Kathleen A. Marinelli

ABM clinical protocol #3: hospital guidelines for the use of supplementary feedings in the healthy term breastfed neonate, revised 2009

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015.

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

ABM clinical protocol #9: Use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First revision January 2011)

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. These guidelines are not intended to be all-inclusive, but to provide a basic framework for physician education regarding breastfeeding.

ABM clinical protocol #10: Breastfeeding the late preterm infant (34 0/7 to 366/7 weeks gestation) (first revision june 2011)*

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. These guidelines are not intended to be all-inclusive, but to provide a basic framework for physician education regarding breastfeeding.

Effects of dexamethasone on blood pressure in premature infants with bronchopulmonary dysplasia

OBJECTIVE To determine the incidence and time course of blood pressure elevation in dexamethasone-treated premature infants with bronchopulmonary dysplasia. METHODS In a prospective, self-controlled, consecutive case study, 16 ventilator-dependent very low birth weight neonates treated with dexamethasone were studied. Systolic, diastolic, and mean arterial pressure and heart rate were recorded at three specific times daily. Data were recorded from day 1 of dexamethasone treatment through the duration of therapy and up to 2 weeks after its completion. Retrospective daily data were collected for up to 14 days before therapy. RESULTS The 788 daily observations (a systolic and diastolic average of the three blood pressure recordings per day) were recorded for 16 infants, a mean of 49 +/- 11 daily observations each (range, 24 to 67). Systolic and diastolic blood pressures before dexamethasone therapy were correlated to corrected gestational age. At initiation of dexamethasone, blood pressures increased significantly from days 1 to 2. For all observations, mean systolic pressure was 51 +/- 9.5 mm Hg before dexamethasone therapy, compared with 64 +/- 10.2 mm Hg during therapy (p < 0.01); diastolic pressure was 29 +/- 6.7 mm Hg before therapy compared with 41 +/- 8.2 mm Hg during therapy (p < 0.01). After completion of dexamethasone therapy, pressures continued to increase: systolic, 67 +/- 8.8 mm Hg (p < 0.01); diastolic, 42 +/- 6.2 mm Hg (not significant). Both systolic and diastolic pressures increased as a function of weight and age; when we controlled for these covariates, an independent effect of dexamethasone itself on the group was shown. Of the 2182 individual systolic pressure readings, 9.4% were considered in the hypertensive range. The six infants treated with hydralazine had higher mean systolic pressures before dexamethasone therapy than did infants without hydralazine (56 +/- 9.4 mm Hg vs 46 +/- 6.4 mm Hg; p < 0.001) and were 2 weeks older at initiation of therapy. CONCLUSIONS Blood pressure significantly increases during dexamethasone therapy, particularly within the first 48 hours, and does not return to baseline levels after therapy. Those infants most likely to be labeled hypertensive tend to be older at initiation of therapy but do not appear to have any other significant risk factors.

ABM clinical protocol #6: Guideline on co-sleeping and breastfeeding - Revision, March 2008

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

ABM Clinical Protocol #1: Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates, Revised 2014

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

The Effect of a Donor Milk Policy on the Diet of Very Low Birth Weight Infants.

Background: Use of donor milk (DM) to supplement mother’s own milk (MOM) in the neonatal intensive care unit (NICU) is steadily increasing based on health and developmental benefits to premature infants. A paucity of data exists documenting the effect of DM use on the diet of very low birth weight (VLBW) infants related to the implementation of a DM policy. Objective: This study aimed to compare VLBW enteral intake type in the first 28 days of life before versus after establishing a DM policy. Methods: This single-center pre–post prospective cohort study included all inborn infants ≤ 1500 grams in a level 4 NICU remaining hospitalized at 28 days and admitted either before (pre-DM period, October 2009–March 2010) or after (DM period, October 2010–September 2012) implementing a DM policy. The feeding protocol was unchanged in both periods. Collected data included maternal/infant demographics, infant clinical data, and daily volume of enteral intake as MOM, DM, and formula. The proportion of enteral feeds from these sources during the first 28 days of life was compared pre-DM versus DM. Results: Compared to pre-DM baseline, formula exposure was significantly decreased, and human milk exposure and proportion of diet as human milk increased. The proportion of infants fed exclusively human milk increased. Exposure to and proportion of diet as MOM was unchanged. Infants were fed earlier in the DM period. Conclusion: Establishment of a DM policy was associated with reduced exposure to formula, promoting an exclusively human milk diet, with earlier initiation of feeds and no decrease in use of MOM.

Breastfeeding support for mothers in workplace employment or educational settings: summary statement.

The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection, and support of breastfeeding and human lactation. Our mission is to unite into one association members of the various medical specialties with this common purpose.

ABM clinical protocol #18: Use of antidepressants in nursing mothers

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.