Collection and storage of breast milk for very low birth weight infants: an overview of Italian practices

Methods of collection and storage of mothers' milk to feed premature infants who weigh less than 1500 g (very low birth weight infants) or who are under 32 weeks gestational age need to preserve the important factors in the milk and avoid infective contamination as much as possible. Mothers are directly involved and given responsibility for this practice, an involvement that requires adequate procedures and useful strategies. The aim of the study was to investigate and describe the procedures applied by Italian neonatal intensive care units (NICUs) regarding the collection and storage of the mothers' own milk for their preterm newborns. To do this, a questionnaire regarding the different aspects of collection and storage of breast milk for preterm newborns was sent out to 105 Italian level III NICUs. Ninety-two NICUs (87.6%) participated, and breast milk collection was possible in 87 of them (95%); 86% had an electric breast pump available as well as the components needed for breast milk collection and/or containers to store breast milk. In 41 (46%) of the hospitals where milk collection was possible, pump sets were loaned to the mother, either for 24 hours (10; 24%) or until discharge (25; 62%). Pump sets were disinfected/sterilised after each use in 75% of the NICUs, and every 24 hours in 18%. Sixty-four per cent of the hospitals did not pasteurise the milk. Refrigerated milk was used in 82% of NICUs, whereas only 58% administered fresh milk. Surplus breast milk was frozen in 79% of the centres. The procedures for collection and storage of mothers' own milk for very low birth weight infants in Italian NICUs were therefore shown in this study to be heterogeneous but (not far from the current evidence) more or less in line with current guidelines and standards of good clinical practice. Further investigations are needed to make this aspect of preterm infant care effective and safe.