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Milk to Go for Providers

​NWMMB has three programs to meet the needs of outpatient families. Milk volume for each program is based on availability and is subject to change. Milk volumes below are valid for prescriptions written on or after today's date.

 

Please choose from the menu below to access the prescription forms and upload documents link. You may also fax documents to 503-469-0962.

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THE BABY IS UNDER 4 WEEKS OLD

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Up to 40 oz per baby,
one time only
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An RX is required

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​Up to 100 oz per baby, one time only​

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An RX and chart notes are required

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THE BABY IS UNDER 8 WEEKS OLD AND WAS:
 

  • born premature (<35weeks)

  • spent time in the NICU

  • IUGR

  • SGA

  • has significant weight loss (>10% at 4+ weeks)​

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THE BABY HAS A CRITICAL MEDICAL NEED:

Please see a list of critical medical needs here

 

 

Volume is based on need and availability​

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An RX, Statement of Medical Need, and chart notes are required

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The baby is under 8 weeks old AND was:

  • born premature (<35weeks)

  • IUGR

  • SGA

  • has significant weight loss or

  • spent time in the NICU

  • ​

​Up to 100 oz per baby, one time only

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An RX and chart notes are required.

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Looking for additional information about outpatient milk orders?

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