EMR-linked system matches premature babies with breast milk

Problem: 50 premature or sick newborns to feed, up to eight times a day, with their own mothers’ breast milk.

For Paragon Data Systems Inc. in Cleveland, keeping track of breast milk was a complex inventory problem, said Larry Laurenzi, Paragon’s president.

So two years ago, the bar code systems integrator began devising a system to track bottles and syringes of breast milk in neonatal and pediatric intensive care units.

Partnering with NeoMed Inc. of Woodstock, Ga., a maker and distributor of neonatal products, including feeding bottles, syringes and tubes, Paragon introduced the SafeBaby Breast Milk Tracking system in 2008.

“SafeBaby was designed to assist NICUs with positive patient identification,” said Diane Zokle, vice president of marketing and sales for Paragon.

How important is it for preemies or sick infants to get the right milk? Feeding is one of the most important things a small baby can do in the hospital, according to the National Institutes of Health. Infants need the sustenance to grow big enough to get out of the NICU.

Studies show breast milk is most digestible for babies, especially premature or sick ones. Often, breast milk is fortified to help premature infants grow — another reason why the right baby needs the right milk.

“Everything that happens to the baby, except for medical emergencies, revolves around feeding,” Zokle said.

The first generation of SafeBaby positively identified newborns and matched them with their mothers’ milk.

“For parents, this is some peace of mind,” said Kim Pace, NICU manager at Henry Medical Center in Stockbridge, Ga., which has used SafeBaby BMT for two years.

“As the manager, it gives me peace of mind,” Pace said. “One of my worst fears is giving a baby the wrong milk and then having an upset parent. It’s one of the safety measures for our unit, just like we double-check our medications to eliminate patient errors.”

Usually, there’s no harm done simply by giving milk to the wrong baby, she said. However, some viruses like those that cause HIV and hepatitis infections can be transmitted through breast milk. So feeding the wrong breast milk could mean harming a baby and financial liability for a hospital.

Positive identification systems are becoming the standard of care for many hospital units, Pace said.

The second-generation SafeBaby system tracks milk from breast to baby, ensuring not only the right babies get the right milk, but also fresh milk.

“It helps us keep track of exactly when that milk comes in — each individual bottle,” said Nancy McAlexander, nurse clinician in the NICU at Gwinnett Medical Center in Lawrenceville, Ga., which has been using SafeBaby BMT since April. “We have it to the point now where we know how many milliliters the mother is bringing in, so we can also track amounts.”

The SafeBaby system comprises hand-held computers, scanners, printers and software, as well as bottles, syringes, tubing and labels. Mothers pump the milk, apply 2-D bar-coded labels to the bottles and drop them off at the hospital where they are checked into the system with a scanner.

Each system can cost between $1,000 and $2,000, Zokle said. The system ties babies to their mothers through information from the mothers’ electronic medical records.

The bar codes and scanners are used for every step of a feeding, from removing a bottle from the refrigerator, to fortifying it, to dispensing it into a syringe, to feeding it to a baby.

Zokle and colleague Jeff Ereth spent days watching nurses and technicians at University Hospital’s Rainbow Babies & Children’s Hospital in Cleveland to develop the system. In addition to ensuring the right milk is fed to babies, they wanted to streamline the feeding process.

For instance, by using bar codes to positively identify milk and baby, nurses no longer have to double-check feedings.

A hand-held Motorola computer loaded with Paragon’s software flashes red and audibly alarms if the wrong or expired milk is being prepared for a baby. Nurses and technicians must acknowledge and correct the error before the hand-held gives a green light for feeding.

Breast milk lasts for seven days if refrigerated and for only 24 hours after it is thawed from the freezer at Gwinnett Medical Center, McAlexander said.

“We don’t want to feed any of these babies spoiled milk,” she said. “Especially these babies in the NICU. They already have more of a struggle. And we don’t want to do anything that will keep them from getting well and going home quicker.”