Download - Banking on Human Kindness Donor Milk
Banking on Human Kindness
Donor Milk
Pauline Sakamoto MS, RN, PHN
Executive Director
Past President of HMBANA
US Breastfeeding Committee Member
MOTHER’S OWN MILK IS THE
FIRST CHOICE
WHEN MOM IS INSUFFICENT OR NOT
AVAILABLE FOR AN INFANT IN NEED
THEN PASTEURIZED HUMAN DONOR
MILK IS USED
HMBANA’s Mantra
Chief bottle washer
What makes us different We’re dedicated to ensuring that every infant has ample breast
milk to get the best possible start in life.
It’s a new day
Breastfeeding timeline by Kellogg Foundation
http://www.youtube.com/watch?v=Zhx-R6p1xAQ&list=UUAYYMRv_yBzT4gP2-uB9r4A&index=1
Making a comeback
• Established in 1974
• Helped found Human Milk Banking Association of North America in 1985
• Become a Medi-Cal provider 1988
• Licensed as a California Tissue Bank 1995
Bursting at the
seams
We may be the greatest
thing since banked milk,
but we’re still elbow to
elbow in a 30 year old
trailer
New digs
What makes us different
• Sole non-profit milk bank in California
• Distribute milk to the most vulnerable
• All processing charges support research, education, HMBANA and breastfeeding!
• Preterm Infants
• Other infants, children and adults: – allergies or sensitivities to formulas
– failure to thrive (FTT)
– immune deficiencies
– malabsorption syndromes
– post-surgical nutrition
– short gut syndrome
– solid organ transplants (including adults)
– cancer chemotherapy patients / apoptosis
– renal failure (replenish IgA)
Clinical Uses of Donor Human Milk
This is me feeding my son donated breast milk from
San Jose Milk Bank.
Thanks Mamas! He got a great start with your help! And it meant so
much to my peace as I fight my battle with breast cancer.
• Given donor #
– no milk accepted until all screening complete
• Donates milk – frozen
• Milk thawed to a slurry
• Milk cultured
• Holder pasteurization (62.5 C X 30 min)
• Milk re-cultured
• Frozen for storage and shipping
HMBANA Donor Milk Processing
Northern California landscape
Hospital Serve
• 103 hospitals in
thirteen states
• We are serving four
hospitals’ NICU’s in
the Sacramento area.
Impact
Largest Distributing US
milk bank – Over 572,000 oz last year
– 93 hospitals
– 86 outpatients in 13 states
– 680 volunteer donors!
A donor milk baby tasting his first spaghetti
Growing Sacramento Area
Local Community Outreach
– Milk Drives
– Express Centers
– 6 Hospitals and growing
– Outpatient Support
Yearly Ounces Distributed
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
Year
Totals
572,700 (20.49% increase)
465,363 (1.33% increase)
Infant Diagnoses 55%
Maternal Diagnoses 43%
Adult Diagnoses 2%
San Jose Diagnosis Codes by Population
Mentoring new banks
A big thank you to all of the staff for taking time out of your day to teach us what you know. It is a huge step toward getting the milk bank up and running in Montana!—Mothers’ Milk Bank Montana
Mothers’ milk supporters
• Surgeon General calls for greater availability of safe banked donor
human milk for fragile infants, 2011
• FDA Pediatrics Advisory Committee endorses human milk banking and deemed informal sharing of human milk to be unsafe, 2010
• WHO/UNICEF “In situations where mothers’ own milk is not available, provisions of pasteurized, screened donor milk is the next best option particularly for ill or high risk infants.” 1980
• The AAP REDBOOK Currently, US donor milk banks that belong to the Human Milk Banking Association of North America voluntarily follow guidelines drafted in consultation with the US Food and Drug Administration and the Center for Disease control and Prevention. 2000
More supporters
ACOG,” The Human Milk Banking Association of North America (HMBANA) is the only professional membership association for milk banks in Canada, Mexico, and the United States, and sets the standards and guidelines for donor screening, storage, sterilization of milk, and modern distribution methods.” 2007
American Academy of Family Physicians “Banked pasteurized donor human milk has been found to be safe and nutritionally sound for babies who do not have access to their mother’s own milk.” 2008
American Dietetic Association. “The value of human milk in reducing the incidence of [necrotizing enterocolitis] NEC has influenced the growing use of pasteurized donor human milk for infants at high risk for NEC (37-41). When mother’s milk is not available, providing pasteurized donor milk from appropriately screened donors from an approved milk bank offers immunoprotection and bioactive factors not found in infant formula and is the next best option particularly for ill or preterm infants. 2009
US Department of Health and Human Services “S/he may need donor milk, not only for food but survival. If your baby was born premature or has other health problems, the best way to find a human milk bank is through the HMBANA (Human Milk Banking Association of North America)”
Our donors
• Eligible blood
donors are
likely eligible
milk donors
• We fill
doctors’
prescriptions
Screen, process, test
• Thawing for bacterial
testing
• Holder Pasteurization,
bacteria testing of all
milk
Sometimes we need to bust out http://www.youtube.com/watch?v=WX4VWBeavGg
Help wanted
• We seek your help in
reaching donors so
that every baby has
ample breast milk to
thrive.
The future is in our hands
Bibliography
Edwards, TM, Spatz, DL, Making the Case for Using Donor Human Milk in Vunerable Infants, Adv Neonatal Care, 2012 vol 12, No5, pp 273-278
Sullivan, S, Schanler R, Kim J, et al, An Exclusively Human Milk-Based Diet is Associated with a lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products, Journal of Peds, 2009, 10.106
Penn, AH, Altshuler, AE, Digested formula but not digested fresh human milk causes death of intestinal cells in vitro: Implications for necrotizing enterocolitis, Peds Research, 21 nov. 2012, doi:10.1038/pr.2012.125
AAP, Breastfeeding and the Use of Human Milk, Peds, Vol129, Number 5, 3/2012
Cohen, RS, Current Issues in Human Milk Banking, NeoReviews, vol 8, No.7, July 2007
Gardner LM, Morton J, Lawrence R, Breastfeeding and the Use of Human Milk, Peds, 2005, vol 115, no 2, 496-506
Boyd CA, Quigley MA, Brocklehurst, P, Donor Breast Milk vs Infant Formula for Preterm Infants, A Systematic Review, Arch Dis Child, Fetal Neonatal Ed. Online, 5 Apr 2006
• Updegrove K, Human Milk Banking in the US, Newborn and Infant Reviews, vol 5, no 1 March 2005, 27-33
• Arnold,L The Cost Effectiveness of Using Banked human donor Milk in the Neonatal Intensive Care Unit, Jr. H Lact, vol 18, no 2, 2002
• Wight, NE, Donor Human Milk for Preterm Infants, Journal of Perinatology, 2001, 21-249-254
• HMBANA, Guidelines for the Establishment and Operation of a Donor Human Milk Bank 2011 ( soon to have 2013 ed)
• Jones, Frances, Best Practice for Expressing, Storing and Handling Human milk in Hospitals, homes, and Child Care Settings, 2011, 3rd edition
• And more if requested!