Keriton Korner

One of the most common misconceptions about transgender people is that they cannot or do not want to have children. Contrary to this rather misleading popular belief, many transgender people desire to have children, with rates comparable to the cisgender population (Auer et al., 2018). Transgender individuals have multiple options for parenthood just like cisgender people. Although transgender parenting is often misunderstood by many, the aspiration of all parents is to have a healthy baby and be a loving parent despite how one may identify. Types of Childbirth in the Transgender Family There are numerous ways in which trans people…

Necrotizing enterocolitis (NEC) is the most common, and most serious gastrointestinal emergency in newborn infants. The pathophysiologic mechanism(s) leading to NEC are complex, and remain somewhat elusive. It is characterized by severe inflammation of the intestinal mucosa, invasion of enteric bacteria, and dissection of gas that can extend into the portal venous system and result in perforation. There is associated intestinal ischemia, and the most severe cases are characterized by extensive ischemic necrosis.   Clinical presentation of NEC can be variable.  Onset can be subtle, starting with simple abdominal distension, followed by insidious progression.  Alternatively, there can be an abrupt and devastating presentation…

The benefits of human milk and colostrum are well recognized, specifically for an infant requiring admission to the Neonatal Intensive Care Unit (NICU). Human milk offers an optimized defense against such co-morbidities as necrotizing enterocolitis (NEC), sepsis, respiratory infections, chronic lung disease and retinopathy of prematurity (ROP). Enteral feedings are better tolerated, feeding progression enhanced and cognitive development fostered when mother’s milk is utilized. Despite the strong evidence supporting the use of human milk feeding, studies have found that infants admitted to the NICU are often not discharged to home receiving human milk due to a variety of factors. These…

1. Presented by Baystate Children’s Hospital at the Academic Pediatric Association Region 1 (Spring) Meeting 2023. CONCLUSIONS based on 2 years of data. Implementation of a Breast Milk Tracking System (Keriton) is associated with increased Breast Milk provision and less exclusive formula use at discharge from the Baystate NICU Any Breast Milk at Discharge (pre-Keriton) 62.3% vs (post-Keriton) 75.6% with p-value 0.002 Exclusive Formula at Discharge (pre-Keriton) 37.7% vs (post-Keriton) 24.4% with p-value 0.002 Increased parental communications using the parent-facing Kare Connect app & decreased Breast Milk errors may have contributed to the overall improvement in Breast Milk provision 2.…

Whether it’s your favorite online store or food delivery service, we’re all used to choosing a product or service and having it delivered without difficulty. When was the last time what you ordered was not what you received?  In neonatal intensive care units everywhere, professionals spend hours each day discussing the merits of one therapeutic feeding option over another, until carefully deciding on a course of action. Now, imagine that the discussed treatment course does not get executed as prescribed. This would be disappointing, to put it lightly. We partnered with Keriton initially because we wanted to reduce the possibility…

The world as we know it is becoming more diverse and so are families. Working as a pediatric healthcare provider allows us the opportunity to experience family structures beyond the traditional Mom-Dad unit. This may be challenging for some of us who are new to this dynamic. We, as humans, have surely evolved into better understanding beings and perhaps this is possible because many of us have consistently challenged ourselves against our old belief systems. Nations, cultures, and races continue to intertwine giving birth to brilliant new ideas and beautiful people. Despite this evolutionary process, there remains a community that…

The goal of this blog is to provide my own “hindsight,” when building the NICU milk/formula lab; and things that helped me with its successful construction and implementation.  Throughout my career in neonatal and pediatric nursing, I’ve been fortunate to experience moving into new clinical units. My first was as a charge nurse, where our team relocated into a 45 private bed NICU. This was my first taste of challenges in change management: new clinical workflows, advanced technology, and the importance of effective transition planning. In later years as a travel nurse, I supported nursing leadership teams in the construction, development,…

A three-part series that looks at how understanding the root causes of mistakes involving infant feeding management can help prevent them in the NICU. Originally published in Neonatal Intensive Care, The Journal of Perinatology-Neonatology: Part 1 (page 38), Part 2 (46), and Part 3 (40). Part 1: Introduction We all know that the NICU is an intense and complex clinical environment where you are dealing with the most precious of patients. This complexity also presents many opportunities for error, specifically involving infant feeding management. At this time, there are no universally accepted national standards to regulate safety management for preparation…

If you are considering a feeding management system, here are the 6 things you need to know about your organization. What are your compliance goals?Who is preparing feeds?Which units need the solution?When should each site go live?How do you approach staff and clinical education?Why should your institution make a change? What are your compliance goals? Hospitals contact us to improve the safety of their feeding management process. Typically they are aligning new safety goals with compliance goals set by external bodies. Examples include: Passing The Joint Commission’s review with flying colorsAchieving HIMSS Stage 7 validationImproving the Leapfrog hospital safety gradeJoining…

I have worked for over 25 years creating and building IT applications for large and small companies. Designing with purpose feels more critical in Health Care than any other industry I’ve worked in. Keriton started as a pair of mobile applications focused specifically on Breast Milk Management.  We managed inventory and ensured feeds were validated for safety and to catch any “near-misses”.  Considerable time was spent working directly with the NICU staff  to ensure our product was a perfect fit for their workflows. This relationship evolved from being transactional into a partnership.  We listened to and worked with these partners as…

This past month I was lucky to attend the Institute for Healthcare Improvement’s (IHI) Patient Safety Congress. Over the course of a few days, I listened to experts from around the world weigh-in on current issues facing healthcare. For background, the IHI was officially founded in 1991, and is a non-profit organization dedicated to improving healthcare globally. It is made up of individual members as well as organizations that seek to share knowledge and research to improve our healthcare systems. Besides bringing people together to learn and grow, the IHI works with other expert organizations to develop its own literature…

When Keriton Kare first came to my unit, the photo-sharing function was a new workflow for staff. We were a bit skeptical about sending pictures to families. Did parents want photos of their babies with all the wires & equipment? Would it be disruptive at night for mothers already coping with sleep loss and stress? The first night I used the app, one of my patients was very premature and sick. He had a breathing tube and multiple IVs. I was a bit nervous about sending photos to his parents because it was hard to hide all the equipment. Still,…

As we approach Patient Safety Awareness Week (March 13-19), clinicians and health systems are called to focus their institutional safety culture as well as the practices that support improved outcomes for patients. What is at stake? The National Patient Safety Goals for Hospitals identified by the Joint Commission for 2022 highlight specific call-outs for improvement, including examples like “improve staff communication” and “use medicines safely.” While these goals remain important aspects of quality clinical care, ask any healthcare provider what’s keeping them up at night? Their answers align globally: poor staffing. Prior to March 2020, there was an estimated worldwide…

As a company focused on improving both safety and the NICU experience for patients and families, we were thrilled to partner with Today is a Good Day (TIAGD). As you continue reading, you’ll learn about all that TIAGD has to offer NICU families. TIAGD works with Keriton to help care teams reach more families through a variety of channels. Hospital staff can send SMS blasts to parents’ for large events.Hospital staff can push out timely notifications as reminders for events in the NICU.Hospitals that have already partnered with TIAGD, can put their customized content right into our Kare Mom app…

Devices and kits are becoming more prevalent among hospitals, donor banks and consumers as the trend continues to expand. Human milk analyzers are having a moment. This category includes devices that use light to analyze milk for macronutrient composition, as well as kits with test strips. But why is the moment now?  Lactating parents, donor milk banks, and hospitals want to know: “What’s in my milk? Is it right for this infant? What, if anything, do we need to add to it to achieve optimal growth and health outcomes for the baby?” The devices and kits provide varying levels of…

Eddie Chang, MD, MBA is Chief of Neonatology at Abington Hospital – Jefferson Health. Here he describes some of the ways that Keriton impacts his NICU/SCN. How did Jefferson Health’s approach to innovation help in adopting Keriton? Your NICU installed Keriton 2.5 years ago. What was the first benefit the data offered? How does the data impact conversations with the parents of NICU patients? Why is it so difficult to prevent feeding errors in the NICU? In May 2020, Dr. Chang and colleagues published, “Virtual Practices Transform the Care Delivery Model in an Intensive Care Unit During the Coronavirus Pandemic”.…

In recognition of Nutrition Awareness Month, I was delighted to interview two Registered Dietitians at Connecticut Children’s about the ins and outs of their clinical nutrition program in the Milk Room, NICU and Pediatrics floors. Thank you to Jennifer Zarrilli, MS, RD, CD-N and AnnMarie Spizzoucco, RD, CD-N for the insightful and candid interview! 1. What do you wish providers & staff knew about what you do? JZ: The work of the dietitian goes beyond healthy eating. Instead, we are really in there with the medical team making suggestions for medical nutrition therapy to treat chronic diseases. Some diseases have…

One of the hardest jobs as a lactation consultant is walking into the room of a new NICU mother. There’s a million things going through her mind and keeping her attention to discuss breastfeeding and pumping is challenging. Rationally, NICU moms know their breast milk is important for their babies – but the reality of pumping can be overwhelming. As a rule, NICU moms are exhausted, often in pain from delivery, and just starting to cope with the separation from their child; getting them to use a machine on their breasts every 2-3 hours is a big ask. Even the…

The Connecticut Children’s Neonatal Intensive Care Unit at the UConn John Dempsey Hospital is offering a high-tech tool for moms to ensure their infants get the most out of breast milk and formula feeding. Mothers with infants in the Connecticut Children’s Neonatal Intensive Care Unit at the UConn John Dempsey Hospital soon will have a new technology-driven tool to get the most out of breast milk and formula feeding. Starting Feb. 17, mothers of Connecticut Children’s NICU patients at UConn Health will have access to the Keriton Kare app, which will enable them and their care team to monitor feedings…

Keriton is committed to supporting clinicians to advance practice through safety, collaboration, and innovation. Did you know that breast milk management can affect at least three scoring metrics (six points total)? You are doing good work. Get the credit. Outcomes and Experience Infant discharge on breastmilk Points for percentage of patients discharged on breastmilk.Points for tracking discharge on breastmilk. Not only do we track, in real time, the number of infants you have discharged on maternal milk, but we can help you increase those metrics! Klassify, Keriton’s lactation analytics dashboard, allows clinicians to take a proactive approach with maternal pumping/production…

The answer should be everything. Everything that is needed to complete one’s feeding task safely and timely. But how can all the information that is recommended live ON a bottle label? Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities 3rd Edition (by the Academy of Nutrition and Dietetics), is also known as the ‘blue book’, and it recommends that labels include the following:  Patient nameMRN/account numberContents plus additivesCaloric densityVolume in containerExpiration date & timeVolume & frequencyRoute of administrationFor enteral use onlyThaw date, time & expiration of original labelInitials of preparer(s) That is…

“Should we be scanning breast milk?” “Ok, but what about the fortifiers? And bases for complex formulas? How about ready-to-feeds?” We hear these conversations at NICUs and children’s hospitals often. For some clinical nutrition programs, it’s important to scan a variety of products, in addition to human milk. Which product barcodes would you want to scan?

As with most things in 2020, World Breastfeeding Week looked a little different than it usually does. This was no exception at Connecticut Children’s, but they did not let it stop the celebrations. Connecticut Children’s typically partners with Hartford Hospital to have a large party with games, prizes, snacks — many hospitals and speakers attend. Since this was not possible this year, they held a Zoom event. Mothers from the Newborn Nursery, Hartford Hospital mothers support group, and the NICU spoke. The first half was hosted by Hartford Hospital’s Lactation Team and the second half by the Connecticut Children’s Lactation…

Breastmilk is a complex mix of bioactive, cellular, and nutritional components that work together to protect and grow vulnerable infants in the NICU. Years of empirical research demonstrate incontrovertible proof that premature infants who receive maternal breastmilk develop fewer infections, have shorter hospital stays, and better long-term outcomes. The biggest challenges premature infants face include Sepsis, Retinopathy of Prematurity, and Necrotizing Enterocolitis (NEC). NEC is a serious intestinal infection. One case of medical NEC can cost a hospital up to $76,700, and with surgical intervention, it can cost as much as $205,300. As we prepare to honor NEC Awareness Day,…

Connecticut Children’s has selected Keriton Kare to improve the quality and safety of feeding management at its Hartford and Farmington campuses. Keriton, a provider of applications for NICUs and children’s hospitals, offers comprehensive breast milk, donor milk, and formula management. Keriton is integrated with Connecticut Children’s Epic EMR. “Connecticut Children’s has partnered with Keriton to ensure accuracy and efficiency into our feeding management operations, which is critical to maintaining the highest standards of care as our organization grows and matures,” said Marge Julian, R.N., M.S.N., Nursing Director of Connecticut Children’s NICU network.   “Keriton’s cloud-based platform is sufficiently agile to scale…

Over the last year, the NICU at Abington-Jefferson Hospital has been a great customer and partner. I was there recently to discuss a QI project, and had the opportunity to chat with an array of end users who touched the infant feeding management process. That included moms. Here are a couple stories moms shared about their experiences with Keriton’s Kare Mom app. Story 1 “Having the photos in the [Kare Mom] app is very different from the bassinet camera. When I log into the camera, my baby is usually sleeping or the camera is off. But with the [Kare Mom]…

Since going live in 2017, the Kare Mom app has received a positive response. Our iOS app rating is 4.8 out of 5 stars (84 ratings), and our Android app rating is 4.9 out of 5 stars (57 ratings), which is especially impressive for a cross-platform app. Google Play App Store Apple App Store The Kare Mom app was designed with moms, to overcome the challenges of having their babies in the NICU and having to produce breast milk. How do we achieve these goals? The app helps moms initiate pumping, maintain a pumping schedule, stay motivated to pump, and stimulates breast milk production…

To honor SIDS awareness month, Keriton is partnering with First Candle to provide this free webinar for clinical staff. For those of you not familiar, First Candle is a non-profit organization dedicated to reducing the rates of Sudden Infant Death Syndrome (SIDS), Sudden Unexpected Infant Death (SUID) and preventable Stillbirths by educating caregivers and families and supporting research. They are also committed to offering bereavement support for grieving families. In order to receive CEUs, please complete the post-survey/evaluation. For non-nursing professions, you will receive a certificate of completion to put towards your continuing education. or download the slides First Candle’s Roundtable,…

Last week was World Breastfeeding Week 2019, the first week of National Breastfeeding Month. This year, the WBW theme is empowerment. Have you read about why it was chosen?? If not, take a moment and see below or visit World Aliance for Breastfeeding Action for more details. “The ‘Empower Parents, Enable Breastfeeding’ was chosen to be inclusive of all types of parents in today’s world. Focusing on supporting both parents to be empowered is vital in order to realize their breastfeeding goals. Empowerment is a process that requires evidence-based unbiased information and support to create the enabling environment where mothers can breastfeed…

Keriton Improves Nursing Productivity Keeping it real When it comes to barcoding, it may seem logical to treat breast milk like blood or medication. But the logic quickly fails. How often is blood combined with other bags of blood, then aliquoted specifically per patient before administration? How regularly is a medication frozen, thawed, and dosed out per patient administration? It turns out, human milk management is far more complex, labor intensive and time consuming by nature. Each bottle of breast milk requires 16-20 mental validations – verifying the baby’s and mother’s identification, updating expiration dates, inventory, etc. If a nurse…

A Great Experience at HMBANA! Keriton had the privilege of attending this year’s Human Milk Banking Association of North America’s (HMBANA) semi-annual Milk Matters Symposium. Over 185 Milk Bank professionals representing 28 Milk Banks from the US and Canada convened in Chicago. These milk bank professionals came to speak, to learn, to share. For those of you that are not aware, HMBANA is the governing body for nonprofit Donor Human Milk Banks. Their mission is to advance “the field of nonprofit milk banking through member accreditation, development of evidence-based best practices, and advocacy of breastfeeding and human lactation to ensure an ethically sourced…

In January and February, two additional hospital systems in the Philadelphia area partnered with Keriton to train and go-live using our breast milk, donor milk, and formula feeding management platform. We have trained over 225 new staff on the Keriton Kare platform in the last two months. For each go-live, our team observed and configured workflows for nurse milk prep at bedside and milk tech prep in dedicated rooms, respectively. Our implementation team worked with each NICU to customize training materials and to run one- to two-hour training sessions per user role. The educational curriculum includes defined competencies for the…

Talking to the Front Line It’s no wondering co-innovating with nurses creates the right solutions. There are 3.2 million nurses working across the U.S., and for the 17th consecutive year, the nursing profession is rated highest for honesty and ethics in Gallup’s annual poll. As the front line of patient care, nursing is intimately tied to patient experience and clinical outcomes. Our team at Keriton knows it well. Nurses, lactation consultants, and clinical nutritionists helped us design our breast milk, donor milk, and formula management platform. Stories of Innovation – Keriton from Penn Med Health Care Innovation on Vimeo. But we…

Patient- and family-centered care is the name of the game in health care. As it should be. If we are not here for our patients and our families, then why are we here? Every interaction we have with our families is a crucial opportunity to improve care outcomes. One of the many questions is: how do we use these fleeting moments and communicate fully and effectively with our families? Traditionally, health care providers communicate in-person or over a phone call. We can all agree that there’s been a substantial cultural shift and electronic communication is not only the new norm…

If you are not in IT, you may not be familiar with the term Software as a Service (SaaS) yet you are likely using at least one of the thousands of SaaS solutions available. The explosion of SaaS applications has come about in recent years thanks to “Apps” and the subscription model mentality. Do you use Gmail? How about Spotify for music or Netflix for movies? Do you use a tool for managing patient relationships like Salesforce Health Cloud?….. the list goes on. These companies have built a better mouse trap and continue to innovate, bringing ever increasing value to…

VENDOR SPIEL……SIGN HERE…..ANY QUESTIONS……WAIT WHAT? I cannot count the number of times a vendor has walked into my unit, spent 2 minutes explaining their product, asked for a signature, and then walked out. This made me crazy! Do you have a formal education plan? no. Do you have a competency? no. Are there follow-up educational tools available? no. But don’t worry! [Insert product name] is very easy to understand/use. ? When an institution launches a new product, platform, technology, etc… it is usually for a good reason. The expectation is that it will in some way improve bottom lines, patient…

NICU baby at Fort Worth hospital fed breast milk from mom with damaging virus – Fox4News Report ℹ️ We all know that the NICU is an intense and complex clinical environment where you are dealing with the most precious of patients. Specifically, the topic of infant feeding management involves some of the most challenging and complicated clinical, educational, operational and administrative decisions. I have had the honor of being a NICU nurse for 15 years and the last six years of my career, I had been a Nurse Manager. “What gets watched gets done” is an old adage we all think…

70% of all change initiatives fail. Why? Because changing human behavior is hard. Newton’s first law of motion dictates that a body at rest will remain at rest (or at least in its uniform motion) unless directly acted upon by another force. You could speculate that change management would have fit right into Sir Isaac Newton’s wheelhouse were he to be a project manager today. Bring up the topic of change management in the hospital environment, and you now have a challenge on the order of Einstein’s theory of relativity. So, What is Change Management? Simply put, it’s the management…

verb. Conference Room Pilot (CRP) is a term used in software procurement and may be used during the selection and implementation of a software application in an organization. The purpose of the conference room pilot is to validate a software application against the business processes of end-users of the software, by allowing them to carry out typical or key business processes using the new software. Try Before You Buy As a digital health provider, offering a new SaaS product to hospital NICUs, Keriton’s remit is to convey the value and return on investment (ROI) of a Keriton installation to the key…

An Interview with the Founder and President of Mothers’ Milk Bank Northeast Recently, Keriton’s own clinical expert and lactation consultant – Kelly Convery – had the lucky chance to chat with Naomi Bar-Yam, the president of the Human Milk Banking Association of North America (HMBANA) and founder of Mothers’ Milk Bank Northeast (MMBNE). MMBNE serves neonatal intensive care units throughout the northeastern United States by providing screened and pasteurized donor human milk. In the event a NICU mother is unable to provide all or any of her own breast milk, donor human milk is recommended by the American Academy of…

Prematurity on the Rise A recent report from the March of Dimes confirms the rate of preterm birth is on the rise: now up to 9.8% in 2016 from a rate of 9.6% the previous year. Very-low birthweight infants (VLBWs – infants born < 1500g or 3 pounds 4.9 ounces) are the most expensive patients for a hospital, averaging $76,224 in direct costs to the unit. Another source put the larger societal burden of preterm birth at $928,800 per infant through age 18 years old. Consequently – as more premature infants enter neonatal intensive care, the overall costs related to…

“Let us not just create the best feeding management system, let us solve the baseline problem of helping NICU moms improve their pumping outcomes while away from their babies” – was the unanimous response from our development team in Spring 2016. Come Winter 2016, we embarked on an aggressive timeline to deliver not just a point solution for the multi-faceted human milk management problem statement, but to build an entire platform for the NICU and its several users viz. the nurses, the lactation consultants, the nurse management and last but most important, the mother. Fast forward 5 months to April…

One of the most common questions we receive from clinicians is concern regarding the required use of smartphone devices to run the Keriton platform. The majority of our customers use mobile devices, like smartphones, to run Keriton in the hospital setting. (However, all Keriton’s clinical applications — Kare Mom, Kare Lactation and Kare Tech — run on desktops, laptops and computer-on-wheels setups too.) A strong body of research shows that personal mobile phones are covered in infectious pathogens and pose an infection risk to vulnerable infants in neonatal intensive care. As a result, most NICUs have strict policies regarding the…

Last month the World Health Organization (WHO) – in conjunction with the Global Breastfeeding Collective – released a jarring assessment of the state of breastfeeding prevalence and support internationally. Although the scientific benefits of breast milk are well proven, the WHO report found only 40% of infants less than 6 months old are exclusively breastfed. Furthermore, no country in the world meets the WHO recommendations for breastfeeding exclusivity or support. The reasons behind the worldwide lack of breast milk exposure are complex and multifold – but lack of financial investment in breast milk promotion is a known contributor. The Global…

When the Institute of Medicine published its groundbreaking report To Err is Human in 2000, patient safety moved to the forefront of healthcare initiatives throughout the US. From instituting electronic medical records in hospitals nation-wide to transitioning to barcode-scanning systems for medication administration, the face of healthcare in 2017 is very different than it was in 2000. Except when it comes to breast milk. While the rest of healthcare evolved, the management and preparation of breast milk in neonatal intensive care units (NICUs) remained largely unchanged. To date, there exist no universally accepted, national guidelines or standards that regulate the…

Pumping milk is hard work as a NICU mom. Here are some strategies to help keep your milk flowing strong! Making Milk When Away from Your Baby The most important thing you can do to start making milk is to pump your breasts early and often! The goal is to pump 8-12x/day. Why pump so often? Well, newborn babies eat a lot – sometimes every 2 hours around the clock. All that eating pulls a woman’s milk in and keeps her milk supply growing over the first two weeks of life. When you’re separated from your baby, your body doesn’t get…