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According to The World Health Organisation, “Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large”.
At a time when many banks are going through a major image crisis, there’s one type of bank which defines the word “support”. Human breast milk banks are not a new idea – they’ve been around for a very long time in some shape or form. But along with our increased understanding of ways infectious diseases can be transmitted, particularly blood borne and body fluid transmission, breast milk banks fell out of favour for a while.
It was felt there was too much risk to young babies especially, of becoming sick from inadequately screened breast milk donations.
But there has been change in this attitude in the last few years with Australia matching many other countries. Currently, there are five breast milk banks operating in Australia – most of them hospital based.
All Australian milk banks screen donors and pasteurise – or heat treat – their donated breast milk. This kills any bacteria or viruses which could pose a risk. The donated breast milk is then called pasteurised donor human milk or “PDHM”, just to make things easier.
Currently breast milk banks supply most of their stock to premature or sick babies. These are the ones who benefit most from the immune properties of human milk. There is not enough stock of breast milk to supply healthy, term babies who are not being breast fed. Perhaps in the future, this will change.
So for now, the babies with the most need are looked after first. Premature babies need less volume of milk each day, whereas a healthy, term baby needs a lot more.
next – The facts
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According to The World Health Organisation, “Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large”.
At a time when many banks are going through a major image crisis, there’s one type of bank which defines the word “support”. Human breast milk banks are not a new idea – they’ve been around for a very long time in some shape or form. But along with our increased understanding of ways infectious diseases can be transmitted, particularly blood borne and body fluid transmission, breast milk banks fell out of favour for a while.
It was felt there was too much risk to young babies especially, of becoming sick from inadequately screened breast milk donations.
But there has been change in this attitude in the last few years with Australia matching many other countries. Currently, there are five breast milk banks operating in Australia – most of them hospital based.
All Australian milk banks screen donors and pasteurise – or heat treat – their donated breast milk. This kills any bacteria or viruses which could pose a risk. The donated breast milk is then called pasteurised donor human milk or “PDHM”, just to make things easier.
Currently breast milk banks supply most of their stock to premature or sick babies. These are the ones who benefit most from the immune properties of human milk. There is not enough stock of breast milk to supply healthy, term babies who are not being breast fed. Perhaps in the future, this will change.
So for now, the babies with the most need are looked after first. Premature babies need less volume of milk each day, whereas a healthy, term baby needs a lot more.
next – The facts
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- Around 12% of all babies are born premature. This means they come before their due date. Of these 12%, 6% are born before 28 weeks gestation. Babies less than 30 weeks of gestation frequently have problems breathing on their own, regulating their temperature, feeding and digesting and are at greater risk of health issues.
- Babies need to be fed milk. If not breast milk then a specially designed infant formula for the first year.
- Prematurity brings many risks to babies and although our care and treatment has advanced significantly, they still need special care to minimise health issues and maximise their chances of having a normal life.
- Mothers who give birth prematurely often have problems lactating. Some don’t produce any breast milk despite their best efforts.
- Sometimes, the physical and emotional stress of having a premature birth means that mothers are just not interested in breastfeeding. Their focus is on their baby and their own recovery.
next – What makes breast milk so special?
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All babies have an immature immune system. But babies born prematurely have an even less developed ability to fight infection. Breast milk is actually considered by many paediatricians to be a form of medicine as much as nutrition.
Breast milk also contains anti inflammatory properties and premature babies are able to feed earlier with breast milk than with formula.
Breast Milk Also:
- Contains immunologic properties which help to fight infection.
- Helps the baby’s gastrointestinal tract to develop.
- Protects the baby’s immature tissues and body system.
- Promotes healing and recovery.
- Contains the best nutrition which is perfectly balanced for a baby to digest.
- Is easy to digest and better tolerated than formula.
next – Who donates breast milk?
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- Mothers who donate come from all sorts of backgrounds.
- Although it may be stating the obvious, women need to have had a baby before they can lactate. There are some medical conditions where women produce milk but these are almost always complex.
- Generally they’re mothers who produce a lot of breast milk and don’t have problems lactating. What they donate is excess to their own babies needs. Most mothers who donate use a breast pump and express using a dual function.
- Mothers who have had personal experience of having a premature and/or sick baby. They know what it’s like to be in a similar situation.
- Mothers who’ve been expressing for their own baby who is now being discharged. These mothers may choose to donate their stored milk to the premature nursery.
- Women who are just altruistic and generous. They see a need which they can fulfil and are happy to do it.
- Mothers who are no longer breastfeeding their own baby but still want to lactate.
- Mothers whose own baby was not breastfed but who still want to lactate.
next – How are donors screened?
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Potential breast milk donors are screened carefully. All milk is on a donor and voluntary basis. Healthy women, non smokers and those with a healthy lifestyle may be considered. Blood tests, health screening consent needs to be given.
next – Why would I want my baby to have milk from a milk bank?
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- If your baby is premature and you aren’t producing as much breast milk as they need.
- Often, premature babies can’t suck as well as if they were full term. Donated breast milk fed via a feeding tube is common management.
- Babies born before 34 weeks gestation cannot coordinate their suck/swallow/breathing, so often need feeding support.
- If you are unwell.
- If you are separated from your baby and can’t be available to express and or breast feed them.
- If your baby is not digesting formula milk.
- If your baby’s paediatrician and/or midwife suggests it would be beneficial.
- Premature babies fed on breast milk tend to go home earlier than those who are formula fed. Their weight gain, growth and development are different to formula fed babies.
- Breastmilk reduces the risk of NEC – necrotizing enterocolitis. This is a condition where sections of the bowel tissue die. NEC is far more common in premature babies who are formula fed.
next – Who regulates Australian milk banks?
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Currently there isn’t any specific legislation covering milk banks; however, most hospital based breast milk banks subscribe to best practice frameworks and standard procedures for “body fluids”.
The Australia New Zealand Food Standards Code contains standards which cover breast milk. The Therapeutic Goods Authority (TGA) may provide a better means of regulation. See here for more discussion about this.
The Human Milk Banking Association of North America HMBANA is another professional organisation which is considered to provide “best practice” guidelines for donor human milk banking.
next – How do I find my local breast milk bank?
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- Speak with your maternity care provider, your midwife and/or your obstetrician.
- Check with the hospital where you are booked in to have your baby.
- Check with maternity hospitals in your local area.
- Check mothersmilkbank.com.au
next – Important to know
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Some mothers choose to source and feed their baby breast milk from a private donor. Contact is made via the internet or informally through milk sharing arrangements. Obviously, personal choice factors strongly in this but there are health risks associated with this.
At the current time in Australia, where milk banks are controlled and managed, donors aren’t paid for breast milk. It’s a purely free transaction.
References
- World Health Organization
- governmentnews.com.au
- Food Standards Australia New Zealand
- Australian Breastfeeding Association
- RBWH Milk Bank, for life
This article was written by Jane Barry, Child Health Nurse and Midwife and director of www.mybabybaby.com.au