Is Milk Warming a Waste of Time?
Evi Dewhurst / January 2017
Most NICUs warm human milk for enteral delivery. Considering that your unit very likely does the same, I ask you: What’s the first thing that comes to mind when you think about warming patient feeds?
Many NICU professionals we’ve spoken to have similar responses to that question:
- Those long lines at the warming stations! Sigh.
- Cup and water warming that requires rewarming… So frustrating!
- Small volume enteral feed heat loss. Why can’t we do something?
With that in mind, have you ever considered that milk warming could be a waste of your valuable nursing time?
This reference to wasted time is not to debate the benefits of warming human milk, which has become common practice due to the apparent impact on gastric residuals, gastric venting, nutrient absorption, and body temperature. It is to address inefficiencies which negatively impact nursing time.
Time you would rather spend attending to your patients’ needs, finishing that charting, or with patient families who seek your guidance. Instead, your valuable minutes are vacuumed away by non-productive and frustrating steps to complete a process that should be simpler.
Let’s take a closer look at these three issues, followed by solutions you can consider today.
Enteral milk warming time loss #1: Long lines
Hospitals that choose multiple-well warmers often make that selection for the purpose of saving time. Unfortunately it can result in the opposite, which can also occur when single warmers are clustered in one warming station.
Multiple-well warmers and/or multiple single warmers in a few central locations can cause a backup in service (so to speak). Nurses inevitably find themselves waiting for a turn, as many infant feeds happen around the same time each day.
A traffic jam then ensues, and, you guessed it – wasted time.
Something else to consider: With so many feeds warming from the same warming station, feeding mix-up potential increases. Definitely NOT something you want! This is one of the primary reasons warming products are often recommended for each bedside.
Enteral milk warming time loss #2: The need to rewarm
Some NICUs still use good ol’ fashioned cup and water. It’s been around since the beginning of milk warming. It works fine if you’re attending to one baby and have minimal distractions. But if you’re like most NICUs, nurses are attending to two, three, or even four infants at once.
In that case, there are many distractions. Not to mention, those infants are all probably on a similar feeding schedule. And that cup of water? Well, it was warmed, syringe dunked, and left, while you were pulled away for any number of patient priorities… that became more priorities. And ten minutes later you’re left with a lukewarm feed and the dilemma of feeding as is, or rewarming.
That’s a frustrating waste of your precious minutes several times a day (not to mention this warming method exposes milk feeds to safety issues you’d much rather avoid).
Enteral milk feeding time loss #3: Small volume heat loss
You know this one well. Many nurses do. When asked about milk heat loss after warming, they say, “I know it happens. It’s so frustrating! But what can I do?”
You can pre-warm a small feed, but it loses heat quickly between the time it is removed from the warming source and is delivered. Considering continuous feeds timing, there’s no doubt it cools down, just as a cup of tea would on your kitchen counter.
The good news is your efforts are still valuable – the milk remains at room temperature and is not cold. However, the point of warming is to deliver near or at body temperature milk. Room temperature is often 25+ degrees cooler.
Does that mean warming small volumes of milk is a waste of time?
Take control of your milk warming efficiency
These three milk warming time concerns CAN be addressed. Here’s how:
Stop those long lines and feeding mix-up possibilities.
Use bedside warmers instead of multiple-well warmers or individual warmers in one central location. This achieves two important things: 1) Removes the line of nurses waiting to warm feeds, and 2) reduces the potential for a feeding mix-up.
Let technology keep milk warm.
Remember the cup and water rewarming scenario? Every nurse gets pulled away for patient priorities from time to time, leaving heated water and the syringe feed cooling in the meantime. Solution: Use a waterless warmer to not only warm human milk feeds, but to also keep them warm until you are ready to deliver. No more worries about a cup of water cooling down… and needing a do-over.
Prevent milk heat loss.
Prevent heat loss for those small volume continuous feeds by using an inline warmer. Inline warmers like the Guardian Warmer warm milk as it is delivered, meaning your patients get the near or at body temperature feed that you intended. No more time spent pre-warming, only to have milk cool during a lengthy delivery.
Nursing time in the NICU is valuable, especially around patient care and family support. Milk warming falls into patient care, but it is only a small part of the large responsibilities nurses manage on a daily basis. Remove wasted time from the milk warming process by deploying products that meet your needs, help rather than hinder, and meet the functionality and safety standards you expect.
In the end, you’ll save time for more important things: your patients.