In India, 35 lakh babies are born premature every year. Many of them die within a month because of complications of prematurity. Simple, cost-effective interventions such as skin-to-skin contact and breastfeeding can save most of these babies.
Breast milk is not only the best food but also a necessary medicine for preterm babies. It saves them from serious infections and malnutrition. Doctors know this, and they use this power of breast milk in their treatment. If a baby is sick or premature and cannot breastfeed, doctors feed expressed mother’s milk by a tube or paladai. But sometimes, mother’s milk is not available or insufficient. In such a case, the best option is donor human milk processed by a human milk bank.
When it is not possible for a mother to breastfeed, the first alternative should be pasteurized human milk from other mothers.
– World Health Organization and UNICEF
Human milk bank is a non-profit institution which collects donated mother’s milk, processes, stores and distributes this milk to treat sick newborns in hospitals.
Our human milk bank Jeevan Dhara has been working since March 2015. And fortunately, I have been a part of team Jeevan Dhara since its inception. In this article, I am giving an insight into our work at milk bank – how it works!
Healthy mothers who make extra milk, which remains after breastfeeding, can happily donate it for sick babies.
Mothers whose babies are sick and being treated in a hospital need to express milk for their babies every 2-3 hourly. This milk helps their babies recover from illness. If some milk remains after feeding her sick baby, mother can donate it to the milk bank where it will help recover other sick newborns.
Mothers who have lost their babies can donate their milk.
We test donor mothers for HIV, Hepatitis B, Hepatitis C and Syphilis and only accept donation if the mother has none of these illnesses.
After donation, we mix the milk of 3-5 mothers. This is pooling, and it ensures uniform nutrition in donor human milk.
We pool our milk under a laminar air flow to make sure it is free from bacteria. After pooling, we pour this milk into sterile bottles for pasteurization.
Pasteurization kills all the bacteria in human milk while protecting the valuable immunological properties.
Human milk is pasteurized using Holder’s method. In this method, we heat the milk to a temperature of 62.5 °C for 30 minutes and then rapidly cool it to 4 °C.
Maintaining precise temperature is vital for a successful pasteurization. Every human milk bank monitors real time temperatures during the entire process.
Human milk is a biological product and there is always a risk of contamination, whether it is mother’s own expressed milk or pasteurized donor milk. However, doctors follow strict rules to store and prepare human milk for your baby to ensure its safety.
Before reaching your baby, every batch of donor human milk undergoes microbiological cultures. Our policy is to discard the entire batch if a single bacterium is grown in the culture of pasteurized milk.
We routinely send cultures of pooled milk before it is pasteurized. We follow international guidelines to discard the milk if it grows over 100,000 Colony-forming Units/ml of any bacteria or 10,000 Colony-forming Units/ml of Enterobacteriaceae or Staphylococcus aureus.
Our Human milk bank strictly follows international guidelines for storage of donor milk. We store human milk in deep freezers at -20 °C. At this temperature, this milk is safe for 3 months.
You can safely store expressed milk in the ice compartment of your refrigerator for 24 hours. Thaw this milk to 37 °C before feeding the baby. Thawing means melting of frozen milk. After thawing, use the milk within 2 hours.
We transport human milk in heat insulating packs maintaining a temperature of less than 6 °C.
We transport only the volume of milk needed for next 24 hours. Once this milk reaches another hospital, nurses store it either in a deep freezer or refrigerator.
We give donor human milk to babies receiving treatment in our hospital for:
– Prematurity and very low birth weight,
– Necrotizing enterocolitis, gastroschisis or omphalocele,
– Infants not having access to their own mother’s milk or when the mother has a contraindication to breastfeed.
Premature or sick babies may not suck or swallow feeds properly. We feed such babies using a tube or paladai.
Before feeding, we melt the frozen milk by a process called thawing. For this, we take a warm water bath at 37 °C and place the bottle of frozen milk in it while taking care that water levels shouldn’t reach the lid of the milk bottle.
We raise the temperature of milk to 37 °C before feeding. This improves digestion of milk, decreases reflux and apnea episodes.
Necrotizing enterocolitis is a killer disease of preterm babies and both breast milk and donor human milk protects against it. Preemies fed formula milk are 10 times more likely to suffer from necrotizing enterocolitis when compared with those fed on breast milk or donor human milk.
Pasteurization destroys many valuable properties of breast milk. Donor milk pasteurized with Holder’s method keep only 70% secretary immunoglobulin A, 20% lactoferrin and 40% lysozyme as compared to freshly expressed breast milk. Therefore, donor human milk can never be a substitute of mother’s breast milk. It is the second best option when mother’s milk is not available.
At Jeevan Dhara, we understand the importance of expressed breast milk for preterm babies. When a baby cannot breastfeed because of prematurity, we help the mother express her milk and feed it to her baby with a tube or paladai.
Over 7000 mothers have happily donated 38 lakh milliliters of breast milk to treat premature babies admitted in hospital. This donated milk helped save lives of 4700 premature hospitalized babies.
For too long are we losing our babies to diseases and malnutrition. We, the doctors, need help from mothers to save these babies. It’s high time mothers come forward and realize the value of their love and breast milk. And to stop losing this valuable resource to formula milk. To break the bounds of peer pressure and to learn what is new. To give their best to their babies and until a time comes when every baby receives own mother’s milk, to help save other babies by donating their liquid gold.
- Preterm Infants May Better Tolerate Feeds at Temperatures Closer to Freshly Expressed Breast Milk.
- Effect of enteral feeding temperature on feeding tolerance in preterm infants.
- Breast milk and neonatal necrotising enterocolitis.
- Donor Human Milk for the High-Risk Infant.
- Benefits of donor human milk for preterm infants.
- Retention of the Immunological Proteins of Pasteurized Human Milk in Relation to Pasteurizer Design and Practice.
- Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemic