Mother & Neonatal Nursing Care

Nutrition plays a vital role in the life of a neonate, particularly in the Newborn Infant Intensive Care Unit (N/IICU). Early nutrition intervention is of the utmost importance. Inadequate nutrition can place a neonate at risk for poor growth, insufficient brain development, poor bone health and nutrient deficiencies. Initiation of parenteral nutrition may be necessary for high-risk full-term infants and almost always for the preterm population. Human milk is the feeding gold standard for full-term and preterm infants alike, however, human milk alone is typically insufficient to meet the specific nutrient needs of the preterm infant. Therefore, fortification of human milk is necessary. There are a number of commercial fortifiers available to address these specific needs. Furthermore, an infant feeding protocol can help guide when and how to fortify feeds for these infants. The Children’s Hospital of Philadelphia (CHOP) has a preterm infant feeding protocol, a late preterm feeding protocol, and a newborn breastfeeding protocol. The fortification of human milk should ideally take place in a designated space for patient safety. CHOP has a Human Milk Management Center (HMMC) that serves this purpose. This space allows for the storage and preparation of all fortified human milk feeds throughout the hospital. Specially trained technicians fortify and deliver feeds twice daily. Multidisciplinary rounds occur weekly to improve patient safety. While it is acknowledged that such resources are not available everywhere, it is well accepted that optimal nutrition is crucial for the neonate.