The (breast) milk of human kindness
Donated milk is an option for moms who have difficulties breastfeeding
Sometimes a mother’s milk doesn’t come in as planned or doesn’t come in at the volume the new baby needs.
“There’s lots of reasons for it,” said Nora Fortin, head of the Women’s & Children’s Service Line/Seacoast Family Care Services at Portsmouth Regional Hospital. “But medically breast milk is the best way to feed the baby, whether the baby is actively being fed from the breast or with bottled breast milk.
Which is why when a baby does need some supplemental breast milk, Portsmouth Regional, along with about nine other hospitals in the state, offer new moms the option of using frozen, donated human breast milk. The hospital buys milk from the Mothers’ Milk Bank Northeast that has been screened, pasteurized and packaged.
As of May, Portsmouth Regional became the fourth hospital in New Hampshire to take the extra step of becoming a human breast milk depot, which is a place where mothers, who have already been screened and cleared by MMBNE, can drop off their excess, frozen breast milk.
The depots, which in New Hampshire also include Cheshire Medical Center in Keene, Memorial Hospital in North Conway, and Nini Bambini in Bedford, sends all the milk they collect to Mothers’ Milk Bank Northeast.
“We opened our milk depot in August,” said Linda “Mindy” Glasschroeder, clinical leader of the Women and Children’s Health Unit at Cheshire Medical Center in Keene. “We’ve had four moms utilize it. …These are basically moms who are cutting back on breastfeeding or some just make an abundance; they are great producers and their freezers are full. We have one mom who has donated more than 2,000 ounces in the last year.”
To become a donor, mothers have to go through the MMBNE. That process begins with a 15-minute phone screening, said Naomi Bar-Yam, executive director of Mothers’ Milk Bank Northeast and president of Human Milk Banking Association of North America.
“That serves two purposes really,” Bar-Yam said. “It gives us a baseline if are there any really big red flags that we won’t be able to take her milk. The other purpose of the screening is for us to get to know each other …because this is a very personal gift and it’s a very personal relationship.”
Part of the screening questions — which are based largely on the model for blood donation — include asking a mom what medications she is taking. There is a list of acceptable medications and ones that will preclude a mother from donating. There is also a question about foreign travel, among other things.
Once a woman clears the first screening, she is sent a packet of consent forms and a five-page medical history form to fill out. The consents, Bar-Yam said, allow the milk bank to contact the woman’s doctor and her child’s pediatrician, so each can attest to the health of the donating mom and her baby.
Then she is sent a blood kit. The mom sends the sample to the milk bank where they test her for HIV, HTLV (human T-lymphotropic virus), Hepatitis B and C and syphilis, as these are diseases that can transfer to a baby via breast milk.
The pasteurization process kills these pathogens, Bar-Yam said, but they screen first to not take any unnecessary chances.
“Once the blood tests come back, which is almost always negative, and we review and everything is fine, then she can donate,” Bar-Yam said.
The whole screening process takes about two to three weeks, although it can be expedited, with the milk bank picking up all of the expenses, Bar-Yam said.
The donating mom can then drop her milk off at a depot, or the milk bank will send her a cooler box in which she can put her frozen milk and send it directly to the milk bank. When the milk comes into the bank, it’s logged into the system and placed in a freezer until it’s time for it to be pasteurized.
When frozen, it is placed in a refrigerator overnight to thaw. The next day, the milk of between three and five moms is mixed together. That milk is poured into bottles and pasteurized using the Holder Method.
“The Holder Method of pasteurization … It’s the best method we have found to get rid of all the bad stuff while holding onto as much of the good stuff as we can,” Bar-Yam said.
The freeze/thaw cycle and the pasteurization cycle do compromise the milk some, Bar-Yam said. Macronutrients, such as fat, carbohydrates and protein, tend to be stable during pasteurization, she said. But other elements such as the protective and brain growth factors, as well as some of the micronutrients, are somewhat compromised.
“We always rather have mothers feeding her own baby getting it from mom straight from the breast,” she said. “If she has to pump it’s definitely better than getting milk that’s been frozen and pasteurized. But under the circumstances that mom doesn’t have that milk, then this is the best that we can do.”
Those circumstances often include premature babies, whose mothers usually don’t have milk yet to feed them or cases where the baby’s digestive system is too sensitive for formula, Fortin said. But it also includes women who may be diabetic, whose babies require a lot of milk to keep their blood sugar up; someone who’s had a C-section, whose milk is slow to come in; or even women who want their babies to have breast milk, but they just don’t want to breast feed, Glasschroeder said.
Bar-Yam said while most of their milk goes to hospitals, they do send milk to outpatients at home with a prescription.
“Unfortunately, insurance rarely covers this,” Bar-Yam said. “That’s sort of on the radar screen, but it is a challenge. We encourage anyone who needs outpatient milk to call their insurance company.”
The milk sold directly to moms is about $4 per ounce. On average, a newborn drinks between one to three ounces every two to three hours, and that increases steadily within the first month.
“By the time the baby is home, that becomes costly,” Bar-Yam said. “We often get families calling us because mom just got home from the hospital and her milk supply isn’t fully in yet, and we send them what we like to call bridge milk. So we send them a few bottles until their milk supply comes in. And then hopefully we never hear from you again, because you don’t need us anymore.”
Melanie Plenda is a mom and longtime contributor to ParentingNH.