title: NICU breast milk warming practices and the physiological effects of breast milk feeding temperatures on preterm infants.
abstract: OBJECTIVE
  No evidence-based standards exist for warming breast milk or determining the optimal milk temperature for preterm infants in the neonatal intensive care unit. In this study, we describe current nursing practices for warming breast milk and examine preterm infants' physiological responses to varying milk temperatures.
  
  
  METHODS
  Randomly selected experienced neonatal nurses (n = 61) were observed as they prepared and administered breast milk gavage feedings.
  
  
  METHODS
  We measured the temperature of water baths and breast milk at the beginning and end of the warming period. Physiological responses of the 33 preterm infants cared for by the nurses were observed before feedings and at 5 minutes and 30 minutes after the start of feedings. Gastric residuals were measured 3 hours after the feeds.
  
  
  RESULTS
  Water bath temperatures ranged from 23.3°C to 45.5°C at the start of warming and from 23.8°C to 38.4°C when milk was removed. Refrigerated milk was 3.8°C to 27.1°C and warmed to 21.8°C to 36.2°C at feeding time. Warming times ranged from 133 to 3061 seconds. Infant axillary temperatures increased at 5 and 30 minutes into the feedings (P < .05), while heart rate, respirations, and oxygen saturation showed no significant changes.
  
  
  CONCLUSIONS
  Further research is needed to clearly define the risks and benefits of warming infant feedings.
authors.affiliation: Nationwide Children's Neonatal Intensive Care Unit at Riverside Methodist Hospital, Columbus, OH 43205, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Dumm
authors.forename: Melissa
authors.initials: M
authors.lastname: Hamms
authors.forename: JoAnna
authors.initials: J
authors.lastname: Sutton
authors.forename: Nancy
authors.initials: N
authors.lastname: Ryan-Wenger
mesh_terms: D061186:Breast Milk Expression; D005260:Female; D006801:Humans; D007224:Infant Care / Q000592:standards*; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D008895:Milk, Human; D020380:Needs Assessment; D017283:Neonatal Nursing / Q000379:methods*; D017410:Practice Guidelines as Topic; D013048:Specimen Handling / Q000379:methods; D013696:Temperature; D014481:United States