Implementing change: steps to initiate a human donor milk program in a US Level III NICU

Initiating a pasteurized human donor milk (PDM) program in a level III neonatal intensive care unit (NICU) can be a difficult process that requires commitment by a multidisciplinary team, education, sufficient funding, and "buy-in" from NICU staff, families, and hospital administration. We began planning for our program in February 2011 and started using PDM in June 2011. This paper describes the steps taken and the obstacles overcome to initiate a PDM program for our hospital's tiniest, sickest, and most vulnerable patients.