Photo Credit: My Client JD Here’s a few things people often think about donor human milk:
It’s like water
Doesn’t have any sugar
Immune properties are destroyed
If donor milk is available people won’t breastfeed
All of these are misconceptions or myths
What is a milk bank?
When you think of milk bank, you think of blood bank. If we donate blood, what’s wrong with donating milk? A milk bank doesn’t have people sitting around pumping like a blood bank where they sit around getting poked and eating cookies. This is a place where breastfeeding support is readily available and lactating people BRING their donated milk in containers to the milk bank for collection and pasteurization to be provided to a baby in need.
This first formal milk bank was established in Vienna, Austria in 1909. There are now 239 active milk banks in Europe. In the U.S., our first official milk bank was in Boston, MA, a year later in 1910. They called it the wet nurse directory. Why is donor milk such an amazing option?
One of the greatest known recipients of donor milk have been the Dionne Quintuplets born in 1934 in a rural part of Ontario, Canada. First known set of quints to survive. Why and how when there were no NICUs? This is where that amazing donor milk title comes in! The babies refused to eat the carnation formula that was provided to them, so instead, they drank donor milk and they all survived to become women of which 2 are still alive today! This was a poor family with 5 children already at home when they became pregnant with 6 children, one passed in utero. It was the Great Depression and they had no way to care for all these kids, so they reluctantly gave custody to the Red Cross for round the clock care. Soon after they were taken by the government in efforts to not be commercialized, however they still allowed it to happen to these baby girls. Donor milk literally saved these babies lives! They would have starved otherwise as the options were much more limited back then.
The year I was born, 1985, was when Hmbana the human milk bank launched and began “mobilizing the healing power of human milk”.
Non-profit milk banks supply to hospitals that don’t have one in house. There are 28 accredited milk banks in the US & Canada. 4 are developing!
In 1989 Mumbai got a milk bank and has since saved 5 million babies annually with donor milk. India has the highest rate of preterm infants in the world and low rates of exclusively breastfeeding.
In 2000 - 2013 about 3 million oz of human milk were dispersed and by 2013 - 2018, that number doubled to 6 million oz of human milk dispersed.
Saving babies with donor milk has been happening for centuries and I’m sure there is a Bible story about it. I need to ask my pastor!
Who donates the milk and why?
Now that you understand how it started and who is running it, back to those misconceptions. Many people may wonder where the milk comes from and then become confused or even disgusted until you make the comparison to blood banking, cord blood banking and organ donation. Then human milk doesn’t sound so bad. They screen you the same way they screen you for blood but with an extra step. Verbal screening is done first. Then a lengthy screening form that is mailed. Minimum volume is required to cover the cost of processing. Blood test, HIV, HTLV, hepatits B and C, syphillis, verbal screening, written questionnaire, letter from physician.
The lactating person pumps alongside their nursing session and brings that milk to the milk bank. Sometimes it’s a parent with a baby home from the NICU and they pumped more than needed. Bereavement pumping is another way milk is donated in order to honor their baby’s life. Most parents don’t know to contact someone like an IBCLC, for help after the loss of a baby. The milk production process may still occur depending on gestation, and therefore support steps need to be taken based on the informed decision that is made by that parent. I’ve even had a dad bring the milk to a milk bank after he was pumping for his wife who was in a coma. I also know families that have lost the mother and turn to donor milk for their baby, a beautiful gesture for that mother who is with us in spirit.
How is it pasteurized and made safe? A few different methods but the most common is the Holder Pasteurization method, or HoP, which aims to rid milk of potentially harmful germs by heating it to 62.5°C (145°F) for half an hour, and then cooling it back down to room temperature. This method is used by all of the Human Milk Banking Association of North America (HMBANA) milk banks and differs from the high-temperature, short-time (HTST) pasteurization used in the dairy industry.
Head, face and body is covered up, plus gloves are worn. The nutritional value is then analyzed and determined each batch. A batch and each label will contain calories, expiration date, volume, and protein content. This way you can trace the milk back if you need. If the cultures are negative, it’s ready to dispense! The standard is 20kcal/calories per oz.
It doesn’t take much, let’s take a look:
1 bottle of donor milk can feed 3 very low birth weight babies for 24 hour stay
112 to feed one Very Low birth weight baby for 2 week stay
540oz for a 24 week gestation baby to stay for an entire stay of 3 months in NICU
So, who is eligible to receive donor milk?
Newborns admitted to NICU - 1st priority
Babies on maternal newborn unit with medical need for supplementation
Babies in the community with medical need
Any baby that doesn’t have access to their mothers milk for example chemotherapy, separation, jail, illness, etc.
Clinical uses of pasteruzied human donor milk:
Intolerance to formula
FTT (Failure to thrive)
Post surgical nutrition or short gut syndrome
Risks of non-human milk diet:
NEC (necrotizing entercolitis)
Bronchi pulmonary dysplasia
Preterm babies suspectible after discharge to hospital readmissions and SIDS
As I approach my lactation clinical internship in a few weeks, I’ve gained a thirst for knowledge on how to support human milk, not just feeding at breast. It’s not about the vessel, it’s about the goodness. If I could do one really great life saving thing in this world one day, it would be to start a milk bank! Perhaps it is my next and best adventure. 😎 If you need a milk bank, ask an IBCLC, your provider, hospital or midwife. If you are local to San Diego try UCSD milk bank. For non profit milk banks, If in the US see Hmbana and if in Europe, see EMBA
Until then, donate milk & use donor milk, it saves and improves a baby’s quality of life!