Donor Breast Milk

Procedure: Check List

1st: Getting the Provider Order

Baby must meet criteria

Inform parents, provide education

If parents interested, page the baby’s Pediatrician

When ped calls back, update them and obtain order for banked milk

Stay on phone and go into patient room

Pediatrician answers and parental questions and gains verbal consent

Complete the template note (dot phrase) .donor breast milk

2nd: Prepare the Donor Milk

Get milk from nursery freezer on second floor

Label the milk with the following information:

Baby label

Add expiration date and time on bottle (48 hours from thawed time)

RN initials who thawed the milk

Complete the donor milk log sheet with the following information:

Baby label

Donor milk batch number

Expiration date

RN initials

Indication for the use of donor milk

Label a Medela liner with baby label

Place donor milk inside the single patient use Medela liner

Turn warmer on an run through 2 warming cycles

Fully thawed milk should have no ice crystals present

If the RN is going to be giving the donor milk a double check between

2 RNs or 1 RN and 1 Parent is needed and must be documented on the

doc flow sheet

3rd: Final Steps

Place a lactation consult with situation

Initiate pumping

Document feedings with the donor milk

Newborn doc flow sheet

Donor milk

Enter lot number and amount

Refrigerate and unused portion in the mother’s refrigerator for up to

48 hours from the thawed time