Breast milk processing

Breast milk donation saves babies, helps grieving moms find meaning in loss

PennLive (May 8, 2015) – She knew her baby wouldn’t survive, but from a place of unspeakable pain she chose to help someone else’s child.

That’s a common scenario in the neonatal intensive care unit at The Children’s Hospital of Philadelphia.

While finding the courage to say the hardest goodbye they’ve ever known, grieving mothers summon the will to selflessly donate their breast milk to tiny newborns fighting for their lives.

“This gives meaning to my child’s life,” is what Diane Spatz often hears.

As director of the lactation program and milk bank at CHOP, she can easily recall several examples of moms helping moms:

There was the mom whose child didn’t survive and spent an entire maternity leave using a breast pump to provide milk for someone else’s baby.

There was the mom from out of state whose baby was in critical condition and not going to make it, but she amassed an industrial freezer full of breast milk during the child’s life and donated it to CHOP.

There was the mom who had a special needs baby and pumped for more than a year. Her child was nourished through a feeding tube, and she donated more than 2,000 ounces for other babies.

“Even though their child or children didn’t survive, they’ve helped countless other babies,” Spatz said.

Since 2010, moms of NICU babies at the Philadelphia hospital have donated 120,000 ounces of milk.

That milk has been sent to an Ohio milk bank to be processed and sold back to CHOP.

But on July 1, the Philadelphia hospital will begin pasteurizing its own milk and be home to the first human milk bank in Pennsylvania.

‘Liquid gold’

Breast milk is the recommended food source for all babies, but it becomes life-saving for those born prematurely or staying in the NICU.

That’s why it’s a priority in CHOP’s care plan for babies in the hospital.

“We’re very serious about our pumping here. Within one hour of birth, we have mothers using a hospital-grade pump on both breasts,” Spatz said.

CHOP’s breastfeeding rate is high, with 99 percent of mothers pumping after delivery and 86 percent of its babies going home on a breast milk diet.

Spatz, who is also a professor at the University of Pennsylvania School of Nursing and nurse researcher at CHOP, has seen overwhelming evidence of the power of breast milk.

“We know human milk can safely navigate a NICU stay,” Spatz said.

Breast milk is the only food that can reduce the risk of necrotizing enterocolitis, an intestinal infection that can be fatal to premature babies. The infection causes the bowel to die and leads to short gut syndrome.

“One thing we can do that really protects babies is feeding them a human milk-only diet,” Spatz said.

“Mom’s own milk is the very best thing. Donor milk is not a replacement to mom’s own milk,” she added.

But for a mom who can’t produce enough milk, due to a previous breast reduction or mastectomy, donor milk is “a much safer and better alternative than formula,” Spatz said.

Donor milk is also needed for babies who are transferred to the children’s hospital 60 to 90 days after birth in situations where breastfeeding hasn’t been established.

“It’s particularly important for NICU babies for how vulnerable they are,” she said.

CHOP has been using donor milk for about 14 years, but six years ago Spatz wanted to expand the program to establish a milk bank at the hospital.

It was approved, and for three years the Human Milk Management Center has operated there. The center has been able to collect human milk, but it’s had to pay another facility to process it.

Frozen milk was sent to OhioHealth Mother’s Milk Bank, which pasteurizes it and sells it back to CHOP. The Ohio milk bank also serves Harrisburg Hospital, Penn State Hershey Children’s Hospital and Heart of Lancaster Regional Medical Center.

Breast milk, often referred to as “liquid gold,” sells for about $4.25 per ounce, according to medical reports.

Babies, depending on their age and health, typically consume from less than half an ounce to 6 oz. per feeding. Newborns nurse eight to 12 times per day.

CHOP has a 100-bed NICU and a cardiac intensive care unit that cares for up to 15 babies. Most of those babies are nourished by their own mother’s milk, with 10 to 12 babies receiving donor milk.

The hospital also has a large oncology unit that uses donor milk.

“We have babies with cancer here, and there are immune properties in breast milk they can’t get from formula,” Spatz said.

How it works

Once CHOP is ready on July 1 to start pasteurizing donor milk, its milk technicians will do some practice runs.

The pasteurization process for breast milk involves a heat treatment and testing to make sure it’s safe for consumption and free of bacteria.

That process will be evaluated by the Human Milk Banking Association of North America.

Once the association signs off on the milk bank at CHOP, the hospital can begin screening donors the way the Ohio bank had done for CHOP previously.

The screening process involves an extensive medical background check and the donor must meet several qualifications before donating breast milk.

Culture of breastfeeding

Should CHOP collect more breast milk than it needs for patients, it will be distributed to other milk banks in the country.

“All the milk banks work together to ensure equal distribution,” Spatz said.

Currently, there are 14 milk banks in the U.S. and three in Canada. The closest one to this region is OhioHealth in Columbus.

Another 10 are in development, including the one at CHOP and the Three Rivers Mothers’ Milk Bank in Pittsburgh, which is slated to open in August or September.

While the number of milk banks is growing, there are still just 40 percent of NICU hospitals using donor milk, Spatz said.

“The science of human milk and the benefits of breastfeeding are well articulated to show less infections, better developmental outcomes, higher scores on intellectual testing, healthier babies. Human milk is powerful, but I don’t know if our culture has fully embraced that yet,” she said.

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