Ex-pub waitress meets Cambridge hospital children’s milk needs

At Addenbrooke’s, it’s not just the patients, staff and visitors that get fed – there is also a specialist kitchen for babies and children.

Tucked away at the end of the paediatric ward at Addenbrooke’s Hospital is a small room known as the milk kitchen.

From there, the feeds for babies aged from two days to children up to 10 years old are prepared, stored and distributed.

“It’s a weird kind of job. In some ways it’s a very simple job, but you’re doing it under conditions that aren’t simple,” explained milk kitchen assistant Alice Chetwyn, 25.

Each day Alice can make up to 30 feeds for around seven babies on the ward. They make 24-hour batches, which is around six bottles per child. The milk kitchen also stores expressed milk for mothers who are breastfeeding.

“Some of the milks are for babies and some of them are for older children with various illnesses where they need something more broken down where they can’t digest food very well,” said Alice.

“I get all my information from the dieticians, who will make up a recipe for me, and I’ll follow that.

“You get the ones that are just one type of milk and then there are ones called ketogenic milks where you’ll get different types to put in. So, you’ll get one powder and maybe another powder and 0.2 grams of something else and 0.1 millilitres of something. It’s very specific.”

As well as digestive problems, allergies and intolerances are among the main factors why Alice would be making a feed.

“Sometimes it’s just if they’re particularly poorly and you don’t want to stress them out too much,” she explained.

Infant formulas must not be made on the wards under any circumstances because of the risk of contamination, so Alice makes those up too.

“The hospital’s surrounded by germs so if anything is going to go wrong it would be here,” she said.

Before taking up her role, Alice worked as a pub waitress and, like many people, did not know what a milk kitchen was.

“I didn’t know what I’d be doing until the day I started because it’s difficult to describe what it actually is and most people have never heard of a milk kitchen,” she said.

Feeding the ward’s young patients is incredibly rewarding for the 25-year-old, who is an aunt, but says sometimes it can be hard to explain to parents.

“When you come into hospital a lot of control is taken away from you and feeding your child is the one thing you can do, so it can be hard for some parents to accept someone else is responsible for feeding your child. That can be a big thing to say,” she said.

Alice, who works all week in the milk kitchen, is also responsible for safely storing expressed breast milk at the correct temperature and making sure it’s labelled correctly.

“Part of my job is decanting the expressed breast milk into the right volumes for when it’s needed,” she said.

The milk is stored in a fridge or freezer and each day it is delivered to fridges on the ward ready for parents, nursery nurses and healthcare assistants. The hospital also stores donor breast milk.

“Normally I deliver to the fridges so it’s ready to be delivered, or when the parents get to know me they just come and ask for milk,” she said. “Breast milk is very precise for that child’s age. If you’re a mother of a three-month-old child, the milk is specifically for that age of child. So it wouldn’t be any good for a six-month-old.

“Sometimes you get a mum who doesn’t drink dairy, so it’s different and has to be labelled as such. It’s dairy-free.

“It can be very specific and there can be a lot to handle in one day as well. Today I’ve had two feeds to do but tomorrow it might be seven or 10. You just don’t know. But I get to see the kids every day and sometimes I get to cuddle them.

Among those to have used the service is Gemma Smart, 31, whose seven-month-old son Drew had bowel surgery at two days old and was back in this week for a reversal operation.

“He can’t have his usual milk because it’s not got enough calories and things in it,” said Gemma.

“They’ve been ever so good because I don’t know anything about that. We’ve been trying all different milks and they’ve been getting it prepared for me, so it’s one less thing for me to think about – what kind of milk he needs and when it needs preparing – because I’ve got enough going on at the minute.

“We’ve just been trying different milks out because he’s still a little bit tender. It’s amazing. It’s hard enough making sure that he has the milk and is putting on weight, so it’s one less thing that I have to think about. I’m lucky that Alice just does it.”

Gemma had not heard of the milk kitchen before she was first in hospital with Drew.

“At the time, he couldn’t be with me so I expressed milk and the milk kitchen would store it. He didn’t eat for 10 days and when he started to eat, it was always ready for me. It had been stored how it should be.

“It’s the last thing that you think about when you’re in hospital, like a lot of things. So initially it was like ‘Where am I going to store the milk?’ But they had all of that covered so that was good.

“He’s doing much better, we’re just trying to get his feeds up. He was on 7oz when he came in and we’re struggling to give him 3oz. We’ve just got to keep trying. Each day he is wanting it more and starting to get back into eating.”

Claire Leivers is a paediatric dietician and is among a team of people who help create the recipes that Alice uses to make the feeds.

“A lot of our standard formulas, because they’re available in liquid form, come straight on the ward so Alice can concentrate on some of the specialised feeds and formulas that are only available in powder form. Or maybe we’d like them in powder form because we’d like a certain amount,” said Claire.

“Naturally, the ones we’re making up are for children with allergies or some gastro surgery where they need something quite sensitive.

“We also have patients that have epilepsy, so part of the treatment they would be on would be a ketogenic diet that helps to reduce the amount of seizures. This is a patient that has that at home or is coming in to start taking it, and that’s something we’d ask Alice to make up because it’s more specialised.”

Having a dedicated milk kitchen assistant means everyone can be confident that the milk being provided meets health and safety requirements.

“We know that the feeds are being made up correctly in a standardised way following the guidelines from a health and safety and infection control point of view to ensure that the temperature of the feed is being made correctly and stored in the correct way as well with the correct patient label on,” said Claire.

And Alice’s job doesn’t end on the ward – when a family are moving or heading home, she’ll prepare a batch of feeds to take with them.

“Her role is essential for making sure that the children are getting the feeds so they’re well nourished in hospital and they get things in a timely manner,” said Claire. “By the time the feeds are gone, Alice is there with the next one.”