Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Tony Rosales DNP, FNP-BC, CNS


Purpose statement and rationale: The purpose of the project was to implement a donor milk workflow for an academic hospital so that babies who qualify for donor milk receive it instead of formula. It aimed to improve adherence to the protocol and increase the percentage of babies who received breast milk in the hospital setting and followed The Iowa Model for implementation.

Synthesis of evidence: Top regulating agencies and healthcare entities all support breastfeeding and breast milk use. Studies have been performed to address formula use versus human milk use in infants and show that babies have better outcomes when given human milk and as such, human milk has become the minimum standard.

Practice change and implementation strategies: To ensure best practice, hospital protocols and guidelines were updated to incorporate utilizing human donor milk for well newborns in Labor and Delivery (L&D) and Postpartum. Updating unit processes such as implementing a baby nurse in L&D and ensuring donor milk implementation supplies were readily accessible were crucial to success. Incorporating interdisciplinary teams that included bedside nurses, L&D baby nurses, milk technicians, lactation consultants, Pediatric nurse practitioners, Pediatricians and leadership helped achieve the goal.

Evaluation: To evaluate the practice change, measuring human donor milk usage in the hospital setting was a key metric. Measuring increased usage of donor milk with up to eighty-nine babies and implementing a baby RN during the transition period in L&D allowed for adherence to protocols, increased infant safety, as well as implementing donor milk.

Conclusions and implications for practice: The implications for practice are that all babies will have access to donor milk whether they are premature or normal newborns. The project helped develop team goals and achieve breastfeeding metrics and quality outcomes as well as allowing for all babies to have access to donor milk.

Included in

Nursing Commons