Got milk?

Many of you may be shockingly unaware that today is World Breast Milk Donation Day! This raises awareness for the practice of donating breast milk and milk banks in general.

I must admit that the existence of this had completely passed me by – my mammary glands being purely for show thus far rather than providing a useful milk producing purpose. It therefore took me a bit by surprise when someone I knew from school presented a picture on Facebook of her fridge full of bottles ready for donation.
The basic idea is that breastfeeding mothers, who have got the milk production thing down, do an extra run at it on a regular basis to produce bottled breast milk. They then freeze it and then on a regular basis a vehicle will arrive from the local milk bank to take it away. From there it is tested and pasteurised and then provided to babes in need.

The expected recipients of donated breast milk tend to be:

  • Premature babies
  • Sick babies
  • Multiple babies
  • Babies recovering from gut surgery
  • Babies allergic to cow’s milk
  • Babies with gut disorders who find it difficult to absorb normal food.
  • An obvious question might be why the mother can’t provide the milk, and that may be because if the baby is premature that her milk hasn’t come in yet, or if the baby is sick that without successful and regular stimulus from the baby that she is struggling to provide milk or not producing enough (and the stress of having a sick baby does not help milk production). Equally, the mother herself might be too sick to provide milk or under treatment that prevents her milk being used.

    As the
    UK Association for Milk Banking explains (supported by a study by UNICEF):

    “Donor breastmilk has benefits over formula because it contains a variety of protective factors which help protect a sick premature baby from infection. These small babies are very prone to catch to infections and they need all the help they can get. These protective factors, such as immunoglobulins, are not present in fomula prepared from cow’s milk.

    Not only does donor breastmilk protect from infection but it also has a protective role against the syndrome called necrotising enterocolitis.

    [Breastmilk is] easier to digest. A preterm baby’s gut is very delicate and it absorbs breastmilk more easily than formula milk because the balance of proteins is different. A sick baby needs to be fed very gently and very small amounts of breastmilk gradually acclimatise the gut to food. This is especially true for babies who have had gut surgery when their gut needs to be introduced to food very gradually.”

    Milk banking has been going on for over a hundred years from starting in Vienna in 1909. In the UK, it has been around for 74 years with the milk bank at Queen Charlotte’s and Chelsea Hospital (my hospital!) in London being the oldest continually operating milk bank in the world.
    The NICE guidelines provide a thorough explanation of who can donate breastmilk, excluding those who:

  • smoke (or ingest nicotine via patches etc)
  • drink more than 1-2 units of alcohol twice a week
  • use recreational drugs
  • have HIV, Hepatitis B or C, syphilis or human T-lymphotropic virus (HTLV) type I or II
  • is at increased risk of CJD (due to a blood transfusion or fertility treatment involving human derived products such as donor eggs).
  • If you want to donate, ideally you would start as early as possible but certainly before six months – partly because earlier milk is more suitable for premature babies but also because starting early makes the investment by the milk bank in you more productive as you are more likely to produce a greater quantity of milk for them over time, which is important given their limited funding.

    In terms of equipment, you need a breast pump (unless you plan to milk yourself – which can be done!) and sterlising equipment. The milk bank provides the bottles and labels as well as a thermometer for the freezer. They will likely send someone round to collect the milk every 2-3 weeks, but that could be more regular if supplies are low.

    It seems like an incredibly worthwhile thing to do, and I would like to. But first I need to see how my own breastfeeding experience goes. In the meantime, it makes the buying of a breast pump and steriliser more important and I’ll have to work out how to make room in the freezer!

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