Unpasteurized Shared Human Milk Use in Pediatric Inpatients: Health and Ethical Implications.

Autor:	Barbas KH; Lactation Support Program, and kimberly.barbas@childrens.harvard.edu., Sussman-Karten K; Lactation Support Program, and., Kamin D; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts., Huh SY; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2017 Jun; Vol. 7 (6), pp. 352-356. Date of Electronic Publication: 2017 May 04.
DOI:	10.1542/hpeds.2016-0178
Abstrakt:	Growing evidence supporting the health benefits of human milk, particularly in the preterm population, has led to rising demand for donor human milk in NICUs and pediatric hospitals. There are no previous reports describing the use of unpasteurized shared human milk (USHM) in the hospital setting, but the use of USHM solicited from community donors through social networks appears to be common. Many pediatric hospitals permit inpatients to receive breast milk that has been screened and pasteurized by a human milk banking organization and will provide pasteurized donor human milk (PDHM) only to infants who are preterm or have specific medical conditions. These policies are designed to minimize potential adverse effects from improperly handled or screened donor milk and to target patients who would experience the greatest benefit in health outcomes with donor milk use. We explore the ethical and health implications of 2 cases of medically complex infants who did not meet criteria in our tertiary care hospital for the use of PDHM from a regulated human milk bank and were incidentally found to be using USHM. These cases raise questions about how best to balance the ethical principles of beneficence, nonmaleficence, justice, and patient autonomy in the provision of PDHM, a limited resource. Health care staff should ask about USHM use to provide adequate counseling about the risks and benefits of various feeding options in the context of an infant's medical condition. Competing Interests: POTENTIAL CONFLICT OF INTEREST: Ms Sussman-Karten is a member of the Board of Directors of the Mother’s Milk Bank Northeast, Dr Huh is a member of the medical advisory board of the Mother’s Milk Bank Northeast, and Ms Barbas and Dr Kamin have indicated they have no potential conflicts of interest to disclose. (Copyright © 2017 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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