Neonatal Facilities Increasingly Use Donated Breast Milk for Premature Babies Neonatal: Hospitals Using More Donated Breast Milk

Daily Herald (Arlington Heights, IL), October 2, 2017 | Go to article overview

Neonatal Facilities Increasingly Use Donated Breast Milk for Premature Babies Neonatal: Hospitals Using More Donated Breast Milk


Byline: Michael Alison Chandler The Washington Post

The weekly shipment arrived at noon Thursday -- 300 ounces of breast milk donated by women across the country and pasteurized at a milk bank in Austin.

It was packed with dry ice and shipped via FedEx to feed the most medically fragile premature infants in the neonatal intensive care unit at Children's National Health System in Washington, D.C.

"Liquid gold," said Victoria Catalano, a NICU dietitian at the children's hospital in Washington, holding up a plastic bottle containing three ounces of frozen milk. Then she corrected herself. "Well, that's liquid gold," she said, pointing to two large deep freezers stocked with milk the infants' mothers had produced. "This is the next best thing," she said.

A growing body of research shows that human milk carries long-term benefits for premature infants and can be lifesaving, but it's often hard for mothers of premature infants to produce enough. Historically NICUs have supplemented feedings with formula, but now they are increasingly looking to milk sharing -- a practice with roots in an ancient tradition of wet nursing -- as the nutritional vanguard for babies who are born too soon.

The percentage of advanced neonatal care hospitals across the country that provide donated breast milk has nearly doubled, from 22 percent in 2011 to nearly 40 percent in 2015, according to an unpublished analysis of data from the Centers for Diseases Control by Maryanne Tigchelaar Perrin, an assistant professor of nutrition at the University of North Carolina at Greensboro.

The rate was even higher --between 65 and 75 percent --for Level 3 and 4 NICUs that serve the smallest and most fragile premature babies.

The bulk of the donated milk is being provided by a network of nonprofit milk banks that are accredited by the Human Milk Banking Association of North America. The organization was established in 1985 to set safety standards for the industry, after nearly all of the 50 or so existing informally organized milk banks at that time shut down in the wake of the AIDS crisis and concerns about how the virus could be spread via bodily fluids.

Today there are 23 accredited milk banks in the United States and three in Canada, twice the number five years ago. A handful of private milk banks have also sprung up to meet the growing demand for human milk in NICUs.

The American Academy of Pediatrics in 2012 recommended that donated breast milk rather than formula be used for preterm infants when a mother's milk is unavailable. The policy statement cited a range of benefits, including the prevention of sepsis and other infections as well as long-term benefits in growth and brain development.

Studies have shown that human milk can also protect against necrotizing enterocolitis, a disease that causes serious damage to babies' intestines. NEC, which affects 12 percent of babies born weighing less than 3.3 pounds, is one of the leading causes of infant mortality in the United States.

(The academy advises against informal milk sharing or using Internet-based sites to share milk, an increasingly common practice among parents of infants more broadly, because of risks of bacterial or viral contamination, or exposure to drugs or other substances).

Donated breast milk in general is less nutritious than milk produced by an infant's mother, which changes in composition -- with varying levels of proteins, fatty acids and white blood cells -- to meet the unique immunity and nutritional needs of her own baby. But for many reasons, it's not practical or possible for many mothers to provide milk, particularly for premature infants.

Just as their babies did not have time to mature in utero, often the mothers' bodies were not prepared for birth, neonatologists say. The stress of being in a NICU also makes it hard to produce milk, said Kim Updegrove, executive director of the Mothers' Milk Bank at Austin, which is one of the largest in the country. …

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