title: Attitudes of NICU professionals regarding feeding blood-tinged colostrum or milk.
abstract: OBJECTIVE
  Mothers of neonatal intensive care unit (NICU) patients sometimes bring expressed milk that is blood tinged to the NICU. In certain instances, the blood contamination appears minimal, whereas in others, the milk is quite dark pink. We have observed inconsistencies in practice regarding whether or not to feed blood-tinged colostrum or milk to NICU patients. We know of no evidence that establishes best practice in this area, and thus we sought to determine attitudes of NICU professionals on which to base a potentially best practice.
  
  
  METHODS
  We conducted a web-based anonymous survey of attitudes of NICU professionals at Intermountain Healthcare regarding feeding blood-tinged expressed milk to NICU patients. These professionals included neonatologists, neonatal nurse practitioners, NICU nurses, NICU dieticians and lactation consultants.
  
  
  RESULTS
  Survey results were returned from 64% (426 of 667) of those to whom it was sent. A total of 75% of respondents reported that their practice was NOT to feed the blood-tinged milk illustrated in the figure as sample 2, and nearly all respondents (98%) reported that they would NOT feed the milk illustrated as sample 3. The majority of the neonatologists (56%) and the lactation consultants (58%) recommended feeding moderately bloody milk (sample 2), whereas only 22% of the neonatal nurse practitioners (NNPs), NICU nurses and NICU dieticians recommended feeding such samples (<0.001). The most frequently selected reason for NOT feeding blood-tinged milk was that it would likely cause gastrointestinal upset and feeding intolerance (selected by 77%). The majority (87%) overestimated the amount of blood contaminating a milk sample (sample 3).
  
  
  CONCLUSIONS
  As colostrum and human milk feedings can be of value to NICU patients, evidence should be assembled to document whether feeding blood-tinged samples indeed have the problems listed by the survey respondents. Such evidence is needed to enable informed decisions involving the benefits vs risks of feeding blood-tinged expressed milk to NICU patients.
authors.affiliation: Department of Women and Newborns, Intermountain Healthcare, Salt Lake City, UT, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Phelps
authors.forename: W S
authors.initials: WS
authors.lastname: Bedard
authors.forename: E
authors.initials: E
authors.lastname: Henry
authors.forename: S S
authors.initials: SS
authors.lastname: Christensen
authors.forename: R W
authors.initials: RW
authors.lastname: Gardner
authors.forename: T
authors.initials: T
authors.lastname: Karp
authors.forename: S E
authors.initials: SE
authors.lastname: Wiedmeier
authors.forename: R D
authors.initials: RD
authors.lastname: Christensen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001942:Breast Feeding; D003126:Colostrum; D005260:Female; D006801:Humans; D007363:Intensive Care Units, Neonatal; D008297:Male; D011364:Professional Practice