Tiny Babies Bank on Liquid Gold
By Lisa Poisso
For the tiniest, sickest babies, the choice between infant formula and breast milk can be much more than a matter of “breast is best” — it can be a matter of life or death. Just ask Julie Brammer of Fort Worth, Texas, who gave birth just 29 weeks into her pregnancy after being hospitalized with toxemia-induced seizures.
“I was under a lot of pressure,” Julie remembers. “I wasn’t sure I could make the milk she needed soon enough or make enough to meet her needs. I was recovering and there was so much stress.”
Her tiny daughter was hospitalized for nearly two long months, during which she was fed through a tube. Inside that tube, providing support no infant formula is capable of duplicating, flowed what many health care professionals refer to as “liquid gold”: donated mothers’ milk.
Growing network of milk banks
Preemies in Julie’s area have a new resource in their battle for life: the Mother’s Milk Bank of North Texas. Based in Fort Worth and serving the entire metroplex and surrounding region, the Mothers’ Milk Bank processed and delivered its first batch of donor milk this past fall.
Yet while organ and blood donation programs touch literally millions of lives across the country every year, most families — and many doctors — are unaware that milk banks even exist. One of two milk banks in Texas, the Mothers’ Milk Bank is only the seventh human milk bank in the entire United States.
“There are a lot of moms who don’t know that milk banks are out there,” Julie says. “I would tell them about donated milk and they would ask me, ‘Are you sure?’ And I would say, ‘Trust me. My daughter got donor milk, and look how well she’s doing now. She’s living proof. Breast milk is the best thing you can do for them, whether it’s your milk or someone else’s.’”
Julie’s daughter was released from the hospital after 50 days. She’s now a happy, healthy nursing baby.
Hundreds of ounces of liquid gold
Tiny preemies and critically ill newborns top the list to receive life-sustaining donations from the milk bank. Hospitalized in neonatal intensive care units around the metroplex, these smallest patients go through 350 to 500 ounces of donated milk each week.
Human milk is not only the healthiest choice but sometimes the only choice for babies with failure to thrive, formula intolerance, allergies and other medical conditions. These infants are vulnerable to infection and organ damage because their bodies are not mature enough to digest human milk substitutes.
“An infant’s immune system has three aspects: her own immature, developing immune system; the small component of immunities that passes through the placenta during natural childbirth (and to a lesser degree with premature births and cesarean sections); and the most valuable, living portion that is passed on through mother’s milk on an ongoing basis,” explains Dr. Linda Folden Palmer, a noted author on breastfeeding and child health. “Remove any of those components and you take away a vital support structure.”
So why can’t these babies get milk from their own mothers? The reasons may be many: a mother might be critically ill (or even have passed away) herself, or perhaps she needs to take a particular drug that is contraindicated for breastfeeding. Breastfeeding may not be an option for mothers of adopted children as well as women who’ve had breast surgery or cancer or have rare conditions such as insufficient milk glands.
Even healthy mothers may not be able to get lactation going quickly enough to meet the needs of their fragile premature babies. “In most cases, their mothers have tried to pump to provide breast milk but have been unsuccessful,” says Amy Vickers, clinical coordinator at the Mother’s Milk Bank. “This is usually due to the tremendous amount of stress they are under, having a sick baby. Sometimes when moms deliver early, they are not very successful with milk production.”
Is another woman’s milk safe?
In this day and age, far removed from the era of wet nurses, many might question the safety of sharing this most intimate of body fluids. Breast milk donors are scrutinized as carefully as any other blood or organ donor, with a full health history and blood tests for HIV, HTLV (human T-cell lymphotropic viruses), hepatitis B and C and syphilis.
Donors must be non-smokers, drink alcohol only occasionally and test free of illegal drug use. They may not be using any medications regularly, with exceptions for progestin-only birth control pills, insulin, prenatal vitamins and several other carefully monitored prescriptions. Donors must be in good health and currently breastfeeding a thriving baby of 1 year or less, with plenty of breast milk to meet their own babies’ needs.
Who donates breast milk?
Many milk donors make one-time donations of supplies they’ve stored but won’t be needing. “I began pumping my breast milk the fifth week into my maternity leave so that I could begin giving my daughter a bottle in preparation for my return to work,” says donor Brandy Meierhofer of Lake Highlands, Texas. “Shortly after returning to work, I realized that I had built up a supply of milk that wouldn't be used by my daughter in the amount of time it could safely be stored. I called my local La Leche League representative to see if there was some way to donate my stored milk. She gave me the phone number of the then newly forming Mother's Milk Bank.”
Other donors pump and donate their own milk simply because they want to help. “As a nurse practitioner and mother, I am well aware of the benefits breast milk has for little babies,” says Melanie Householder of Venus, Texas. “Since God was blessing me with extra milk, I decided to become a donor. I live about 45 minutes away, so I keep milk in my deep freeze and take it by when I go to Fort Worth. I have donated about 500 to 600 ounces so far.”
Once accepted as donors, mothers receive detailed instructions on how to hygienically collect, handle and store their milk. Meierhofer has become so accustomed to pumping that she enjoys the “me time” first thing every morning.
“I wake up about 30 minutes early and pump, store the milk in 4-ounce portions, then clean and sterilize my pump components,” she says. “My husband and daughter are usually still sleeping, so while pumping I drink a glass of water, read a magazine and take advantage of a little ‘me time’ that is at such a premium for new mommies.”
Donated milk actually comprises a pool of milk from several donor mothers, which ensures a good mixture of fat content and a greater variety of immune factors. Frozen milk from donors is slow-thawed, pooled and pasteurized. Samples are sent to a lab to be checked for bacterial growth. The rest of the milk is quick-cooled and then frozen until it’s dispensed for use up to 12 months later.
How much does it cost?
Collection and processing costs are borne directly by milk banks, which are non-profit organizations. The Mothers’ Milk Bank in Fort Worth covers the cost of blood tests for donors and provides collection bottles. Donors are not paid for their milk.
As for the patients, some insurance plans cover prescription donor milk. Vickers says she’s heard of occasions when insurance companies have covered milk for non-hospitalized infants, and Medicaid covers milk for non-hospitalized infants in cases of medical necessity. No infant with a medical need for donor milk will be denied because of inability to pay, as long as the milk bank has milk available, Vickers said.
Hospitals pay a processing fee when they order milk for their inpatients. “We call it a ‘processing fee’ because we are not really ‘selling’ milk,” Vickers explains. “We take donations and then screen donors, pasteurize the milk and then dispense it with a doctor’s prescription. The fee goes towards covering our expenses but comes nowhere close to making us profitable —hence we are a 501( c )3, not-for-profit organization depending on grants and donations.”
For a complete listing of milk banks in the United States, visit the Human Milk Banking Association of North America.
© Lisa Poisso; this article first appeared at Dallas Child magazine