Oral Pharyngeal Administration with Mother’s Breast Milk to Neonates in the CVICU
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Authors
Schottler, Carrey
Issue Date
2024-05-09
Volume
Issue
Type
Manuscript
Language
Keywords
Oral Pharyngeal , Breastmilk , Neonate , Oral Care , Congenital Heart Disease
Alternative Title
Abstract
Purpose: This project aimed to create and implement a standardized protocol for oral pharyngeal breast milk administration for infants that cannot feed orally in the cardiovascular intensive care unit (CVICU) at a Midwest Children’s Hospital.
Background: Newborns who are admitted to the hospital immediately after birth with severe congenital heart disease (CHD) are usually not permitted to eat anything by mouth, often for long periods. This causes an interruption to the natural mother-baby connection and often affects the ability of the infant to receive the benefits of breastmilk. Breastmilk as an oral immune therapy is one documented method available to critically ill neonates unable to feed orally, which provides immune benefits to infants and offers potential risk reduction in infections.
Sample/Setting: The setting was a 25-bed CVICU at Children’s Minnesota. Participants included cardiac patients aged 0-30 days in the acute care setting and registered nurses in the CVICU.
Methods: An oral pharyngeal breast milk protocol was created and implemented utilizing evidence collected from current data. Before implementation, education was provided to all staff. Nurses were surveyed pre- and post-implementation via a Likert to ensure an understanding of the project and the protocol. Data was collected and reviewed from the EMR for six weeks to determine participation in oral pharyngeal breastmilk administration and documentation compliance.
Results: The pre-education survey had 37 respondents, and the post-education survey had 39 respondents. The results indicated a statistically significant improvement in education concerning OPA and consistent attitudes toward supporting its importance. Twelve neonates (six pre- and six post-education) were eligible for inclusion, and compliance with practice standards improved but was still below 50%.
Conclusion: Changing clinical practice in a large CVICU during unprecedented high acuity is difficult. One quickly identified barrier was that the former standard oral care kits were still available in the rooms and used by nurses instead of breastmilk oral care. The use of breastmilk for oral cares in newborns with CHD is critical and needs to be reinforced as a standard with nursing staff.
Description
Citation
Publisher
Creighton University
License
Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University