Nutritional Support of the Very Low Birth Weight Infant: Part I

Quality Improvement Toolkit

California Perinatal Quality Care Collaborative: This material was developed by and produced for the members of the California Perinatal Quality Care Collaborative. Reproduction for commercial purposes is prohibited. Utilization and copying of the materials to improve care of pregnant woman and their newborns is encouraged with proper citation of source.

The following was excerpted from http://www.cpqcc.org/NutritionIIToolkit.htm. This toolkit is available in PDF format. You may download the Adobe Acrobat reader for FREE from http://www.adobe.com

I. The Nutrition Tool Kit (Full toolkit download not available at this time, please see below)

II. Separate Sections of Toolkit

1. Cover Page

2. Table of Contents

3. Introduction

4. Section 1: Improving VLBW Infant Nutrition: A Perinatal/Neonatal Team Approach

5. Section 2: Setting the Stage for Lactation Support

6. Section 3: Establishing Lactation: The First 100 Hours

7. References

8. Appendices

A. Attitude Survey

B. Risk Factor Screening

C. Resource List

D. Office and Hospital Scavenger Hunt ;Photo

E. J. Morton Video/Ordering Information

F. Nursing Competencies

G. Policies and Procedures

1. General Breastfeeding Policy

a. Example A b. Example B

2. Collection, Storage and Use of Expressed Breastmilk

a. Example A b. Example B

3. Use of Fresh Donor Human Milk Protocol

4. Kangaroo Care in the NICU Protocol

5. Triggers for Lactation Consult Protocol

6. Use of Pasteurized Donor Human Milk Protocol

H. Information on Mothers Milk Bank (http://www.milkbanksj.org) Article: Pasteurized Donor Human Milk for Preterm Infants

I. Insurance Coverage Letters

1. Breast Pump Insurance Coverage Letter 2. Donor Milk Insurance Coverage Letter

J. Mother’s Pumping Questionnaire

K. Milk Volume Graph (Neville 1991) L. Team Overview M. Clinical Pathway “Establishing Lactation in the Mother of the Preterm Infant:A Care Plan for the First 100 Hours” N. Mother’s Discharge Check List O. Rush Mothers’ Milk Club Diary P. Staff Questionnaire Q. Staff Questionnaire – Answers R. Perinatal Lactation Record S. Nutritional Database