Le Bonheur Children's Medical Center has crafted a simple, feasible, cost-free way to cut health risks to neonates using available resources. The Mommy's Medicine Program, less than a year old, removes barriers keeping new mothers from breastfeeding their newborns that have been transferred to Le Bonheur's NICU.

 

The program came out of a collaborative effort among Le Bonheur departments after key people attended a conference where research was presented on the value of just the first few pumps of colostrum. Since a premature or sick infant needing surgery leaves their mother's side so quickly after birth, many fail to get these first few feedings from their mother. These feedings, within the first 80 hours after birth, contain the largest amount of IgA, which coats the lining of the baby's stomach, decreasing infection and increasing feeding tolerance. It is essentially the baby's first immunization.

 

The Mommy's Medicine Program gives the mother pumping materials and information via Pedi-Flite or ambulance when they pick up the baby for transport. The birthing hospital's lactation consultant helps the mother collect the first few bottles of colostrum, which are then delivered to Le Bonheur's NICU. Then, Le Bonheur lactation consultants take over and help the mom facilitate the next few feedings. The program is offered to all moms, except those with contraindications such as thyroid problems, significant medications, drug histories or infection.

 

"The good thing is that some of these mothers have not originally planned to breastfeed, but when we present them with the facts that this is more of a medical intervention and not just a social choice, then many choose to do it," said Ruth Munday, RN, BSN, certified lactation consultant, Le Bonheur.

 

A chief concern with these fragile infants is necrotizing enterocolitis (NEC), a serious stomach infection which can cause intestinal perforation and require a colostomy. This infection can extend the hospital stay by more than 22 days and mean treatment costing nearly $75,000. Sometimes, complications or concurrent issues may lead to death. Research shows colostrum can reduce the risk of NEC by more than 20 percent.

 

"Of course, we know colostrum also helps with the baby's eyes, respiratory system, brain growth, developmental concerns and more importantly, provides a lot of antibodies and immune factors — even if we can just get the mom to pump for a week or two," Munday said.

 

In the South, there are special sets of circumstances making education about breastfeeding vital. High infant mortality rates and low rates of breastfeeding present challenges. According to a 2005 report by the Centers for Disease Control (CDC), in Shelby County alone, the infant mortality rate is 12.8 deaths per 1,000 live births. This is 48.8 percent higher than Tennessee's rate of 8.6, and nearly twice America's rate of 6.86.

 

"Especially in Shelby County, with the mortality rates so high, we are trying to look at all the things that might affect the morbidity and mortality of the newborns in our care," said Marilyn Robinson, MD, FAAP, neonatologist. "This program is 'low-hanging fruit.'"

 

Robinson explained babies at Le Bonheur, just by virtue of their need for a specialized facility, have increased risk factors. Crossing hurdles to encourage a mother to breastfeed, even briefly, is just a basic step in NICU care. Over 40 babies have been helped by the program in just a few months and numbers are steadily increasing. In June, 77 percent of mothers approached with the pumping opportunity complied. It has been noted through the Mommy's Medicine Program that the babies receiving mother's colostrum and milk achieve their feeding goals faster and feedings are better tolerated.

 

Munday recounted the story of one mom who was older and had not planned to pump. This was her fifth baby, and she had never breastfed before. The baby had been born early (28 weeks) and had multiple issues. She received a kit, and after hearing the benefits of colostrum decided to "try pumping" because the baby was so "little and sick." Mom provided breast milk for over five weeks and the baby tolerated feedings well.

 

Another young mother was skeptical about pumping, but upon receiving information on the benefits of colostrum, she began pumping, telling Munday, "I can't believe it!" It really works! I feel like I can make a difference for my baby by giving my milk. Now I will do whatever it takes."

 

To encourage continuation of breastfeeding, TennCare has a program for NICU babies where with certain insurance supplements, an electric breast pump is provided. There are also rental stations for breast pumps that rent by the week or month. Even if the baby just gets a few feedings while at Le Bonheur where materials are provided, then that is worth it, according to Robinson.

 

"We are trying one mom at a time," she said.