MOM program brings high-tech precision to human milk for NICU babies

HN Summary

• McMaster Children’s Hospital’s Mother’s Own Milk (MOM) program combines advanced technology with personalized nutrition to provide human milk for vulnerable NICU babies. 

• Using electronic milk tracking and individualized fortification, the program ensures each infant safely receives the right nutrition to support growth and development. 

• The program strengthens family-centred care by enabling parents to play an active role in their baby’s recovery while improving safety and outcomes in the NICU.

Human milk is widely recognized as the best source of nutrition for babies, supporting healthy growth and development. But what happens when a baby is born too small or sick to latch and needs nutrition delivered in other ways, like through a feeding tube, for the first few weeks or months of life?

At Hamilton Health Sciences’ McMaster Children’s Hospital (MCH), even the tiniest, frailest babies in our Neonatal Intensive Care Unit (NICU) can benefit from human milk through a partnership between their birthing parents, who pump, and the hospital’s high-tech Mother’s Own Milk (MOM) program. Donor human milk is an option for babies who medically qualify in cases where supply from their birthing parent is limited.

MCH’s NICU is the largest in Canada, with 72 beds and a 400-plus member team caring for more than 1,500 babies and their families each year. Every day, about 50 NICU babies benefit from human milk prepared by the MOM program, with prescribed fortifiers to add calories, fat, protein, and other essential nutrients to support each baby’s individual needs.

Because human milk contains important nutrients and immune protection, the MOM program is designed to improve health outcomes for vulnerable newborns, says Becky Thomas, clinical manager for MCH’s NICU.

“Our MOM program is a beautiful intersection of care between our parents and the rest of our care team for each baby who benefits from human milk in our NICU,” says Thomas

MOM’s the word

Babies who are stable enough to digest milk but can’t yet suck, swallow, and breathe at the same time are fed through a tube that goes to their stomach. This allows them to receive human milk supplemented with nutrients.

Babies who are more critically ill, extremely premature, or recovering from certain surgeries may not be able to use their digestive system at first, so they receive nutrition through an IV directly into the bloodstream. While these babies wouldn’t receive human milk through their IV, the birthing parent’s nutrient-rich colostrum can be swabbed inside their mouths shortly after birth to support early immune protection, promote a healthy gut, and encourage bonding between the parent and baby.

A parent’s perspective

“It’s great to have this support,” says mom Joanna Wajda, who’s staying at the nearby Ronald McDonald House while her infant daughter, born prematurely in early March and also needing surgery, is in the NICU.

Wajda’s baby has a gastrostomy feeding tube that goes directly into her stomach through a small opening in the abdomen. For many infants, including those born prematurely or recovering from surgery, tube feeding is a safe and reliable way to make sure they get the nutrition they need while they grow stronger.

Wajda supplies pumped milk, which is fortified through the MOM program to support her daughter’s recovery and growth. “I can’t breastfeed her because of her health, so I’m exclusively pumping,” says Wajda. “It makes me feel good to know I can be involved in supporting my baby by providing human milk.”

Carefully crafted nutrition

Every day, pumped milk is collected from the NICU by dietetic assistants and delivered to the MOM room, located in another part of the building. There, specially trained dietetic assistants carefully measure and prepare each baby’s individual feeding, following the directions of a NICU dietitian.

The human milk and prescribed fortifiers are mixed using a sterilized whisk, taking care to combine everything slowly and carefully to protect the living cells in human milk, which play an important role in supporting a baby’s nutrition and immune defence.

Dietetic assistants then deliver the prepared human milk back to the NICU fridges, for feedings. “One of the nicest parts of our day is picking up and returning milk to the NICU because we get to see how the babies are developing,” says Donna McAulay, a dietetic assistant with the MOM program.

“The gold standard of care”

The MOM program’s electronic milk tracking system is used to safely manage and track human milk and infant feeds. This tracking system uses barcodes to follow milk from the time it’s expressed, stored and prepared, all the way to when it’s fed to a baby.

The milk tracking system is connected to HHS’ organization-wide Epic electronic hospital information system, and dietitians’ feeding orders are automatically sent to the milk tracking system, allowing dietetic assistants know exactly what to prepare for each baby’s feeds. This technology helps ensure each infant receives the right milk at the right time.

A key patient safety feature of the system is that every bottle of milk is labelled and assigned a unique barcode. When scanned, the system instantly identifies important details such as the expiry date, whether the milk is fresh or frozen, and which patient it is intended for. In the NICU, this information is cross-checked with the baby’s own barcode, helping ensure that each infant receives the correct milk safely and accurately.

“It’s the gold standard of care for human milk workflows,” says Thomas, adding, “The work our registered dietitian and dietetic assistant teams complete in the MOM room on behalf of our patients and families every day is so important.  We are very grateful to have such a passionate and committed team focused on nutrition and growth for our fragile patients.”

Lise Diebel works in communications at Hamilton Health Sciences.

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