There are quite a lot of preterm (less than 34 weeks) and very low birth weight babies born in India (less than 1500 grams). These babies have immature intestines and they find less capable of digesting any other milk other than human milk, particularly in the initial few weeks of their life. Unfortunately, during the first few days of life, mother's milk production is not sufficient and these babies end up on a drip. Dr. S. Ramakrishnan, Chief Neonatologist at Womens Center says, “they are at risk of infection if mother's milk supply does not catch up over the next few days and if they continue to require nutrition through the drip for some time. They are also at significant risk of infection if they are fed formula milk. There is plenty of scientific evidence to support the use of human milk as opposed to any other form of milk for these babies.”
Donor milk banks exist in Western Countries, unfortunately there are no formally organized human milk banks in South India. The Womens Center Donor Milk Bank, will benefit those vulnerable babies where mother's milk production has either not started on time or there is an interrupted supply of milk half way through the baby's stay in the Neonatal unit. Feeding these babies with human milk (either mother's own or donor bank milk) is a very natural way of reducing the risk of serious, life- threatening infections, enabling these infants to be discharged at an earlier than anticipated date and also a reduced hospital bill for parents.
Donor Milk Bank
Donor milk bank is a service, which includes collecting, screening, processing, storing and prescribing donated human milk by lactating mothers to babies who are not biologically related to the donor.
The following type of patients benefit from a donor milk bank. Premature babies who weigh less than 1500 g (very low birthweight babies) and less than 1000 g (extremely low birthweight babies) and sick babies where the biologically related mother is unable to produce sufficient milk at any stage during the course of the neonatal stay.
Advantages of human milk versus formula milk
Breast milk is considered to be the best for the baby. There is strong evidence that human milk protects the babies from gut associated problems like necrotising enterocolitis (serious and life-threatening disease process involving the intestines). There is also sufficient evidence to prove that human milk fed babies have better IQ than formula milk fed babies. Human milk also protects the babies from infections, allergy and metabolic programming. Starting human milk early in small babies helps to establish full feeds faster, reduces risk of infection, reduces length of stay and the cost of neonatal intensive care stay.
Risks of donor milk
All donor milk is subjected to triple screen(Donor screen, milk screen and heat treatment of milk) as per International guidelines. The above process significantly reduces the small risk of transmission of infection. The use of untreated, unscreened, improperly stored donor human milk caries more risks.
Risks of donor milk
The following are some factors that can place a baby at high risk and increase the chances of being admitted to the NICU. However, each baby must be evaluated individually to determine the need for admission. High-risk factors include the following:
Use of human donor milk is not expensive. In fact, it is cost-effective as compared to formula milk, as it reduces infections in baby, helps to establish feeds faster and also reduces the cost of NICU stay.
Confidentiality is strictly maintained. Neither the donor nor the recipient's are made aware of each other. We have system of tracking donor to the recipient that is based on numbers rather than names, which ensures confidentiality.
Healthy lactating mother of Term or Preterm babies who are not on any medications and no significant illnesses in the past or present can donate. We ascertain the suitability of potential donors to donate milk.
Effect on donor’s child
It is only the excess milk (milk obtained after fully feeding the donor’s own child) that is donated, the donor’s child will not suffer due to this.
Safety assurance / Risk Minimization
- All the milk samples are handled under strict asceptic precautions after wearing sterile gloves.
- All potential donors are tested for crucial transmittable infections diseases and selected only if they are negative for those diseases
- All the milk samples (after donation) are tested for growth of germs and the samples are discarded if any significant germ growth is seen.
- Following the above step, all the donated milk is pasteurized at 62.5oC for 30 minutes to make milk extra safe.
- Another testing is undertaken on the pasteurized milk samples to ensure it is germ free.
- Only if the sample passes through all the above steps, it is given to the recipient baby after obtaining informed consent from both donor and recipient.
Availability in India
There are no organized milk bank facilities that we are aware off in India especially in South India.
USA, UK and most Western Countries have milk banks, which are running efficiently over the past 2 decades. We are following the Guidelines issued by National Institute of Clinical Excellence (NICE, UK) in 2010 and Human Milk banking Association of North America on “How to set up and run a donor milk bank? ”.