Because of its perfect balance of nutrients, immune-boosting properties, and easy digestibility breast milk provides optimal food for infant growth and development. While not all new moms are able to breastfeed now there may be a new option.
Milk banks provide human breast milk to the neediest babies who otherwise wouldn't get this nutritional and developmental boost.
Who Benefits From Milk Banks?
Premature infants weighing less than 1,500 grams (about 3 pounds, 5 ounces) at birth receive the bulk of the milk from human milk banks, explains Nancy Wight, MD, neonatologist, and professor of Pediatrics at the University of California, San Diego. Babies who reject formula and, as a result, experience inadequate growth, are also prime candidates for milk banks.
Neonatologists prescribe breast milk for these infants because of the specific advantages it offers. Breast milk protects against necrotizing enterocolitis, an intestinal disease to which premature infants are susceptible. "It gives these babies three to four times more protection. To me, that's a big seller," says Donna More, administrator of Delaware-based Christiana Care Health system's milk bank, in operation since 1947.
Premature babies fed breast milk have shorter stays in neonatal intensive care units than those who consume formula -- about 15 days on average -- and are less likely to develop retinopathy (retina problems that can lead to poor vision), notes Mary Rose Tully, director of Lactation Services at University of North Carolina Hospital and past president of the Human Milk Banking Association of North America, an organization established in 1985 to promote and support safe donor milk banking.
"Overall, babies do better on breast milk," More says emphatically.
Not Regulated by the FDA
The milk banking association, with assistance from an advisory council comprised primarily of physicians, oversees the collection, processing, and distribution of most human milk banks in North America. Because of the association's small output relative to other food sources, it is not regulated by the FDA. However, its original processing guidelines were compiled with direct input from the FDA and CDC.
The FDA continues to play an active, though unofficial, role in overseeing milk banks affiliated with the milk banking association. "The FDA has been closely monitoring what donor milk banks are doing. They make surprise visits and take copious notes," Tully tells WebMD.
Currently, the association operates milk banks in each of the following states: California, Colorado, Delaware, Indiana, Iowa, Michigan, North Carolina, Ohio, and Texas, as well as Canada. Some of its banks are affiliated with hospitals; others are community-based. Recently, Prolacta Bioscience opened North America's first for-profit human milk processing facility, in California.
Recipients do not need to reside near a milk bank to benefit from the pasteurized milk it supplies. "All but one location has milk shipped in and out," Tully explains.
"I ship all over the U.S. I've even sent milk overseas," adds Gretchen Flatau, executive director of Mother's Milk Bank in Austin. Because it is perishable, the milk is shipped on ice and overnighted, Flatau explains. Most of the milk shipped from milk banks around the country finds its ways to hospital neonatal intensive care units, where vulnerable infants stand to gain the most from human milk.
About Donors
Women are not paid for donating to milk banks; their motivation is purely altruistic. "They know they're helping babies. For a lot of women who donate, it's kind of a spiritual thing. They feel a connection to moms who can't breastfeed," Flatau tells WebMD.
So far, supply has never been a problem. "I get at least 10 emails a day, and five to 10 phone calls, from people wanting to donate," More says.
The amount of milk donors supply varies. Milk banks require that donors provide a minimum of 100 ounces to 200 ounces over three months or less. Some women far exceed that requirement, donating up to 10,000 ounces, Flatau notes.
A willingness to donate a minimum amount of milk is not the only requirement. Donors, and their own infants, must be healthy. "Donors must be free of illness and have babies that are thriving," says Tully. "We never want to be taking milk from a baby who's not healthy," she tells WebMD.
How Safe Is It?
Parents of prospective recipients may wonder about the safety of human milk extracted from strangers and shipped to and from all over North America.
According to experts, they needn't worry.
"In the whole history of milk banks, there's never been a single reported adverse effect," More says.
Tully concurs. "The safety record of milk banks is pretty remarkable, compared to other health care procedures," she tells WebMD. "We know we have to be careful. We have small recipients."
Industry experts attribute the stellar safety record of milk banks associated with the banking association to rigorous screening and processing procedures.
Screening Process
The multistep screening process applies both to prospective donors and to their milk.
The screening process for prospective donors goes something like this: They receive testing for a battery of communicable diseases, including HIV; and they undergo testing multiple times. "We screen the donors thoroughly every six months," More tells WebMD. Lifestyle and medical records of candidates are also reviewed. Finally, both their primary care physician and pediatrician must sign a statement vouching for their viability as donors.
Once donors are approved, the same scrutiny is applied to their milk. At association-affiliated milk banks, a pasteurization process eliminates bacteria while retaining many of the milk's nutritious components. Plus, lab workers test samples for bacterial growth. Finally, the milk is sealed in 4-ounce glass bottles and delivered, frozen, to the nearest milk bank.
Cost
While the scrupulous screening done by milk banks has prevented problems related to the safety of the breast milk they supply, cost remains a prohibitive factor for some would-be recipients.
At around $3 per ounce, breast milk can quickly get expensive.
Some milk banks award grants to offset the cost to parents, but such grants fall far short of covering the total cost of breast milk for all recipients.
"I have had no success in getting insurance coverage for recipients. Your heart breaks for those who need it and can't afford it," More tells WebMD.
She and others hope that as science continues to build up evidence of breast milk's specific and significant health benefits, an increasing number of insurance companies will see it as a necessary medical expense rather than an optional mode of nutritionnutrition and, in turn, cover its cost.
For some, breast milk is more than sound nutrition. With the most vulnerable babies, it can be critical to their survival. "There's nothing else they're going to tolerate. It can be a lifesaver," Flatau says.
