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New mom Amber Kelly gets assistance on using a breast pump from Le Bonheur lactation consultant Ruth Munday

Several times a week, the rhythmic thumping of a helicopter overhead announces the arrival of a sick child to Le Bonheur Children's Medical Center. The patients are often just hours old, babies born prematurely who are then airlifted to Le Bonheur from regional hospitals around the Mid-South. They are typically the sickest of the sick, starting out life in desperate need of surgery or intensive care. While parents can feel helpless at such critical times, there is hope.

And it comes in the form of mother's milk.

In September, Le Bonheur launched Mommy's Medicine, a new program that promotes the importance of getting breast milk to newborns — especially those in critical condition. Because these children are often born unexpectedly and taken immediately to the hospital's neonatal intensive care unit (NICU), they cannot breast-feed normally. But evidence-based research shows a range of benefits provided by colostrum, the milk a woman's body produces during the first 80 hours following birth. The hope is that this program will educate other hospitals of the importance of having mothers express their milk when they can't breast-feed their child immediately after birth.

The Mommy's Medicine care package is sent along with Le Bonheur's Pedi-Flite medical transport team, which flies helicopters to outlying hospitals in order to transport critically ill patients to Le Bonheur. They deliver instructions, baby bottles, and labels to the new mother, so she can pump and send the colostrum back to the hospital for her newborn. The birthing hospital's lactation consultant helps the mother collect the first few feedings, though Le Bonheur also provides a lactation consultant to answer questions or walk the mother through the pumping process.

"We wanted to reach moms better, which is why we use Pedi-Flite to take these care packages to them," said Le Bonheur's lactation consultant Ruth Munday, who spearheaded the project. "(Breast-feeding) is free and such a simple practice but it's not commonly done. Babies were being flown to the hospital but the mothers couldn't always be reached to pump until two or three days after the baby had been admitted."

Other challenges abound as well, from the stress of giving birth prematurely, which can make it difficult for the mother to even consider pumping, to the unavailability of hospital-grade electric pumps to express milk efficiently. "Mothers need a lot of support," echoed neonatologist Marilyn Robinson, MD. "The main barrier to breast-feeding in the NICU is sorry breast pumps." Ideally, preemies do best when they're well enough to receive kangaroo care, the practice which gives infants skin-to-skin contact by laying them on the mother's chest. What's more, enabling a mother to maintain nearness to the baby, even smelling the child and hearing his or her cries, can improve the mother's milk supply. But since preemies frequently aren't stable enough for this to take place (though some doctors debate this fact), the importance of receiving the much needed antibodies and immune factors present in colostrum is heightened.

Munday said a high percentage of the premature infants treated at Le Bonheur's NICU have gastric issues requiring surgery. The benefit of colostrum for these patients is evident. "Colostrum coats the lining of the GI track and can help protect the gut from getting infection," said Munday. Colostrum is highly digestible, and the antibodies it carries helps the body ward off gastrointestinal infections like necrotizing enterocolitis (NEC), a "huge" scare factor for preemies, according to Munday. She said 30 to 40 percent of premature babies admitted to the hospital contract NEC. Since preemies have intestines that are underdeveloped, the organ is at greater risk for perforation or infection. Once NEC attacks the gut, it can extend a baby's hospital stay by 22 days and cost more than $73,000 to treat. Munday said colostrum has been proven to reduce the risk of NEC by 20 percent. It also helps the eyes and brain to develop, an additional benefit for preterm infants born with retinopathy due to prematurity.

"We've got a lot of sick babies that need help," added Robinson. "If we can give a baby a good start in life, then they can grow up into real people and meet their potential." Robinson also likes that their NICU personnel can share best practices they've learned with other healthcare outlets, thereby potentially bringing up the level of care for new moms regionally.

Currently, mothers who arrive at Le Bonheur can pump their breasts in two lactation rooms within the NICU (the hospital uses the Symphony Double Electric hospital-grade pump). Plans for the new hospital include 60 NICU rooms which will be individually outfitted with electric breast pumps, so women can more readily express their milk in private.

Munday said their hope is to make clear the multiple benefits of colostrum to an infant's health. "We want to educate others about the importance of pumping during the first 80 hours after birth, to get the antibodies going. We want people to think of breast-feeding more as a medicine — not just a social choice."

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