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.
THE BABY IS UNDER 4 WEEKS OLD
Up to 20 oz per baby,
one time only*
An RX is required
*volume is based on milk availability and prioritization of hospitalized infants
Up to 60 oz per baby, one time only*
An RX and chart notes are required
*volume is based on milk availability and prioritization of hospitalized infants
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)
THE BABY HAS A CRITICAL MEDICAL NEED:
Please see a list of critical medical needs here
Volume is based on need and availability
An RX, Statement of Medical Need, and chart notes are required