Transcript Human Milk Bank - Oregon Public Health Association

Increasing the Use of Human
Donor Milk:
A Public Health Imperative
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Dixie Whetsell, MS, IBCLC
Board Member
Why are Donor Milk Banks
Needed?
• Human milk provides
optimal nutrition,
promotes growth &
development, & reduces
the risk of illness and
disease.
• Some mothers are unable
to provide all the
breastmilk their infants
need.
• In the absence of
mother’s own milk, donor
milk is the best substitute
Why use donor milk?
• Human milk also contains growth
factors that can:
– protect immature tissue
– promote maturation, particularly in the
gastrointestinal tract
– promote healing of tissue damaged by
infection.
Human milk-fed premature infants receive significant
benefits with respect to host protection and improved
developmental outcomes compared with formula-fed
premature infants.
American Academy of Pediatrics 2005
Breastfeeding and the Use of Human Milk
American Academy of Pediatrics,
Breastfeeding and the Use of Human Milk 2005
Courtesy Kingproductions.com
Michelle Obama’s “Let’s Move”
Obesity Prevention Campaign
Oregon Health Insurers
Partnering for Prevention
(OHIPP)
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Who needs donor milk?
• Donor milk must be
prescribed by a health
care provider.
• Common reasons for
prescribing donor milk
include:
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–
–
–
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Prematurity
Allergies
Feeding/formula intolerance
Immunologic deficiencies
Post-operative nutrition
Infectious diseases
Inborn errors of metabolism
US Surgeon General’s 2011
Call to Action to Support Breastfeeding
• Call to Action – #12
– Identify and address
obstacles to greater
availability of safe banked
donor milk for fragile
infants
Necrotizing Enterocolitis (NEC)
• Frequent and lethal disease affecting the
GI tract of premature infants
• Average mortality is 30-40%
• Incidence among formula-fed infants in
NICU 12-15%
• Incidence among breastmilk fed infants in
NICU 1.5%
Call to Action
Report
• About 12% of preterm infants weighing <1,500gms
will suffer from NEC.
• Hospitalization for a surgical case of NEC costs
about $300,000 per patient.
• NEC treatment accounts for 19% of all initial
newborn health care costs in the US.
• Human milk, including donor milk can reduce the
burden NEC places on families and health care
institutions.
What is a donor milk bank?
• A service established
for the purpose of
screening, collecting,
processing, and
distributing human
milk to meet the
specific medical
needs of individuals
for whom it is
prescribed.
History of Milk Banking
• Roots of donor milk banking came from wet nursing.
• 1909 - first European milk bank was established in
Vienna
• 1919 - first US milk bank was established in Boston
• 1980’s, the increasing awareness of AIDS resulted in the
closure of many milk banks in the US.
• 1985 - Human Milk Bank Association of North America
was formed to set standards for North American milk
banks.
• 1990’s -The number of milk banks grew with evidence of
safety, and research on the benefits of human milk.
• 2000’s - Use of donor milk is expanding, and the number
of milk banks in North America is growing.
• HMBANA is a professional membership association
that sets the standards and guidelines for donor milk
banking in North American milk.
• Member milk banks are nonprofit. They screen donors,
process and distribute donated milk.
www.hmbana.org
Who do milk banks
serve?
• Currently there are 11 HMBANA
member milk banks providing human
donor milk to the US and Canada.
• In 2000 the banks dispensed a
combined total of 409,077 ounces of
milk; that rose to 745,329 ounces of
milk 2005—a 45% increase.
• In 2005, the HMBANA milk banks
sent milk to hospitals in over 80 cities
located in 29 states and 3 Canadian
provinces.
Why Develop A
Milk Bank in Portland?
2007 US Breastfeeding Initiation
Goal 75% - Dark Blue
Donor Milk Banks in North America
Operating Milk Banks
• Austin, TX
• Ft Worth, TX
• Denver, CO
• San Jose, CA
• Raleigh, NC
• Iowa City, IA
• Indianapolis, IN
• Kalamazoo, MI
• Columbus, OH
• Newtonville, MA
• Vancouver, BC, Canada
Developing Milk Banks
-Portland OR
-Orlando, FL
-Jackson, MS
-Kansas City, MO
-Toronto ON Canada
Donor Screening/Selection
• Potential milk donors must meet
requirements like those for blood donors.
They must be:
– In good general health
– Willing to undergo blood tests to confirm
health status
– Not on medications or herbal remedies
Donor Milk is Received and Logged In
• Frozen donor milk is
brought in
– by donors
– by staff or volunteers who
pick it up from depots, or
– delivered by express mail
services
• When donor milk is
received it is
– Logged in
– Given a batch #
– Transferred to a
holding freezer to wait
for processing
Donor Milk is
Processed
• Tech follows
HMBANA
guidelines to
process milk
• Milk is thawed
• Milk is emptied
into flasks and
mixed repeatedly
• Milk is poured into
smaller containers
Donor Milk is Pasteurized and Cooled
• The milk will be held
in a shaking water
bath at 62.5 degrees
C for 30 minutes.
• Then milk is plunged
into an ice slurry to
quickly cool the milk.
Bacterial Testing and Milk Analysis
• Testing is done
before and after
pasteurization
Donor milk is analyzed for
nutritional composition
-Protein
-Carbohydrates
-Fats
-Calories
Donor Milk is Frozen and Stored
Donor Milk is
Distributed to
Recipients
• Orders are received
• Critically ill infants are
given priority
• Frozen milk is boxed to fill
orders
• Boxes are labeled and
shipped overnight
In the NICU, drops of Janie’s milk, Alicia’s milk,
and Sarah’s milk were fed to Nora and Alison
who grew up and breastfed happily ever after
What is the charge
for donor milk?
• There is a cost for each step of screening, processing,
and shipping milk. Donors are volunteers and do not get
paid.
• Non-profit milk banks charge $3.50 - $4.50 per oz for
processing donor milk.
• Health insurance will sometimes cover the processing
fees.
• Some health care institutions do not charge patients for
the cost of donor milk processing and shipping.
• The processing fees do not cover all operating costs.
• All HMBANA donor milk banks depend upon donations
from individuals, corporations, foundations and
community groups to cover the true costs of processing
and shipping donor milk.
Northwest Mothers Milk Bank Board
-Non-profit established in 2008.
-Recognized by HMBANA as a Developing
milk bank
-Not processing milk yet.
-Board of Directors
-Medical Advisory Council
Our first large fundraiser
“Harvest”
September 2010
Raised $30,000
Drop-Off Sites
• A donor drop-off site works with a
specific milk bank. Donors that
have already been screened and
accepted can drop milk off at that
site to be shipped to that milk
bank.
Providence St. Vincent
Medical Center
March 2011
Providence Health
Donates office space for 3 years
In SW Portland for
Northwest Mothers Milk Bank
Frequently Asked Questions about
Northwest Mothers Milk Bank?
• How long will it take? 1836 mths
• How much money do we
need? $400,000 to get
started
• How many staff members
are needed? 3-5
• How many volunteers are
needed? Lots!
What can I do to help create
Northwest Mothers Milk Bank?
• Make a financial donation$$$$ on our web
site www.nwmmb.org
• Attend a fundraising event and donate
www.nwmmb.org
• Volunteer – become a Board Member
email: [email protected]
• Become a milk donor for another milk bank
until one exists here
• Use www.goodsearch.com to do internet
searches and donate to Northwest Mothers
Milk Bank every time you do an internet
search.
• Invite others to come with you to see our
new office space and encourage them to
get involved too. [email protected]
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