Human Milk Bank: Understanding the importance of Mother

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Increasing the Use of Human Donor Milk A
Public Health Imperative
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• Dixie Whetsell, MS, IBCLCBoard Member

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Why are Donor Milk Banks Needed?

• Human milk provides optimal nutrition, promotes
  growth development, reduces the risk of
  illness and disease.
• Some mothers are unable to provide all the
  breastmilk their infants need.
• In the absence of mothers own milk, donor milk
  is the best substitute

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Why use donor milk?

• Human milk also contains growth factors that can
• protect immature tissue
• promote maturation, particularly in the
  gastrointestinal tract
• promote healing of tissue damaged by infection.

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Human milk-fed premature infants receive
significant benefits with respect to host
protection and improved developmental outcomes
compared with formula-fed premature
infants. American Academy of Pediatrics
2005 Breastfeeding and the Use of Human Milk
American Academy of Pediatrics, Breastfeeding
and the Use of Human Milk 2005
Courtesy Kingproductions.com
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Michelle Obamas Lets Move Obesity Prevention
Campaign
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Oregon Health Insurers Partnering for Prevention
(OHIPP)
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Who needs donor milk?

• Donor milk must be prescribed by a health care
  provider.
• Common reasons for prescribing donor milk
  include
• Prematurity
• Allergies
• Feeding/formula intolerance
• Immunologic deficiencies
• Post-operative nutrition
• Infectious diseases
• Inborn errors of metabolism

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US Surgeon Generals 2011 Call to Action to
Support Breastfeeding

• Call to Action 12
• Identify and address obstacles to greater
  availability of safe banked donor milk for
  fragile infants

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Necrotizing Enterocolitis (NEC)

• Frequent and lethal disease affecting the GI
  tract of premature infants
• Average mortality is 30-40
• Incidence among formula-fed infants in NICU
  12-15
• Incidence among breastmilk fed infants in NICU
  1.5

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Call to Action Report

• About 12 of preterm infants weighing lt1,500gms
  will suffer from NEC.
• Hospitalization for a surgical case of NEC costs
  about 300,000 per patient.
• NEC treatment accounts for 19 of all initial
  newborn health care costs in the US.
• Human milk, including donor milk can reduce the
  burden NEC places on families and health care
  institutions.

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What is a donor milk bank?

• A service established for the purpose of
  screening, collecting, processing, and
  distributing human milk to meet the specific
  medical needs of individuals for whom it is
  prescribed.

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History of Milk Banking

• Roots of donor milk banking came from wet
  nursing.
• 1909 - first European milk bank was established
  in Vienna
• 1919 - first US milk bank was established in
  Boston
• 1980s, the increasing awareness of AIDS resulted
  in the closure of many milk banks in the US.
• 1985 - Human Milk Bank Association of North
  America was formed to set standards for North
  American milk banks.
• 1990s -The number of milk banks grew with
  evidence of safety, and research on the benefits
  of human milk.
• 2000s - Use of donor milk is expanding, and the
  number of milk banks in North America is growing.

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• HMBANA is a professional membership association
  that sets the standards and guidelines for donor
  milk banking in North American milk.
• Member milk banks are nonprofit. They screen
  donors, process and distribute donated milk.

www.hmbana.org
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Who do milk banks serve?

• Currently there are 11 HMBANA member milk banks
  providing human donor milk to the US and Canada.
• In 2000 the banks dispensed a combined total of
  409,077 ounces of milk that rose to 745,329
  ounces of milk 2005a 45 increase.
• In 2005, the HMBANA milk banks sent milk to
  hospitals in over 80 cities located in 29 states
  and 3 Canadian provinces.

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Why Develop A Milk Bank in Portland?
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2007 US Breastfeeding Initiation Goal 75 - Dark
Blue
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Donor Milk Banks in North America

• Operating Milk Banks
• Austin, TX
• Ft Worth, TX
• Denver, CO
• San Jose, CA
• Raleigh, NC
• Iowa City, IA
• Indianapolis, IN
• Kalamazoo, MI
• Columbus, OH
• Newtonville, MA
• Vancouver, BC, Canada

• Developing Milk Banks
• -Portland OR
• -Orlando, FL
• -Jackson, MS
• -Kansas City, MO
• -Toronto ON Canada

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Donor Screening/Selection

• Potential milk donors must meet requirements like
  those for blood donors. They must be
• In good general health
• Willing to undergo blood tests to confirm health
  status
• Not on medications or herbal remedies

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Donor Milk is Received and Logged In

• Frozen donor milk is brought in
• by donors
• by staff or volunteers who pick it up from
  depots, or
• delivered by express mail services

• When donor milk is received it is
• Logged in
• Given a batch
• Transferred to a holding freezer to wait for
  processing

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Donor Milk is Processed

• Tech follows HMBANA guidelines to process milk
• Milk is thawed
• Milk is emptied into flasks and mixed repeatedly
• Milk is poured into smaller containers

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Donor Milk is Pasteurized and Cooled

• The milk will be held in a shaking water bath at
  62.5 degrees C for 30 minutes.

• Then milk is plunged into an ice slurry to
  quickly cool the milk.

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Bacterial Testing and Milk Analysis

• Testing is done before and after pasteurization

Donor milk is analyzed for nutritional
composition -Protein -Carbohydrates -Fats -Calorie
s
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Donor Milk is Frozen and Stored
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Donor Milk is Distributed to Recipients

• Orders are received
• Critically ill infants are given priority
• Frozen milk is boxed to fill orders
• Boxes are labeled and shipped overnight

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In the NICU, drops of Janies milk, Alicias
milk, and Sarahs milk were fed to Nora and
Alison

• who grew up and breastfed happily ever after

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What is the charge for donor milk?

• There is a cost for each step of screening,
  processing, and shipping milk. Donors are
  volunteers and do not get paid.
• Non-profit milk banks charge 3.50 - 4.50 per oz
  for processing donor milk.
• Health insurance will sometimes cover the
  processing fees.
• Some health care institutions do not charge
  patients for the cost of donor milk processing
  and shipping.
• The processing fees do not cover all operating
  costs.
• All HMBANA donor milk banks depend upon donations
  from individuals, corporations, foundations and
  community groups to cover the true costs of
  processing and shipping donor milk.

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Northwest Mothers Milk Bank Board -Non-profit
established in 2008. -Recognized by HMBANA as a
Developing milk bank -Not processing milk
yet. -Board of Directors -Medical Advisory Council
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Our first large fundraiser Harvest September
2010 Raised 30,000
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Drop-Off Sites

• A donor drop-off site works with a specific milk
  bank. Donors that have already been screened and
  accepted can drop milk off at that site to be
  shipped to that milk bank.

Providence St. Vincent Medical Center
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March 2011 Providence Health Donates office space
for 3 years In SW Portland for Northwest
Mothers Milk Bank
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Frequently Asked Questions about Northwest
Mothers Milk Bank?

• How long will it take? 18-36 mths
• How much money do we need? 400,000 to get
  started
• How many staff members are needed? 3-5
• How many volunteers are needed? Lots!

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What can I do to help create Northwest Mothers
Milk Bank?

• Make a financial donation on our web site
  www.nwmmb.org
• Attend a fundraising event and donate
  www.nwmmb.org
• Volunteer become a Board Member email
  volunteers_at_nwmmb.org
• Become a milk donor for another milk bank until
  one exists here
• Use www.goodsearch.com to do internet searches
  and donate to Northwest Mothers Milk Bank every
  time you do an internet search.
• Invite others to come with you to see our new
  office space and encourage them to get involved
  too. info_at_nwmmb.org

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