s In recognition of World Breastfeeding Week (WBW), below are some helpful guidelines for working moms who wish to breastfeed. WBW is celebrated ...
  • Thank You, Nursing Mothers!
    Another group of people I am extremely grateful for are the community’s nursing mothers, who can also help the babies receiving care at CHOC. Under CHOC’s breast milk donation service, women ...