Patient-Focused Decisions: When Better Outcomes Drive Better Business Discussions
By Bobbie J. Smith, MSN, RN, NEA-BC, ANLC-P, Synova Associates Clinical Advisor
In the NICU, outcomes aren’t just numbers — they are babies, families, and futures. When I round in the NICU I think about how the decisions we make as nurse leaders directly shape those outcomes
A Pathway to Exclusive Human Milk in the NICU
I recently had the pleasure of moderating a panel presentation: A Pathway to Exclusive Human Milk in the NICU at the NICU Leadership Forum. As I reflected on the session, I thought about how the speakers responded to my questions related to making the case to their leadership about making the investment for a. program supporting exclusive human milk diets. What stood out in their answers wasn’t just the science — it was the clarity it brought to a conversation many of us as nurse leaders have been navigating for years.
When we evaluate products, especially something as significant as human milk–based nutrition like Prolacta, the discussion can quickly become layered: Cost. Workflow. Staff buy-in. Practice variation.
As we prepared for the session, the stories around overcoming the barriers with integration into a unit were compelling. In these conversations what stood out to me the most was the data that helped get over the hump of “why should we have this option for all babies and families?”
We are no longer asking if nutrition impacts outcomes. We are asking, “how much” and, “at what cost to the infant if we don’t optimize it?”
Evidence to Support Bedside Observations
The stories reinforce what many of us have seen at the bedside:
For every 10% increase in cow’s milk–based protein in a preterm infant’s diet1 :
- 21% increase in surgical necrotizing enterocolitis (NEC)
- 11.8% increase in NEC
- 17.9% increase in the risk of late-onset sepsis
These aren’t marginal differences, they are life-altering outcomes. If you listened to the livestreamed session with Dee Bien and Mindy Fuzesy, BSN, RNC-E in March, Dee talked about what she would need to make the case to her CFO, who isn’t a nurse. And she was clear that the data is the key.
Across multiple centers, implementing an exclusive human milk–based diet has shown improvements not only in NEC, but in a combined morbidity index including death, sepsis, ROP, and BPD. 2 And this is where the conversation shifts. Data opens the door, but outcomes and the stories of babies who have benefited from an exclusive human milk diet are what ultimately create buy-in.
Human milk-based Pathway Adoption
Adopting an exclusive human milk–based pathway isn’t just a clinical decision; it’s also a cultural one. It requires us to challenge norms, address skepticism, and lead teams through change grounded in evidence. As nurse leaders, we must continually ask:
What is the cost of not changing? Will we lose patients choosing a different hospital because they do offer it? Will the outcomes for our most fragile babies be less optimal? Because every decision we make is about a baby, a family, and a future.
This is the power of clinical leadership: turning evidence into action and outcomes into lasting impact.
For more information about making the budget case and additional resources, visit the Prolacta Biosciences website: https://www.prolacta.com/en/resource-library/
References:
- Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9(6):281-285. doi.org/10.1089/bfm.2014.0024
Hair AB, Peluso AM, Hawthorne KM, et al. Beyond necrotizing enterocolitis prevention: improving outcomes with an exclusive human milk-based diet. Breastfeed Med. 2016;11(2):70-74. doi.org/10.1089/bfm.2015.0134
LIVESTREAM
A Pathway to Exclusive Human Milk in the NICU
The material presented in this blog represents the opinion of the author(s) and not necessarily the views of Synova Associates. Synova Associates does not endorse any specific products or organizations but strives to connect its industry partners with leaders interested in product/educational innovation.
