Human Milk Banking.
Meena Grace was born in September of 2004 at 24 weeks gestation, and weighing only 740 grams. Initially receiving nutrients via IV, she was slowly and carefully transitioned onto expressed breast milk, fed to her through a tube running from her nose into her tiny stomach. Several weeks later, she was ready to practice her suck-swallow-breathe technique and began the next transition, from tube to full oral feeds. Breast milk was instrumental in helping Meena grow into the healthy, vibrant, 7-excited-to-turn-8 year old little girl she is today. Calgary Mothers’ Milk Bank is excited to be helping provide the gift of pasteurized donor milk to babies in need so that they, too, can grow healthy and strong and have the best possible start to their precious life!
(story and photo from Calgary’s Mother’s Milk Bank)
Milk banks save the lives of premature and sick infants around the world, every day. Without the benefit of banked milk, many of these fragile babies would have difficulty growing, thriving, and surviving. We are what we eat. And we are humans. In 1970, there were 23 milk banks in Canada, providing essential nutrition to hundreds of babies annually. In the 1980s, all but one shut down, with the advent of HIV/AIDS and the need for in depth research into safe pasteurization of human milk.
Safe pasteurization has long since been achieved. But Canada still sported one lone milk bank for over 30 years. In April of 2012, Calgary changed that. Calgary’s Mother’s Milk Bank opened its doors and started accepting donations, pasteurizing, and providing milk for needy babies in Calgary, Edmonton, and beyond. Calgary’s Mother’s Milk Bank DOUBLED Canada’s capacity to provide banked milk for our babies!! What a feat!
The following is an interview I did with Jannette Festival, Executive Director of Calgary’s Mother’s Milk Bank…
When was your milk bank established?
We started interviewing potential donors in February of last year, from my home. We opened our doors on April 6th, 2012, although we have not yet had our “official” opening~that is yet to come in the fall of 2012! We are looking forward to the minister of health being there for the opening. Calgary’s Mother’s Milk Bank is a community based milk bank, modeled after the Austin Milk Bank in Austin, Texas. It is not publicly funded. We are entirely funded by sponsorships from corporations and individuals.
We are very pleased to alter the chance of health outcomes for sick babies.Jannette Festival, Executive Director, Kim Updegrove, President of the HMBANA, and Anne-Marie, Treasurer, at the Calgary Mother’s Milk Bank
What does a day in the life of the milk bank look like?
We are a very busy place. I spend 60 to 80 hours per week facilitating the milk bank.
We spend a number of hours per day on pasteurization. We select the oldest milk first, and often mix the milk depending on the age of the baby whose mother is donating. Preemie milk is mixed with older baby milk, to make it stretch further. Generally, several donors’ milk is mixed together to achieve optimal distribution of nutrients and fats. Pasteurization takes 5-6 hours.
We also spend a portion of our time screening new milk donors; we have a volunteer who does all our screening for us.
I spend a portion of my day checking in with donors; I usually try and touch base with each donor by phone every few weeks. We chat, I see if they have any questions or need any supplies (we provide storage containers for all our donors), and how they are doing.
I also spend a good portion of the day filling orders. We have an astonishing demand for banked milk here in Alberta.
I do a lot of media communication, promoting the Milk Bank, answering questions, providing interviews, and etc.
We are a member of HMBANA, the Human Milk Banking Association of North America, which accredits milk banks and sets the standards for milk banks, so we do work associated with HMBANA, including meetings and ongoing tasks.
We also promote our milk bank by doing presentations educating medical staff and neonatologists on the benefits of human milk and the process of ordering from the Calgary’s Mother’s Milk Bank. Our medical staff is overwhelmingly supportive of our milk bank and is just wonderful. Hospitals in Alberta have been very supportive and are purchasing milk and asking for presentations on milk banking for their staff.
We also provide breastfeeding support for women in our community. We offer free breastfeeding classes, and breastfeeding and lactation support for women who need it. Our goal is to raise the value of breastmilk in the eyes of society, and hopefully raise breastfeeding rates overall because of this.
That’s an incredibly busy day!
How many volunteers or employees work at the milk bank?
We have a number of volunteers, and one paid part time employee. The director, treasurers, and pasteurization team are volunteers. Karen is our paid employee, and she works three days per week.
What type of education or background do they have?
We have a variety of backgrounds, including Lactation consultants, Registered Nurses, Prenatal Educators, a breastfeeding educator, and a teacher.
Who are your donors?
Donors are healthy women in Alberta who have extra milk to share with babies in need. Their babies are under one year of age, and breastfeeding. We have so many wonderful women who donate to our milk bank and of course we couldn’t do it without them. Some women who donate have one baby, some have large families, and some had babies who were in the NICU and recieved donor milk themselves. We currently have around 130 donors.
Who are your recipients?
Recipients are babies in the NICU (Neonatal Intensive Care Unit) whose mothers are not able to provide all the milk they need, or whose milk has not yet come in. Many of these babies are premature. All of them are medically fragile.
Sometimes we have enough milk to provide some donations to women in the community who are not able to provide a full milk supply for their babies. They are undergoing medical treatment and cannot breastfeed, they had a breast reduction, or have low supply. We are not able to provide all the supplement these babies need, because we don’t have enough milk to do that, but we are sometimes able to give them some. And some donor milk is better than none.
We triage the milk so that the neediest babies get it first. Banked milk costs $3.65 per ounce~the Calgary health authority pays for it for Calgary NICU babies, but in the rest of the province this bill is paid by the parents.Donation to Foothills NICU
How are donor women screened?
Women who wish to donate contact us. We do a verbal interview over the phone that takes about twenty minutes. We talk about their lifestyle, life history, what is expected of donors, and we go over disqualification criteria. For example, any woman who lived in the UK during the Mad Cow Disease epidemic cannot donate milk in Canada. This is the same as blood donor disqualification. Human milk is considered by medicine to be a body tissue, similar to blood.
Next we send the potential donor a Donor Package. This includes a questionnaire and forms for her doctor to sign to verify her identity. It also includes lab tests that must be ordered: HIV, Syphilus, Hepatitis B and C, and other diseases are screened for by blood test.
Once these questionnaires and labs have been completed, she is approved as a donor and we can accept donations from her, including milk she has expressed and stored for up to six months prior to being screened. We provide storage containers for donor milk, and shipping is provided by one of our sponsors at a reduced rate. Calgary’s Mother’s Milk Bank pays for the cost of shipping storage containers and expressed, frozen milk as needed. If donors live locally, they can drop their donations off at the milk bank directly, or at our collection depot at Grey Nun’s Hospital.
A minimum of 150 ounces is required from donors, to make the cost and time of the screening process worthwhile.
How is the milk pasteurized?
First time donor milk is pasteurized separately from repeat donors. This is because some women’s milk contains Bacillus, a pathogen that is not killed by the pasteurization process. We cannot use milk containing Bacillus, and usually donate it to University reasearchers for breastmilk research purposes. Donors are aware of this.
All donor milk that is raw (unpasteurized), is kept frozen in storage, dated, and in batches of 100 ounces (3 Liters). To pasteurize it, we select milk from the raw storage freezer. We use the oldest frozen milk first, and try to mix preemie milk with more mature milk, and to mix the milk of several women together to get the most uniform nutritional value possible. This is called ‘pooling.’
We thaw this milk, and homogenize it (a fancy word for mixing and swirling), dividing it into flasks and pouring it back and forth six times.
The milk is then poured into bottles, and the bottles are heat sealed. They go into the pasteurizer, which submerges the bottles in water. The bottles are then heated to 62.5 degrees for 30 minutes and quickly cooled to 4 degrees to prevent pathogen growth. This produces a safe product, free of pathogens, and ready for donation. One bottle from each pooling is sent to the lab for testing to ensure it is free of pathogens.
The pasteurization process causes 30% of the nutrients and enzymes in the milk to be lost or destroyed. So you can see, this pasteurized milk still contains a lot of really important nutrients for medically fragile babies, who would otherwise receive formula.
The bottles are then frozen again, ready for distribution to babies in need.
Do you ever get low on donors?
Yes! We are constantly promoting the milk bank to ensure a regular influx of donated milk. Sometimes we put out a call on our facebook page for more donors, as our milk stash gets low.
Do you ever have an excess?
Not that often, but when we do, we donate it to babies in the community whose mothers are not able to produce enough milk.
What would you love to see happen for your milk bank, as a vision for the future?
Good question! We would love to see the milk bank grow. We want to get posters and billboard advertising, and to expand. The need is great, and I think it is very likely to happen that we will need more space, more staff, that we meet our projections and have more women involved and provide even more milk for babies in our area.
We would love to see increased breastfeeding rates, and an increased value placed on breastmilk by our society. We would love to see more milk banks! Especially community milk banks; we are able to do so much in such a short amount of time by being community based.
all images used with permission from the Calgary’s Mother’s Milk Bank