Milk that mothers can bank on!
Goa’s first human donor milk bank, an initiative to make the Goa Medical College baby friendly and which discourages formula milk, has not only brought satisfaction to mothers but also brought down the mortality rate in NEC infected preterm babies
04th March 2018, 07:11 Hrs
It feels great that my milk has been able to fulfill the need of not just my baby but other babies who are in need of mother’s milk. It has also helped me get relief from engorgement of breasts,” says 24- year-old Meena Oli, a native of Nepal who was at the human donor milk bank to express milk. Meena had delivered her baby at the 40-bedded Neonatal Intensive Care Unit (NICU) of the Goa Medical College. Like Meena, one can see the satisfaction of donating milk on the faces of many mothers who come to donate their milk at the milk bank.
“Goa’s first human donor milk bank was an initiative spearheaded by Dr Maria Silveira, Head of the Department, Paediatric. It is a life saving step for many preterm and sick babies admitted in the NICU as the hospital aims to be baby friendly, free of formula milk and promotes breast feeding owing to its innumerable life saving benefits,” says Dr Kavita Sreekumar, Assistant Professor, Department of Paediatrics, GMC.
The project idea was brought in 3 years back under the National Rural Health Mission and the human donor milk bank started functioning in August 2017. Around 25 lakhs were spent to set up the bank in the already available space in the paediatrics department. “In the minimal time alotted, we had to restructure one room which was earlier used to admit delivered and recouping mothers, into a laboratory to take the milk samples and pasteurize them,” says Dr Sreekumar. A medical laboratory technician has been alotted to handle the laboratory under the supervision of the senior staff nurse who has set strict norms to maintain the hygiene of the laboratory. Apart from this, there are lactation counselors who visit the NICU wards to help make mothers as well as their relatives aware of the importance of breast milk. It is important to note that this is pasteurized donor human milk meant for preterm and sick infants who cannot get the milk directly from the mother due to various reasons. Before donating milk, the mother has to fill in the donor screening proforma which checks the history of the donor for tobacco consumption, alcohol use, medicines/herbs/addictives, drugs, present illness, past illness and chronic disorders. The donor has to also give in details of any high risk behaviour, blood product transplant in the last one year, live vaccines received in the last 3 months, jaundice, tattoos in last three months, silicone implants and tuberculosis. The donor also has to undergo laboratory tests for HIV 1and 2, HbsAg, VDRL. The doctor later examines the donor for mastitis, local skin lesions in the breasts.
Once the tests are negative the donor is then told to thoroughly wash the hands and the breast, change into sterile laboratory gowns and only then the donors are allowed to express the milk with the help of the breast pumps. The milk samples are later sent for microbiological tests to check for any contamination and only if the reports are negative is the milk then sent for pasteurisation (Holder’s method used at GMC), then brought to room temperature and freezed for later use.
Pasteurised donor human milk (PDHM) which is ready to be given to the preterm or the sick baby is first brought to room temperature and then given to the baby.
Before donation, a completed consent form is taken from the mothers and also duly signed by the relatives. At the same time, the recipients also have to fill in a consent form before the babies are administered the PDHM.
As of February 2018, 19555ml of milk has been received by the DHMB from 858 donors. The figure is increasing substantially every month and the department aims to have 100 % breastfed babies. But more importantly, Dr Sreekumar informs that they have also found out that the mortality rate due to NEC (Necrotizing enterocolitis ~ a devastating disease that affects mostly the intestine of premature infants) in preterm babies has also come down.
There have been cases referred from other hospitals as far as from Karwar, Sawantwadi, Kolhapur, Ankola etc. Such babies have also received the PDHM from here and Dr Sreekumar stated that it would be nice if mothers who have their babies separated and recouping at the GMC, to express and donate milk while visiting their child here.
Also the mentality and the misconceptions with regards to donating breast milk has to change, she states. “Mothers come up with various notions in their minds with regards to donating breast milk as well as accepting milk for their child from other mothers. One has to understand that breast milk is the ultimate and the only complete nutrition that the child has to get at least in the first six months of its birth. Research has proved and also if one compares the health of breast fed babies to that of formula fed, breast fed babies are less prone to asthma, allergies, hypertension, diabetes, obesity and their immune system is much stronger than than formula fed babies,” she explains.
And while, it is a positive sign that mothers are willing to donate their milk, there are other areas which still require work
“Our next aim is to have the milk bank 24/7 so that the babies have access to the PDHM during night hours also. At the moment due to lack of staff, the milk bank is run during the 9am-5pm period and due to which the the babies are switch to formula milk at night. We have tried to make necessary arrangements by getting another freezer in the NICU unit but once the stock is exhausted the babies have to wait till the bank opens the next day,” says Dr Sreekumar.
At the same time, they are also trying to arrange for a freezer in every pre natal ward so that the milk is easily accessible to the babies and there is no wastage. This is because PDHM once removed from the freezer cannot be kept at room temperature for more than an hour to avoid contamination.
“We are also focusing on awareness drives to reach out to the mothers delivered in other hospitals to come and donate. We have also made arrangements to keep the babies and also to feed them while the mother is here to express the milk. There are also suggestions to keep some incentives to the donors which is still under pipeline. But the main motive is to come up voluntarily to donate for a cause. Prenatal counseling is also required so that the mothers know the importance of breastfeeding and also be mentally be prepared to donate their milk after delivery,” informs Dr Kavita.
“During the 30 years of my service in the health department, this has been my most satisfying job. Mothers come here for stimulation of breast milk, engorgement of breasts, abnormal nipples (flat or inverted). While leaving this room, they come and thank us for helping them feed their babies,”says Sister Josephine Fernandes E Periera, senior staff nurse, while requesting that more mothers should come forward.
“It’s not their babies but they should know there are many other lives saved here. In fact breastfeeding mothers have reduced chances of breast cancer,” she says.