Human Milk Banks – If They Save So Many Lives, Why Aren’t There More?

Human Milk Banks - If They Save So Many Lives, Why Aren't There More?

It’s well known that breast milk is the optimal nutrition for all babies, especially sick and preterm infants.

The evidence demonstrating that prolonged breastfeeding can limit or prevent numerous diseases and conditions, is staggering.

Yet today, more women than ever are not exclusively breastfeeding for the first 6 months of their baby’s life.

In the 1980s, Brazil decided a concerted effort to improve their high infant mortality was needed.

So the country worked hard to normalise breastfeeding and milk donation.

As a result:

  • infant mortality dropped by 75%
  • around 50% of Brazilian babies are exclusively breastfeed for the first 6 months
  • 214 milk banks are in operation.

Despite numerous health organisations advocating screened donor milk as the next best available option for babies, many countries are failing to provide this option.

Accessibility and acceptance of donor breast milk remains controversial in many countries.

The History Of Human Milk Banks and Milk Donation

Mothers providing breast milk for babies who are not their own is not a new idea.

Women have been breastfeeding babies other than their own for thousands of years.

In many cultures, mothers would wet nurse each others babies in many situations, regardless if the baby had access to his mother’s milk or not. Until the invention of the feeding bottle in the 19th century, wet nursing was considered the safest and most acceptable alternative to mother’s own milk.

Because breast milk was known to be beneficial for sick babies, lactating women were encourage to express their milk and donate directly to hospitals.

The first human milk bank was opened in Austria in 1909, followed 10 years later by the first bank in America. Milk banks continued to open and operate until the 1980s, when the fear of HIV transmission was so great that many milk banks closed.

By the 19th century, artificial feeding had become a feasible substitute for wet nursing. Improvements in infant formulas as well as bottles and teats meant artificial feeding gained popularity very quickly. Wet nursing fell out of favour and infant formula quickly filled that void.

By the mid 1900s, doctors were recommending formula to mothers who were having breastfeeding difficulties in the first few days after birth. As a result, formula was considered a safe and well known alternative to breast milk and breastfeeding rates declined steadily until the 1970s.

Why Is Milk Donation More Important Than Ever?

Breast milk is species specific nutrition, meaning it’s perfectly engineered by a mother’s body to ensure her baby has the exact nutrition required for growth and development.

There are literally hundreds of substances in breast milk that haven’t been identified by researchers and can’t be replicated, providing benefits such as:

  • Being antimicrobial and anti-inflammatory
  • Promoting long term health
  • Less likelihood of many infections and diseases in premature babies (bacterial meningitis, respiratory tract infections, necrotizing enterocolitis, urinary tract infection)
  • Less likelihood of SIDS
  • Less likelihood incidences of many diseases such as type-1 and 2 diabetes, leukemia, Hodgkin’s disease, obesity, asthma.

Read the results of a study which set out to discover what is contained in breastmilk and what is in formula.

In promoting the message that breast milk is optimal, health experts and governments are going some of the way to ensure breastfeeding rates increase. This how many other countries have significantly increased their breastfeeding rates.

Awareness, education and availability of donated breast milk offers mothers an alternative to infant formula that provides the same benefits as direct breastfeeding.

Human milk banks not only improve the rate of infant mortality as seen in Brazil, but offer mothers the chance to provide their babies with optimal nutrition if she is unable to breastfeed. Currently donor milk is seen as useful only for premature babies, but has the potential to support women in achieving exclusive breastfeeding rates worldwide.

Why Isn’t Donor Milk More Accessible?

Mothers with poor supply, medical reasons for being unable to breastfeed, who are sick themselves, or simply wish to supplement feed their babies – all have only one option before them – infant formula. It’s promoted and sold as ‘the’ next best alternative to a mother’s breast milk – simply because it’s the only alternative.

There are a number of milk banks open around the world but their use is specifically for sick and premature babies. A small number of mothers will offer to wet nurse or donate breast milk, but this usually occurs within their own circle or via social media networks such as Human Milk 4 Human Babies and Eats on Feets.

Ask other women what their thoughts on milk donation are and usually the response is not positive. Some women see it as disgusting, and milk from a cow would be a better option. Other women feel it would be too difficult to do on a regular basis.

Yet most people see no problem with donated blood, organs, eggs or sperm.

These acts of donation are seen as helpful, selfless acts that improve or even save lives. Which is exactly what breast milk does for babies and young children.

Cultural Awareness And Acceptance

The World Health Organisation (WHO) and UNICEF jointly developed the Global Strategy for Infant and Young Child Feeding to demonstrate the impact that feeding practices have on the health, growth and survival of babies and young children. The Global Strategy promotes the use of breast milk from a healthy wet nurse or a human milk banks as the best alternative to mother’s breast milk.

Yet in Australia, Europe and America, awareness about milk donation and banking is scarce. Australia has 5 milk banks, North America has 16, and Europe has 203 (across 50 countries).

Women are continuously exposed to the message that breast milk is the optimal source of nutrition for their baby and when breastfeeding doesn’t work out, they’re left with the sense they have failed and are compromising their child’s health. But it’s not the mothers who have failed. There are so many other contributing factors at various levels, from government policy to the lack of breastfeeding education for key healthcare providers.

Women who donate milk report feeling a great sense of satisfaction and worth that they’re helping other mothers provide optimal nutrition to their babies. These women are usually long-term donors, storing and donating milk over a number of years while they’re nursing their own babies.

Stories Of Milk Donation

Ariane’s story: “My first milk donation was when my firstborn was 4 months old. I was part of a group of women donating to a newborn whose mother had passed away. It was a great honour to be part of that group and I’ve made many friends. I’ve gone on to donate to nearly 10 families, some long-term donating relationships and some one off donations. The donations were needed for a variety of reasons. I enjoy being able to help other families, as I’ve been assisted many times by those around me in my parenting journey. We can donate blood, sperm, eggs and organs, why not breastmilk?”

Jen’s story: “I wish milk banks were more widely available – I got treated like I was daft asking about it whilst still in hospital. I was blessed to receive milk from a couple of close friends but it wasn’t enough for the amount of top ups required. Once I had breastfeeding established I went on to donate to several families, some acquaintances and others strangers. I also wet nursed my niece a couple of times.”

Amber’s story: “I donated my milk to 5 different babies in need, both long term (1.5 years) and short-term. I helped coordinate a group of women to ensure a baby never needed formula due to the mother having IGT (Insufficient Glandular Tissue). I also wet-nursed a set of twins I cared for to assist their mama so she didn’t have to pump. Being a breastmilk donor helped encourage me to become an egg donor too.”

Alex’s story: “I donated through my hospital to babies in special care. There was only a small window for donation – when my babies were 0-6 months and the first two months were devoted to recovering from birth and establishing supply. I always did a ‘drop and run’ outside the hospital but once I had to go into special care to deliver the milk and being up there (never been there before) made it really hit home how important it was for these tiny and very vulnerable babies. I felt blessed to be able to provide the milk and figured it was the least I could do.”

Natalie’s story: “I was very lucky to have a regular donor and some one off donations that kept us going. It was such a blessing to receive milk, it really did feel like the gift of life and knowing my son was still able to have breast milk really helped my mental health at a very difficult time.”

Cate’s story: “I have IGT (Insufficient Glandular Tissue) so have an undersupply that could never meet my baby’s nutritional needs. With the help of donor mothers on social media I was able to avoid formula completely until he weaned from top ups at around 19 months old. My heart will always be so full of gratitude for those selfless generous mothers.”

Emmaline’s story: “When my eldest was born he had a bad case of jaundice and needed extra milk to help him recover. Of course I was told, and believed at the time, that the only way to do this was to express the few mls that I could before my milk had come in and then supplement with formula. I really wish that I had known that donor milk was another option as I hated giving my newborn formula. If the hospital had a milk bank I could have accessed that would have been amazing. Or even if they had just asked me if I knew anyone who could have donated I could have asked my sister in law who was breastfeeding a 5 month old at the time and had a huge stash of breast milk in the freezer. I really think we need more milk banks, better educated health professionals and informal milk sharing needs to be normalised. If it was something everyone did then my sister in law would have just offered and I wouldn’t have even had to ask.”

Emily’s story: “I had low supply, and my twins reacted badly to formula. While I was at home, we could feed around the clock and this kept supply up together with medications. When I looked at starting work, I sourced donor milk from 3 donors to keep in the freezer while I pumped at work. I couldn’t pump as much as the babies needed, so in the end I stopped work again. The donors provided recent blood test results and we had frank discussions about health and safety before the donation. The donors were lovely women and we still stay in touch.”

The decision to source donor milk is often a challenging one as there is little chance of accessing screened milk through national milk banks unless your baby is sick or premature. Most women are unaware of informal milk sharing networks in their area or that this is even an alternative they could utilise instead of formula.

While there is considerable cost in setting up and running milk banks, this cost should be offset by improving the health of all babies who are entitled to receiving optimal nutrition. As Brazil has shown, when breastfeeding is seen as the norm and not as an alternative to infant feeding, it changes the social and cultural viewpoint.

Recommended Reading: The ‘Breast Is Best’ Message – 5 Surprising Facts.

 

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Sam McCulloch Dip CBEd CONTRIBUTOR

Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.


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