Roles in the NICU
OIT
Donor milk & EBM
Pumping
Beauty of Breastmilk
200
Why is it important for NICU staff to support and engage parents in infant care?
Parents are essential members of the care team, supporting their confidence improves their emotional wellbeing and infant’s outcomes
200
When providing OIT, where in the mouth is milk placed?
Between cheek and gum.
200
What are the main two benefits of EBM compared to donor milk?
Immunity and nutrient content
200
What are the ABCs of breastfeeding?
Attachment, breastmilk production, colostrum
200
Name one way NICU staff can promote the use of fresh EBM:
Encouraging bedside pumping
Prioritizing fresh feeds
Educating families about the benefits
400
True or false:
Every interaction NICU staff have with parents can influence the parent’s confidence and their baby’s outcomes
True
400
True or false: donor milk can be used for OIT.
False
400
Provide three examples of when donor milk should NOT be used
As OIT
When infant has galactosaemia
If EBM is available
400
Why is hand expression helpful in the first few days?
Capture small amounts of colostrum for the premature infant
400
True or false: Mothers often feel guilty when NICU nurses emphasize the importance of EBM?
False
600
What is one key reason staff should take initiative in engaging parents rather than waiting for questions?
Parents may not know what to ask or how to ask, proactive engagement ensures they feel supported and included as part of the care team
600
What is the main benefit to administering OIT?
Immune system development
600
EBM and DM reduce the risk of what 2 issues?
Necrotising enterocolitis (NEC) and feeding intolerance
600
Name one of the benefits of early (for the first 24-48h) hand expression AND mechanical pumping compared to mechanical pumping alone
Able to capture small amounts of colostrum
Higher breastfeeding rates at 2 months
Colostrum volumes are equal or greater than from pumping
Greater fat content
600
Preterm infants receiving high EBM intake demonstrate better outcomes in this domain:
Neurodevelopment
800
What is the impact of using positive reinforcement when giving OIT
Parents feel encouraged, proud, and motivated to continue expressing milk
800
How long does fresh milk last in the fridge before it cannot be used for OIT?
48 hours
800
What is the criteria for Donor Milk at Sunnybrook
Infants born <33 weeks, infants born <2000g, other medical conditions
800
When should parents start hand expressions?
As soon as possible after birth (ideally within first 1-3 hrs)
800
Research suggests milk cells may communicate through this type of cell-to-cell interaction.
Intercellular communication
1000
List ways you can empower parents during visits and help them recognize why pumping is vital for breastfeeding
Provide guidance on pumping
Celebrate small successes
Encourage participation in Kangaroo Care
Offer reassurance
Maintain frequent communication
Acknowledge that pumping is hard and can feel like a task
Emphasize that building a supply now supports goals for feeding in the future
Provide practical support (water, a comfortable chair, help setting up, LC support if needed)
1000
OIT can decrease the risk of the following 2 infections
Ventilator associated pneumonia and NEC.
1000
True or false:
Donor milk goes through a two-step process during pasteurization. First, it is pasteurized then it is frozen and shipped to hospitals.
False. Donor milk is first frozen, then pasteurized, then frozen again before being shipped and stored at a hospital.
1000
In the pump dependent mother name 2 strategies that can support consistent pumping:
Any of these would be right:
Using a hands free bra
Tracking the pumping events to ensure she is pumping regularly and her volumes are rising
Focus on frequency rather than volume or timing/schedules--just pump!
reaching out for support at the first sign of discomfort or pain
Encouragement from the staff -help setting up in the middle of the night
Having a mother pump while talking to and hand hugging her baby
1000
Freshly expressed milk contains these living components that support growth and immunity but begin to lose bioactivity with time and storage.
Stem cells
