NV DOC - Breast Pumping Program, Ad. Reg. 657, 2014
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NEVADA DEPARTMENT OF CORRECTIONS ADMINISTRATIVE REGULATION 657 BREAST PUMPING PROGRAM Supersedes: Effective Date: NEW AUTHORITY: NRS 209.131 RESPONSIBILITY The Director of Nursing (DON) at Florence McClure Women's Correctional Center (FMWCC) will be responsible for the oversight of the administration of this procedure. Licensed nursing personnel in the Medical Division are responsible for ensuring this procedure is followed. 657.01 PURPOSE OF PROGRAM 1. The breast pumping program is established to allow inmates who have recently delivered babies to provide nutrition for their children despite being incarcerated, and to provide services for inmates who are in the process of discontinuing lactation. 2. Pregnant inmates shall be informed about the benefits of breastfeeding, and educated about the eftects on breastfeeding by active tuberculosis. HIV infection, illicit drug use and certain medications. 3. Participation in the program is voluntary, subject to approval by the Medical Division. Participation is subject to the following conditions: A. The inmate must have given birth within the previous 30 days. B. Prior to admittance to the program, a physician shall review the inmate's medication(s) for the purpose of providing the inmate with information on legitimate risks to an infant associated with the provision of breast milk while on particular medications, including the nature, level, and likelihood of such risks, and strategies on how the inmate may limit these risks. including but not limited to reducing dosage , eliminating the medication, or using an alternative medication. Admittance to the program may be denied only if, in the professional medical opinion of the physician, it will not be possible to provide mi lk that is safe for an infant's consumption while still maintaining the health of the mother. Where admittance is AR657 Pagt: 1 of 5 denied, the physician must record the nature of the problematic medication, specified medical risks, and any proposed alternative accommodations. C. The inmate must arrange for someone to pick up breast milk at the institution at least weekly. The person picking up milk must provide personal identification upon arrival, and must sign for the mi lk when picking it up. D. Participation in the program is limited to 12 months after delivery. 4. Once approved, an inmate will receive training on how to use and clean the breast pump and be provided with adequate nutrition, including vitamins and/or nutritional supplements as ordered by the facility physician or medical provider. 657.02 BREAST PUMPING 1. Inmates will pump breast milk in a designated infirmary cell using equipment provided by the Department of Corrections. Privacy will be provided. Two inmates may use the cell simultaneously. 2. If authorized by the warden, inmates in this program may keep manual breast pumps in their cell s to pump milk during the night without the need for repeated trips to the infirmary. If an inmate pumps in her cel l overnight, she must have the appropriate accessories and tubing, collection bags and an insulated cooler with ice to store the milk overnight . Milk pumped in the inmate's cell must be delivered to the Medical Division no later than 0700 the following morning. Manual pumps may be used between the hours of 1800 and 0600 hours. After 0600 and until 1800, inmates must come to the infirmary and use the electric pumps. 3. Inmates are not allowed to take electric pumps to their cells. Electric pumps may only be used in the infirmary area. Pumping will be scheduled for inmates approximately every three hours, depending upon institutional operations and restrictions. Times will be scheduled in advance by the Medical Division , with the intent of maintaining the mother's milk supply. Unscheduled appearances will not be accommodated. I f an inmate refuses an appointment time. it will be counted toward the number of missed appointments. Extra pumping times will not be provided for those that are missed. 4. 5. Scheduled pumping times may be delayed due to counts, institutional lockdowns, disruption of utilities (water, electricity, etc.), medical emergencies and other events that disrupt Medical Division or fac ility operations. Reasonable efforts will be made to accommodate program participants within a reasonable amount of time after the disruption ends. The warden may authorize the in-cell use of manual breast pumps in the case of a prolonged institutional disruption. AR 657 Page 2 of'S 657.03 GENERAL REGULATIONS 1. The inmate must arrive at the Medical Division within ten minutes of her scheduled pumping time. If the inmate arrives later than this, her pumping time is subject to cancellation by medical personnel. 2. Three mi ssed appointments are grounds for removal from the program, so long as the appointments were not missed due to an institutional disturbance such as those described in section 660.2.5 . 3. An inmate who intentionally misuses or damages equipment, or who violates facility rules while in the infirmary area for the purpose of pumping milk is subject to removal from the program. The inmate will be directly responsible for the cost of repair or replacement of any equipment that she damages or destroys. 4. An inmate who engages in violent or assaultive behavior that causes her to be housed in disciplinary or administrative segregation may be dropped from the program. 5. An inmate in protective custody (PC) will be housed in the infirmary until either her PC status or her program participation ends. 6. Upon completion of the program or withdrawal from it, a schedule of tapered pumping to abate breast engorgement will be offered to the inmate. The schedule will be determined by the facility physician. 7. Manual pumps will not be purchased or provided by the Nevada Department of Corrections (NDOC). [nmates may use the manual pumps that they were given at the hospital prior to discharge in situations when such use is authorized. 657.04 USE OF ELECTRIC PUMPS 1. A specitic in firmary cell will be designated by medical personnel to be used for breast pumping. The windows of this cell wi ll be covered while i! is in use to ensure privacy. 2. Inmates must use breast pumps provided or authorized by the NDOC. 3. [nmutes will be instructed in the proper care and use of breast pumping equipment, breust reeding and proper nutrition by nursing staff. 4. Each inmate will be provided with her own supplies for the purpose of breast pumping. These supplies wi ll be stored in the Medical Division when not in use. 5. The maximum allowed time for pumping is 30 minutes. AR 657 Page 3 ofS 6. Inmates are responsible for the cleaning and maintenance of supplies following pumping. 7. A nurse will collect the breast milk from the inmate, and apply a pre-printed label to each bottle. The label will contain the inmate's name and DOC number. The nurse will write the date and time of collection on the label and place bottles in the designated freezer for storage until pickup. 8. A log will be maintained for each inmate participating in the program to document her pumping times and any missed appointments. 657.05 . STORAGE OF BREAST MILK 1. Pumped breast milk must be stored in a sealed container in a freezer. The ideal storage temperature is -4 degrees Fahrenheit. Every effort should be made to maintain this temperature. A daily temperature log will be maintained for this freezer. 2. Each inmate will have a separate bin in the freezer for the storage of her breast mi lk. 657.06 PICKUP OF BREAST MILK 1. Breast milk must be picked up at the institution each week on days and times determined by the Warden, but no fewer than two days per week. At the discretion of the institution and with warden approval, an alternative pick-up time may be made available if need is presented. 2. Pick-up will occur at the gatehouse. No visitors will be allowed inside the institution for the purpose of milk pickup. 3. The inmate may designate up to three persons who are authorized to pick up her breast milk. Each person authorized to pick-up milk will be provided with written instructions regarding the transportation and storage of breast milk. If an inmate's child is in the care of the State, milk will be released to the person who possesses documented proof of guardianship of the child (i.e., foster parent). 4. Medical staff will carry the collected breast milk containers to the gatehouse in an insulated container and give them directly to the person picking-up the milk. The NDOC will not provide a container for transportation to the person picking-up milk. 5. The person picking-up milk must bring an insulated container. 6. Three consecutive weeks of missed pick-ups are grounds for removal from the program . The inmate will be notified if a pick-up is missed, and given the opportunity to designate another pick-up agent. 7. The NDOC will not arrange or pay for the pick-up, delivery or shipping of breast milk. AR657 Page 4 of5 657.07 DISCONTINUING BREAST FEEDING 1. When an inmate chases to discontinue breastfeeding or is no longer permitted to participate in the program, she will continue to have access to a breast pump to relieve engorgement and prevent discomfort, including a hand pump as authorized by the Warden to relieve overnight engorgement. 2. The inmate will have access to the breast pump for this purpose as long as it is determined to be medically necessary by her doctor. APPLICABILITY I. This regulation applies on ly to Florence McClure Women's Correctional Center (FMWCC). 2. This regulation requires an audit. Medical Director Date Director Date AR 657 Page 5 of 5