As the benefits of breast milk for premature babies are being formally recognized by major health organizations including the American Association of Pediatrics and the World Health Organization, major obstacles remain when it comes to getting donor milk to the babies who need it. I want to talk today about human milk banks and how we can all support efforts to provide the very best nutrition for preemies. There are many reasons why a newborn may need donor milk, including:

  • delays in a mother's own milk production if the baby is born at an early gestational age, before the milk-producing mechanisms have fully developed
  • stress, anxiety, and lack of sleep that accompany preterm birth can impact a mother's milk supply
  • supplemental fortified milk may be needed to provide extra nutrients, especially protein and certain minerals that are critical to a premature baby's growth (link here)
  • a mother's own medical condition may prevent adequate milk production

This last example was Sue's experience when Jacqui was born. Sue had severe hemorrhaging of several organs, and recovery was long and difficult. Even though she tried desperately to pump, her body just could not produce milk. 

While formula has been a life-saving alternative for many babies, including Jacqui, it's becoming clear that human milk is so beneficial to premature babies that every effort ought to be made to provide it for them. The incidence of dangerous infections, especially necrotizing enterocolitis, and other complications is significantly lower in babies fed with human milk. Hospitals have stepped up their counseling and support for mothers so that they are able to successfully pump milk for their babies. Research suggests that a mother's preterm milk has a unique composition that is well suited to meet a premature baby's nutritional needs. But what if, for whatever reason, a mother cannot provide her own milk?

Donors and milk banks step in to meet the need. All over the United States, women pump extra milk and donate it to milk banks, which screen, process, and deliver it to hospitals. The Human Milk Banking Association of North America (HMBANA) is an umbrella organization for non-profit milk banks. Their website is an excellent source of information about milk donation, including safety procedures and donation locations.

Unfortunately, despite the general consensus that human milk is the preferable nutrition for all babies, and especially beneficial for premature babies, access to donated milk remains limited because of its high cost. Patchwork policies across the country regarding how to treat human milk add to the complexity; in different states it's treated as food, medicine, or human tissue, and therefore covered by insurance differently. The reality is that many families cannot afford to pay for donated milk. So what can we do?

Women can donate to a non-profit milk bank! They offer a lot of support to make donating as easy as possible. If you aren't able to provide milk, banks can always use financial support to help cover the cost of their work. Volunteers can pick up and deliver milk. There are many ways to get involved, and the HMBANA website, www.hmbana.org, is a great place to find information about the milk bank nearest you. More donors and volunteers will help lower the cost of donor milk.

We can all also educate ourselves and others about the importance of making human milk available to preemies, regardless of their family's financial situation. As long as the cost of donor milk remains high and insurance coverage is spotty, babies are at risk. Recent efforts to allow Medicaid coverage of donated milk are encouraging. The health benefits of breast milk for preterm babies are so substantial, it's in all of our interest to help make it as widely available as possible.

We would love to hear your perspectives; have you donated milk? Did your baby receive donor milk in the NICU? Many people are unaware that milk banks exist and how important they are to the health of premature babies. Let's change that!

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