ST. PETERSBURG — Like most American moms, Natrina Shultz hadn't planned to breastfeed her babies for long. Maybe, she thought, just for the first month.
But she had time to reconsider during the five weeks she spent in the hospital before her twin girls were born. Arriving three months prematurely, Brinley weighed 2 pounds, 1 ounce; Piper was just 3 ounces larger.
By the time they were born, their mom had learned that study after study shows the benefits to mother and child of breastfeeding newborns for at least six months and preferably a year. And the evidence is especially compelling for the sickest babies. But for mothers with babies in intensive care, nursing is especially tough. The infants may be too small to suckle or fragile to hold. Mothers can be too stressed to produce enough milk to pump for bottle or tube feeding.
So medicine is stepping in to give nature a boost.
All Children's Hospital, where the Shultz twins are just now learning to breastfeed at 11 weeks of age, has designed a particularly high-tech support system. New mothers are encouraged to pump breast milk at home and bring it to the hospital, where bar codes and computer algorithms ensure it goes to the right baby, fortified with any nutrients needed.
St. Joseph's Children's Hospital of Tampa has its own careful systems in place. At both hospitals, the main goals are getting moms to breastfeed, and when babies can't nurse, treating the milk with the utmost care and getting it to the right babies.
Shultz, who has had to pump every three hours, says the assistance was invaluable. "I probably wouldn't have stuck it out," without services such as a phone line to quickly answer her questions about lactation.
Now her twins are close to going home after nearly tripling their birth weights.
"It's been worth it," the 37-year-old Seminole mother said. And as her babies increasingly breastfeed directly, the benefits are increasing.
"You get to cuddle. There's no bottles to clean."
• • •
The American Academy of Pediatrics recommends babies get nothing but breast milk for the first six months, and continue to breastfeed for at least a year. But only a third of U.S. mothers exclusively breastfeed infants at three months, reports the Centers for Disease Control and Prevention. Breastfeeding has become a staple of public health efforts, including last week's International Breastfeeding Week.
Breastfeeding may be the most natural thing in the world, but it's not the easiest, especially for working mothers and those who have older children to care for.
The obstacles are unique for mothers of babies in a neonatal intensive care unit. The body's natural reaction to stress can make it difficult to nurse, and it's harder to produce milk away from the babies, explained Beth Sherron, a nurse and lactation consultant at All Children's.
But breast milk is the best medicine mothers can give their babies, encourages the poster outside the hospital's breast milk depot, where mothers bring bottles after pumping.
In addition to a host of longer-term benefits, breast milk helps protect from respiratory problems, infections and necrotizing enterocolitis, a potentially life-threatening intestinal disorder.
"Milk is like liquid gold to our mothers," said Cindy Quackenbush, nurse and director of neonatal services at All Children's, who says nearly 80 percent of her mothers breastfeed or pump. "You don't want to waste a drop."
• • •
The hospital was jolted by some "near misses," in the past, when it nearly brought one mother's milk to another's baby, Quackenbush said. A mixup would pose minimal medical risk, but could upset families that already are deeply stressed.
"This is a large emotional issue for both families involved if there is a mixup," she said.
Today, from the time mothers drop off their milk, to the time it's fed to babies, bar code labels ensure there is no confusion.
The milk is hand carried to the pharmacy, since excessive agitation could breaking down delicate nutrient compounds. In the pharmacy, an isolated room is devoted to breast milk preparation. Gloved and gowned technicians defrost any frozen milk slowly so as not to damage it. Supplements are stirred in, according to computerized formulas six months in the making, as shaking could be damaging.
The milk is transferred to syringes labeled with the baby's name and bar code, and carried back to the neonatal intensive care unit. Nurses scan bar codes on syringes, the baby's bracelet and their own ID tag to ensure the match before feeding.
St. Joseph's also puts bar codes on bottles, to do its own checks. "We encourage our parents to question us at any time if they think we aren't doing something or missed a step," said Sheila Johnson, director of patient care for critical areas at St. Joseph's.
If all this seems extraordinarily complex for something as basic as breastfeeding, consider the goal. As Kevin Olson, All Children's director of pharmaceutical services, noted, "We put this in place to get to zero errors."
Letitia Stein can be reached at firstname.lastname@example.org or (813) 226-3322. For more health news, visit www.tampabay.com/health.