Fa La La La La!! ‘Tis the season for giving, so I thought, hey this would be an appropriate topic to cover!

I very recently ran into a new mom (Hi, Christa!) at Buy Buy Baby who isn’t able to feed her newborn breastmilk due to a protein intolerance. She expressed her disappointment that her frozen milk is going unused. So, I suggested milk banking. After voicing her interest in the topic, I mentioned Little Sproutings (of course) and the post I’d written earlier that mentioned milk banking (“Boobienomics: Nature’s Supply & Demand). One of my loyal Sprout readers also suggested the topic, so how could I not dedicate a post to something I feel so proud to have been a part of?

A quick bit about my experience: I donated almost 600 ounces of milk to The King’s Daughters Milk Bank, in Norfolk VA after we realized we couldn’t feed any of my pumped milk to Jia. If you recall, we went through a process of eliminating dairy and soy from my diet (see: My Little Soy-Free Dairy-Free Sprout) so the milk I’d pumped couldn’t be given to her. I had a freezer almost entirely filled with frozen bags of milk (and no room left for food)! The milk bank I contacted made the process quick and painless!

So for those of you who have been lucky to have a supply like I was/am, your little one is past the point of breastfeeding and you’ve got a stash, or if your baby isn’t able to drink the milk you have saved up, here’s some info about a wonderful thing you can do with your liquid gold!

What is Milk Banking?

Milk banking is the process of collecting, screening, then pasteurizing excess donated breast milk to be used for babies in need. Excess milk refers to the milk that is produced and stored after your baby has already received what s/he needs. 

“The potent benefits of human milk are such that all preterm infants should receive human milk (Table 3). Mother’s own milk, fresh or frozen, should be the primary diet. If mother’s own milk is unavailable despite significant lactation support, pasteurized donor milk should be used.” (19, 66) ~ AAP Policy on Breastfeeding and the Use of Human Milk

The AAP maintains that if a baby is unable to receive his/her mother’s milk, pasteurized donor human milk (DHM) should be used. 

The Milk Bank you would donate through is sometimes tied to a nearby children’s hospital for immediate transfer and use of milk for NICU babies. This has been accepted as the “gold standard” of care for babies in the NICU, as published by the AAP.

The King’s Daughters Milk Bank (the one I donated to) is associated with the Children’s Hospital of The King’s Daughters, and milk received by the CHKD Milk Bank is also sent to nearby VA (Veteran’s Affairs) Hospitals and other east-coast NICU’s. 

Benefits Specific to Human Milk for Babies

Breastmilk has amazingly valuable therapeutic and nutritional properties that cannot be replicated in any other form. Breastmilk has “documented short- and long-term medical and neurodevelopmental advantages” that are the essential in establishing good health for infancy on through adulthood (AAP). Establishing nourishment with breastmilk as the norm for infant nutrition is a “public health issue, not only a lifestyle choice (AAP).”  This is why the AAP, Centers for Disease Control, and Joint Commission (the head honchos in hospital practices) have established that breastmilk is THE GOLD STANDARD for infant nutrition and that NOT providing breastmilk to infants is actually a HEALTH RISK that should be addressed.  

Benefits of breastmilk for babies (Obtained from CHKD Milk Bank and AAP Policy Statement on Breastfeeding and Use of Human Milk)

• High quality protein
• Enhanced fat absorption
• Improved absorption of lactose and minerals
• Enhanced gastric emptying
• Unique series-specific ingredients promote brain growth & cognition
• Unique growth factors enhance intellectual & visual development

Feeding breastmilk to infants is evidence-based to prevent or cure (source: AAP; vs. formula)

• Type 1 Diabetes (30% lower risk with BF greater than 3 months)
• Type 2 Diabetes (40% lower risk with any amount of BF)
• Leukemia; ALL type (20% lower risk) AML type (15% lower risk) with > 6 mos BF
• Sudden Infant Death Syndrome (SIDS) 35% lower risk with BF > 1 month (seriously, 1 month of breastfeeding can lower your risk of SIDS by 35%, why WOULDN’T you?)
• Atopic Dermatitis (42% lower risk > 3 months BF)
• Otitis Media (the common middle ear infection in babies), 23% lower risk with any amount of BF and 50% lower risk with > 3 months exclusive breastfeeding, and a whopping 77% reduction in recurrent otitis media infections with exclusive breastfeeding >6 months!
• Asthma (40% lowered risk with a family history of asthma!) with exclusive BF 3 months or longer
• Gastroenteritis (inflammation of the GI tract) 64% lowered risk with ANY amount of BF
• Celiac Disease (52% lowered risk) with > 2 months BF
• Obesity (24% lowered risk) with any amount of BF
• RSV (Respiratory Syncytial Virus, the major cause of hospitalizations due to lower respiratory infections in infancy) has 74% lowered risk with > 4 months BF

Seriously the list goes on. Read more in the AAP Policy Statement, link here. Not convinced yet? You can also read about the maternal benefits of breastfeeding (like reduced risk of type 2 diabetes, rheumatoid arthritis, breast and ovarian cancers, cardiovascular disease, hypertension) in the Policy document as well. With these facts, it can’t be ignored that DHM is a must. 

For Babies in the NICU, Breastmilk Has Shown to Help (source: KD Milk Bank)

• 77% Decrease in necrotizing enterocolitis (when the premature gut is failing to function; takes almost $300,000 to treat one case without the use of DHM, vs. $20/day for DHM to optimally and effectively treat during a NICU stay)
• Decrease infections and length of hospital stay
• Improve neurocognitive (brain/cognitive) functions
• Decrease severe retinopathy of prematurity (ROP); a disease of the eye that all preterm babies are at-risk of developing
• Decrease chronic lung disease (NICU babies are often on machines to help them breathe and breast milk can help decrease the need for extra oxygen when they leave the hospital)

Denying infants of the benefits of breastmilk is actually harmful, as well as a financial burden to society. This is a bold statement, but it is not one that I am writing to make a point. It’s a fact, backed by research study after research study, statistic after statistic. I even remember back in public health seminars, WIC educational sessions, and board meetings how “choosing not to breastfeed is harmful to your baby,” was a concept that had yet to become commonplace, but was very much justified.

Consider the cost-savings of preventing many life-threatening diseases by establishing breastfeeding as the normative standard for all babies in all hospitals nationwide. I don’t understand why you wouldn’t provide breastmilk to your baby if a way was possible. To me it’s reckless and it’s downright ridiculous to deny your baby their best chance at optimal health. I mean, come on.

Further, as the benefits of human milk are so apparent, this highlights the need for DHM for NICU babies who aren’t able to receive breastmilk from their mothers.

A Little on HMBANA (Human Milk Banking Association of North America)

HMBANA is an association of supporters for non-profit milk banking. The organization was founded in ’85 to establish best practices and guidelines for safe and effective pasteurization of human donor milk to nourish and save the precious and fragile lives of vulnerable infants. They facilitate the distribution of donor milk to other member milk banks in need, educate the public about the benefits and need for DHM as the gold standard for ALL babies, especially those in intensive care, encourage continued research on human milk and its therapeutic and nutritional properties, the list goes on.

“All HMBANA milk banks are non-for-profit. Some HMBANA milk banks are community based and others are hospital based. The King’s Daughters Milk Bank is one of the only not-for-profit milk banks that is part of a freestanding, not-for-profit childrens hospital.” ~ Ashlynn Baker, BSN RN IBCLC (Manager of CHKD Milk Bank)

What Happens to the Milk that is Donated?

“Milk donated to The King’s Daughters Milk Bank (ed note: like other non-profit HMBANA Milk Banks) is provided to hospitalized, medically fragile infants throught CHKD, VA and hospitals on the east coast. Insurance does not cover the cost of donor human milk (DHM) and we do not charge the families for DHM. Hospitals that choose DHM as a gold standard for the NICU patients provide it for them at the hospitals cost.” ~Ashlynn Baker BSN RN IBCLC

The Process of Preparing Donor Milk:

Donor human milk undergoes a very thorough and gentle pasteurization  process (HMBANA uses the recommended Holder Method of pasteurization) in order to retain the maximum amount of milk’s precious immunological and nutritional components. The Holder method of pasteurization kills HIV, CMV, skin bacteria, and many other titers of viruses (FDA). 

All batches of milk are pasteurized then checked for bacteria content. Milk containing bacteria is discarded. After all, fragile and sick babies have lowered immune systems so this is crucial.

Do Donors get Compensated?

I personally don’t believe in receiving compensation for donating breast milk, for ethical reasons. Breastmilk is nourishment that all babies should receive if they are able. When mom isn’t able to provide milk to her sick baby (if baby is in the NICU and mom isn’t able to produce enough, if mom’s supply hadn’t fully come in despite seeing a lactation consultant, etc. etc.) the last thing I think they should do is pay an exorbitant amount for something that is made for free.

I imagine that if Jia were a sick baby in the NICU and I wasn’t able to produce enough milk, I would be absolutely heartbroken. And, ontop of all of that stress, if we had to pay a pretty penny for Jia to get ample nourishment through breastmilk, it would hurt even more.

So, I don’t think that it’s good karma to get paid for something that should be fairly cost-free. It’s natural, it’s needed. It’s like getting paid to donate blood. People need blood. You shouldn’t get paid for donating something you have plenty of. Uncompensated donation of breast milk is a beautiful and wonderful gift.

When you donate your milk, the milk bank typically pays all costs to screen you, your milk, and arranges and pays for all shipment of milk.

Non-Profit milk banking ensures that your milk is going to fragile and sick babies who absolutely need it the most, without discrepancy on whether or not the family can afford it. 

That being said, there are milk banks that do compensate donors for their milk. But, keep in mind that this means that they also put a premium price tag on that milk sold to parents and hospitals. This means that families of sick babies that can’t afford milk, go without. These donors aren’t “extra super high quality” milk makers, they’re just the donors who wanted to make some money on the side.

How Do You Become a Donor? (Per Junior League Powerpoint Presentation from KD Milk)

Well, first you want to locate your closest milk bank and give them a call. Remember, even if there is not one really close to you, they will help you arrange for donation!

During your initial call, they will do a quick painless (about 10 minute) phone screening to check if you’re a suitable donor. The remaining screening process includes blood testing (for HIV, HTLV, Hep B & C, Syphillis), and a Medical Release from your pediatrician and primary physician. This verifies you and baby are both healthy enough to donate to sick babies. 

From start to finish, it took me about 3 weeks from the first time I contacted KD Milk Bank to when they received and measured my donation.

I have our doctors to thank, since they were especially quick on their end! (Thank you to the amazing physicians at Northern Virginia Physicians To Women and Virginia Pediatric and Adolescent Center!) My contact at the Milk Bank also really expedited the process since she knew I was running out of freezer space and needed the milk donated as soon as possible. 

What Disqualifies You to Donate?

• Positive blood screening results
• Donor or partner high risk behaviors for HIV
• Use of illegal drugs
• Smokes or uses tobacco products
• > 2 alcoholic drinks per day
• Organ or tissue transplant recipient
• Blood transfusion in prior 4 months
• Tattoo or body piercing in the last 12 months
• Travelled or lived in the UK for >3 months or to Europe for > 5 months from 1980-1996

What if HMBANA Does Not Have a Milk Bank Close to Me?

Per the HMBANA “Donate Milk” page, moms throughout the United States, Mexico, and Canada can donate. Just contact the milk bank closest to you and they will help arrange for your donation.

How Do You Ship Donated Milk? 

In exchange for donating milk, a non-profit milk bank provides you with shipping supplies (cooler, paperwork, shipping label, and usually a stock of milk storage bags) and arranges for all delivery to you and for shipment of milk back to the Milk Bank.

When I donated to the King’s Daughters Milk Bank, they shipped a giant Coleman cooler to my condo, complete with packing materials (sheets of bubble wrap), a short questionnaire that I had to fill out and sign (attesting to any changes to my donor interview), and a FedEx Overnight label (along with the FedEx phone number to arrange for my already-paid pick-up at my convenience).

I had to be sure I had more than 200 ounces to donate at one time, to ensure that the milk would stay frozen during an overnight shipment. This volume of milk (in divided bags, obviously) would keep itself frozen. Any less and the milk could start to defrost in the cooler. As you can see from the title photo, I filled that sucker up to the top with my 564 ounces. 

So please, if you have milk saved in your freezer, don’t throw it out. I urge you to contact your nearest milk bank so that struggling babies in need can receive their best nourishment. It is not only what’s best for them, it’s what they need to give them the best fighting chance at getting out of the hospital as soon as possible. Hospitals across the US are always in need for DHM, so give the milk bank the opportunity to find a baby whose life you can save.

“If you are a diabetic and admitted to the hospital, you would never be told that you couldn’t get a diabetic (meal) tray because it cost too much. It would be a standard doctor’s order. Same goes with DHM. It’s established by the AAP that it is the gold standard for babies to receive DHM, so all hospitals need to be doing this.” ~ Ashlynn on how the Children’s Hospital of The King’s Daughters NICU provides DHM to all infants who don’t receive it from their mothers, but that many hospitals have yet to adopt the AAP’s Policy.

Please feel free to comment with a question if I forgot to address any particular part of this process! 

Happy Donating and Happy Holidays!

Special thanks to Ashlynn Baker BSN RN IBCLC and The King’s Daughters Milk Bank for your insight, assistance, and wonderful resources and photos!

Sources:

Human Milk Banking Association of North America: https://www.hmbana.org

If you are a Virginia Resident and/or want to contact the King’s Daughters Milk Bank: kdmilkbank@chkd.org or call (757) 668-MILK (6455) or visit their website below.

Children’s Hospital of the King’s Daughters Milk Bank http://www.chkd.org/Our-Doctors/Our-Pediatricians/Patient-Resources/King-s-Daughters-Milk-Bank/

Baker, A.  (2014) The King’s Daughters Milk Bank at CHKD [Powerpoint Slides]. Received by e-mail directly from author. 

American Academy of Pediatrics Policy Statement on Use of Human Milk <http://pediatrics.aappublications.org/content/early/2012/02/22/peds.2011-3552.full.pdf> 

Holder Method of Pasteurization from the National Library of Medicine <http://www.ncbi.nlm.nih.gov/pubmed/21622093>

Rodriguez, W. Potential Risk Which Could Be Associated with Consumption of some Human Milk [Powerpoint Slides]. Retrieved from http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM235629.pdf