SURVEY ON PASTEURIZED DONOR HUMAN MILK USE

The Minnesota Milk Bank for Babies has added a MIRIS Human Milk Analyzer to its milk processing lab allowing for measurement of donor milk macronutrient content. Nutrition content, calories/ounce and total protein, of MMBB pasteurized donor human milk (PDHM) will be added to the bottle labels. To ensure availability, we are asking hospitals and distribution sites about current use, preferences, and volume for certain products. Please submit one survey per hospital unit/maternity center/distribution site. Please provide contact information should follow-up be needed. Complete information about nutrition content will be provided with the updated products list.

FACILITY INFORMATION

Type of Facility (Ordering Unit):

Form completed by:

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CURRENT PDHM USE

Is your facility currently using pasteurized donor human milk (PDHM)?
Is your facility ordering PDHM from another source due to lack of availability at MMBB?
Does your facility currently use human milk fortifiers?

FUTURE PDHM USE

In the following sections, please estimate your facility’s anticipated use of these specific PDHM products: Preterm, Term, High Calorie, and Outpatient PDHM.

PRETERM PDHM

Preterm PDHM will only be available to Neonatal Intensive Care Units (NICUs) and Special Care Nurseries (SCNs). Preterm milk is pumped during the first 4 weeks for babies born <37 weeks gestation. Bottle volume offered: 50mL (1.7 oz). Availability may vary due to limited eligible donors in this category.

Does your facility plan to use Preterm PDHM?
On average, how often would your facility use Preterm PDHM?
Less than monthly
Monthly
Weekly
Daily
Other
Preterm

Term PDHM

Term PDHM will only be available to NICUs, SCNs, and other inpatient units (i.e. Mother Baby). Bottle volumes offered: 100mL (3.3oz) and 120mL (4oz). Consistent with our current products, the greater the bottle volume ordered, the lower the cost. The caloric content of Term PDHM will be 20-22 kcal/oz (actual range of 19.5-23.4 kcal/oz).

Depending on demand, we may offer 20 kcal/oz (19.5-21.4 kcal/oz) or 22 kcal/oz (21.5-23.4 kcal/oz) options (only for the 120mL bottle volume).

Does your facility plan to use Term PDHM?
What is your preferred bottle volume for ordering Term PDHM?
Would your facility prefer to use 20 kcal/oz AND 22 kcal/oz PDHM as separate products?
On average, how often would your facility use Term PDHM?
Less than monthly
Monthly
Weekly
Daily
Other
On average, how often would your facility use each type of Term PDHM? (select frequency for each type)
Less than monthly
Monthly
Weekly
Daily
Other
20 kcal/oz
22 kcal/oz

 

High Calorie PDHM

High Calorie PDHM will only be available to NICUs, SCNs, and inpatients with medical need. Bottle volume offered: 120mL (4oz). The caloric content of High Calorie PDHM will be 24 kcal/oz (range of 23.5 kcal/oz and greater).

Does your facility plan to use High Calorie PDHM?
On average, how often would your facility use High Calorie PDHM?
Less than monthly
Monthly
Weekly
Daily
Other

 

OUTPATIENT PDHM

Outpatient PDHM is offered in 120mL (4oz) bottle volumes. The caloric content of Outpatient PDHM will be provided on each bottle label. This type of PDHM is available to all ordering units.

Does your facility plan to use Outpatient PDHM?
On average, how often would your facility use Outpatient PDHM?
Less than monthly
Monthly
Weekly
Daily
Other

QUALITY IMPROVEMENT