engleski

The experience of implementing a comprehensive breastfeeding support model in the human milk bank in Croatia.

Introduction: Breastfeeding (BF) support is crucial in establishing and ensuring the sustainability of the operation of a human milk bank (HMB). To ensure BF support to all donors and young families of preterm and term infants cared for in neonatal intensive care units (NICUs), as well as the optimal BF education for health professionals a model of HMB which integrates education and clinical aspects of BF support should be established and implemented. The aim of this study was to describe the activities of the Division on Breastfeeding Support established within the HMB in Croatia in November 2019 as a model of comprehensive BF support management. Methods: We described the activities of the Division on BF Support provided between November 2019 and May 2021. As an integral part of the first HMB established at the University Hospital Centre (UHC) Zagreb in November 2019, the Division has had two major activities: a) providing education on BF and DHM use for health professionals and b) organizing a BF Medicine Clinic which provides professional clinical support and counseling for women with BF difficulties. In the BF Medicine Clinic the professional support was provided by a neonatologist who is an IBCLC. We prospectively collected data on a number of hospitals that received BF education on HMB organization, DHM use and BF support, as well as data on a number of women with BF difficulties who visited the BF Medicine Clinic or were seeking counseling via telehealth. Results: During the first 18 months of HMB operation, the Division of BF Support organized and provided the education of health professionals on HMB and DHM use in 11 hospitals throughout Croatia (7 maternity hospitals or hospitals with NICU in Zagreb, 3 regional UHC with NICUs level 3 and 1 general hospital with NICU level 2). For the first 7 facilities the education was organized in-person, while after that the education was organized via webinar. These hospitals/NICUs cared for more than 85% of all preterm and sick infants in Croatia and the pasteurized DHM were distributed to 7 out of 11 hospitals. The BF Medicine Clinic provided clinical care and counseling for 111 women, of whom 5 were donors. There were 130 visits to the Clinic and 539 telehealth counselings. The telehealth was used more often due to the COVID-19 pandemic, lockdowns and two earthquakes in Croatia in the last 18 months. The most common difficulties were lactational mastitis, persistent nipple or breast pain, breast lumps (galactocele) and failure to thrive. Conclusions: The establishment of the Division on BF Support within the HMB in Croatia provides a comprehensive BF support model of HMB which integrates educational activities and clinical aspects of BF support. Taking into account the challenges of the COVID-19 pandemic, our first experience was quite positive. NEW

human milk bank, breastfeeding support, Croatia

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