Got (Breast) Milk?

Dear Diary,

All moms-to-be pray for a healthy baby.  Unfortunately, one in eight deliver a child preterm.  In all, 500,000 premature babies are born every year in the US, and 40 percent die before they can say their first words, take their first steps or celebrate their first birthdays. When we hear such statistics, we are moved to tears to grieve, to our knees to pray or to our wallets to donate.  But what if you could give something much more valuable, like liquid gold?  That’s what breast milk is to neonatal intensive care units. According to the Human Milk Bank Association of North America, 8 million ounces are needed, but only 2.8 million were distributed to hospitals last year.  Diary of a First Time Mom caught up with HMBANA President Jean Drulis to find out how you can help save lives.

Heather: Hi Jean.  Thanks for taking time out of your busy schedule to join us.  First off, what exactly is a milk bank?  I am a breastfeeding mom, but I never heard of it until after I gave birth.

Jean: Hi Heather.  Thank you for educating others about our milk banks!  A milk bank is a clinical health care service similar to a blood bank.  It recruits and screens donors, collects, pasteurizes, stores and distributes donor human milk to infants who need it.

Heather: Some people are grossed out by the idea of feeding an infant breast milk from a stranger.  Why do you think people have this reaction?

Jean: I don’t know why.  Are they thinking that they don’t want their infant fed milk from someone they never met?  I think they’re concerned about whether it is safe. Donor milk from a HMBANA (Human Milk Banking Association of North America) member milk bank has never been linked to the transmission of disease.  There are 3 layers of recipient protection:

• Donor screening for medical and lifestyle risk
• Donor blood testing
• Pasteurization and microbial testing of milk post-pasteurization

Society should embrace feeding an infant donor human milk in the absence of the mother’s own milk, because human milk is far superior to formula.   Human milk is the best gift.  It delivers short- and long-term advantages.

Heather: What are some of the advantages?  Why use donor milk versus formula?

Jean: Formula is inferior to donor/human milk.  Human milk contains numerous immunological factors that protect infants from infections and diseases.  The life-long benefits are well-recognized and documented not only for the infant, but also for the mother and society in general.  It is species specific, nutritionally optimal and easily digested.  Human milk saves lives!

Heather: What are some reasons a mother cannot provide milk for her baby?

Jean: A mother may not be able to meet her baby’s needs for the following reasons:

• because of premature delivery, a mother’s milk supply may be delayed or not become established enough to provide sufficient milk for her child.
• if she is pumping for twins or triplets and cannot provide enough.
• due to the stress of having a hospitalized, ill infant whom she cannot hold or directly nurse.if she requires medications that may pass into breast milk and are harmful to the infant.
• if she has a chronic infection such as HIV or HTLV, or another medical condition that precludes breastfeeding.
• if she has a breast infection that temporarily affects her milk production.

Heather: How can she receive donor milk?

Jean: Donor human milk requires a prescription for dispensing it to infants at home.  Hospitals can have an inventory of donor milk. They determine which infants receive it.  The highest priority is the premature infant.  The evidence is overwhelming that human/donor milk is vital for this vulnerable population.

Heather: How does breast milk help pre-term infants?

Jean: Human milk protects preemies from NEC (necrotizing enterocolitis), sepsis and other infections.   They reach full feedings sooner and have enhanced feeding tolerance.  They have higher IQs and enhanced short- and long-term immunity.  They likely will be discharged from the hospital sooner.

Heather: Can you explain more about NEC?

Jean: NEC is a disease that attacks the intestinal tract, damaging or destroying it, and requiring surgery to repair or remove the intestines. Emergency surgery on a preterm infant is difficult and dangerous. Mother’s milk makes a huge difference in how well these little babies do after birth because it vastly reduces the incidence of NEC, and it helps to repair the intestines should they become infected. Human milk fights infection while providing ideal nutrition. Consider:

• 1.5 percent of preterm infants fed human milk acquire NEC
• 10-17 percent of preterm infants fed formula acquire NEC
• Of those babies who acquire NEC, many die or develop lifelong complications of the illness

Heather: Where does the milk come from?

Jean: It comes from our donors, who are healthy lactating women.  They produce more milk than their infant consumes.  Milk donors are non-smokers and not on medication (with a few exceptions).  They are the foundation of a milk bank.  They’re remarkable.

Heather: Yes!  They may think they are just pumping a few more bottles a week, no big deal.  But they are making a big difference and saving lives!  How are they screened?

Jean: Milk donors are carefully screened.  They undergo a verbal interview and complete a written questionnaire.  Their health care providers are contacted and their serum is screened for HIV, hepatitis B and C, HTLV and syphilis.    

Heather:  After the donors get the green light, what happened next?  How is the milk processed?

Jean: Milk from several donors is pooled and pasteurized (heat treated) using the Holder method to destroy bacteria and viruses.  Thereafter, the milk is quickly chilled, labeled and stored frozen.  The milk is microbially tested after it is pasteurized.  It is dispensed only if there are not bacteria present.

Heather: I’ve read that some mothers sell and buy breast milk online and not through a milk bank.  Sounds risky!  Is this safe?

Jean: Casual sharing, selling and purchasing milk from unscreened donors are risky both for the recipient and the donor. There were 25 confirmed positive blood tests in 2011.  These potential donors had no idea that they had contracted HIV, hepatitis B, hepatitis C, syphilis or HTLV.

Heather: Fortunately, the screening process catches any unsafe donations before it reaches in infant.  How many milk banks are there?  How much milk is collected?  Distributed?

Jean: There are 12 milk banks in NA.  The 13^th bank will open soon. In 2011, HMBANA- member banks collectively dispensed more than 2.18 million ounces of donor human milk with 69% of it fed to hospitalized infants mostly in neonatal intensive care units.  This was a 17 percent  increase from the year before.  In 2010, HMBANA served 39 US states and 264 cities and three provinces and seven cities.

Heather: Let’s hope that number continues to grow!  Is there anything else you would like to add?

Jean: If there isn’t a milk bank in your state, please contact one that is closest to you.  Milk bank locations are listed on HMBANAs website. Milk donors are heroines who make a difference!

You don’t have to be a nursing mother to help an infant in need.  You can spread the word to breastfeeding mothers or you can work to establish a milk bank in your community.  Click here to find out how. Log on to Diary of a First Time Mom tomorrow to hear from one woman who decided to donate her surplus breast milk and a mothers who benefited from her priceless gift.