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Donor Milk – Increasing Access Across the State NOVEMBER 3, 2017

BRAINERD AT MADDENS RESORT ON GULL LAKE, MINNESOTA

DONOR HUMAN MILK

u Why Donor Milk?

u Who are the donors?

Who are the Donors?

u  Why do they donate their milk?

u  Are they breastfeeding their own baby?

u  How much milk do they donate?

Mothers Know the Value of their Own Milk

u Mothers are feeding their own babies and have extra milk and are wanting to help other mothers have milk for their babies.

u When mothers have experienced a loss of their baby, some choose to donate their milk and find it helps as they grieve.

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Mothers choose to learn how they can give their milk to help other babies.

u  They have stored their milk for a few months and are needing room in their freezers.

u  They then go thru the screening.

u  Mothers are screened by the milk bank of HMBANA –Human Milk Bank Association of North America Milk Bank. The screening is done by a phone interview, a written questionaire and blood testing.

Blood Test

1.  HIV – 1

2.  HIV – 2

3.  Hepatitis B and C

4.  HTLV-1 and 2

5.  Syphilis

Cost of lab testing paid by Milk Bank

Mothers bring their milk to a Milk Depot

The Donor Number u Each mother who passes the screening receives

a donor number. IE: 17- 100 u  She labels her milk with her number. u Her milk is taken to a MILK COLLECTION DEPOT. u  From the MILK DEPOT, her milk is transported to the MILK BANK. u  There her milk will be put together with 3-5 other mothers’ milk.

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GENTLE PASTEURIZATION

u Milk is heated to 62.5 degrees Celsius for 30 minutes then quickly cooled.

u  The milk is tested for bacteria before and after the pasteurization.

u  Then frozen, packed and ready to be shipped to the hospitals.

DONOR MILK AFTER BIRTH

– helping a mother to reach her goal to

breastfeed her baby exclusively.

KEY STEPS FOR DONOR MILK USE IN THE HOSPITAL

u  Ensure proper freezer/refrigeration in a convenient location to keep the frozen donor milk that come in 2-4 oz bottles. Temperature alarms to be sure milk is kept frozen.

u  Educate Prenatally for mothers to have an understanding before birth.

u  Educate the Hospital Staff

When is Donor Milk Needed Soon After Birth?

u  Low or delayed maternal milk supply associated with:

Cesarean Birth

Breast Reduction

Late initiation of breastfeeding (mother in ICU)

Post Partum hemorrhage

IDDM

Hypoglycemia

Obesity

Ineffective suckling by infant

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Donor Milk is a Bridge

u  First give mother’s milk if baby not breastfeeding– hand expression and/or pumping

u  If baby needs more milk than she is yet able to supply, donor milk is available.

u  The goal is to have mother breastfeed, hand express and pump to help her own supply to increase.

u  Milk is available for after discharge for purchase.

u  Parents are reaching out to reduce disparity among low income families.

Supplementing With Donor Milk u  Educate family of option to give human breast milk versus formula.

u  Obtain a consent to use Donor Milk.

u  Warm thawed donor milk.

u  May use a sterile syringe to draw up

the milk or pour milk into a med cup.

u  Container of donor milk can be used

for more than one baby

to avoid waste.

Supplementing

u  Supplement – volume matters. Baby needs to breastfeed 8 or more times in 24 hours. Age appropriate related to stomach size of newborn.

Less than 24 hours – 5- 10 ml

24 – 48 hours -------- 10 – 20 ml

48 hours -------------- 20 – 30 ml

MINNESOTA MILK BANK FOR BABIES

5,000+ babies born in Minnesota (annually) are premature or ill and may require human donor milk while hospitalized.

Minnesota’s Human donor milk

is currently sourced from

Colorado and Iowa,

neither of which can consistently

meet our demand.

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Our Progress

u  When we started in 2012 there were 4 hospitals using donor milk that we knew of in Minnesota. The last count was 24 hospitals who are now using human donor milk.

u  We have helped to developed 4 milk depots with an additional to open soon. We now collect enough milk to supply and sustain a Minnesota Bank. The milk is presently being transported to the Iowa Mother’s Milk Bank.

1. We have provided education about the importance of breastfeeding. 2. We have created community awareness about human donor milk

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The Fundraising - for the Minnesota Milk Bank for Babies.

u  Two Developers have been hired. These experienced fundraisers are working outside and within the Twin City Metro making contacts .

They are communicating the need and connecting us to people for funding.

Grants have been submitted and more being prepared.

Expected Outcomes from the Minnesota Milk Bank for Babies •  Increased access to human milk for ill and

preterm infants.•  Increased exclusivity and duration of

breastfeeding. •  Decreased length of stay in neonatal

intensive care units (NICUs).•  Decreased infant mortality and improved

child health.

Financial support

u  Goal: $300,000 u  General operating and equipment

Advocate

u  Lend your name to our list of endorsers u  Talk to your employer and others about

supporting this initiative. u  House a milk collecting depot at your

hospital, clinic.

Future opportunities

u  Board of Directors and Committee Member roles

u  Public policy advocate

Partnership Opportunities Bibliography u  [The benefits of breastfeeding and associated risks of replacement

with baby formulas]. Beneficios de la lactancia materna y riesgos de no amamantar. (Spanish) By: Brahm P; Valdés V, Revista Chilena De Pediatria [Rev Chil Pediatr], ISSN: 0717-6228, 2017 Feb; Vol. 88 (1), pp. 7-14; Publisher: Sociedad Chilena De Pediatria; PMID: 28288222; http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=28288222&site=ehost-live&scope=site

u  Immediate and Sustained Skin-to-Skin Contact for the Healthy Term Newborn After Birth: AWHONN Practice Brief Number 5. Nursing for Women's Health, Dec2016/Jan2017; 20(6): 614-616. (3p) (Article) ISSN: 1751-4851 AN: 120141576 http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=rzh&AN=120141576&site=ehost-live&scope=site

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u  Breast Milk and Hair Testing to Detect Illegal Drugs, Nicotine, and Caffeine in Donors to a Human Milk Bank. (English) By: Escuder-Vieco D; Garcia-Algar Ó; Joya X; Marchei E; Pichini S; Pacifici R; Pallás-Alonso CR, Journal Of Human Lactation: Official Journal Of International Lactation Consultant Association [J Hum Lact], ISSN: 1552-5732, 2016 Aug; Vol. 32 (3), pp. 542-5; Publisher: Sage Publications; PMID: 27197576; © The Author(s) 2016. http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=27197576&site=ehost-live&scope=site

u  Oroopharyngeal Administration of Mother’s Milk to Prevent Necrotizing Enterocolitis in Extremely Low-Birth-Weight Infants. J Perinat Neonat Nurs, Volume 29 Number 1, 81-90, Copywrite@2015 Walters Kluwer Health, Inc.

u  An Adoptive Mother Who Became a Human Milk Donor. (English) By: Flores-Antón B; García-Lara NR; Pallás-Alonso CR, Journal Of Human Lactation: Official Journal Of International Lactation Consultant Association [J Hum Lact], ISSN: 1552-5732, 2017 May; Vol. 33 (2), pp. 419-421; Publisher: Sage Publications; PMID: 28056181; http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=28056181&site=ehost-live&scope=site

u  Optimal Distribution and Utilization of Donated Human Breast Milk. (English) By: Simpson JH; McKerracher L; Cooper A; Barnett D; Gentles E; Cairns L; Gerasimidis K, Journal Of Human Lactation: Official Journal Of International Lactation Consultant Association [J Hum Lact], ISSN: 1552-5732, 2016 Nov; Vol. 32 (4), pp. 730-734; Publisher: Sage Publications; PMID: 27364932; http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=27364932&site=ehost-live&scope=site

 

u  Immunology of breast milk. (English) By: Palmeira P; Carneiro-Sampaio M, Revista Da Associacao Medica Brasileira (1992) [Rev Assoc Med Bras (1992)], ISSN: 1806-9282, 2016 Sep; Vol. 62 (6), pp. 584-593; Publisher: Associação Médica Brasileira; PMID: 27849237; http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=27849237&site=ehost-live&scope=site

 

 

u  [The Changing Value of Mother's Milk. Feeding Premature and Sick Newborns Since the Late 19th Century]. By: Sunder-Plaßmann A, Zeitschrift Fur Geburtshilfe Und Neonatologie [Z Geburtshilfe Neonatol], ISSN: 1439-1651, 2016 Dec; Vol. 220 (6), pp. 239-250; Publisher: Ferdinand Enke Verlag; PMID: 28002856; http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=28002856&site=ehost-live&scope=site

u  High-temperature short-time pasteurisation of human breastmilk is efficient in retaining protein and reducing the bacterial count. (English) By: Klotz D; Joellenbeck M; Winkler K; Kunze M; Huzly D; Hentschel R, Acta Paediatrica (Oslo, Norway: 1992) [Acta Paediatr], ISSN: 1651-2227, 2017 May; Vol. 106 (5), pp. 763-767; Publisher: Wiley-Blackwell; PMID: 28135766.

u  Public Reporting of Hospital-Specific Breastfeeding Measures. (English) By: Jurkowski JM; Svistova J; Nguyen T; Dennison BA, Journal Of Human Lactation: Official Journal Of International Lactation Consultant Association [J Hum Lact], ISSN: 1552-5732, 2016 Nov; Vol. 32 (4), pp. 666-674; Publisher: Sage Publications; PMID: 27565202; http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=mnh&AN=27565202&site=ehost-live&scope=site