For hospitals and clinicians

All donor milk from our milk bank is pasteurized, nutritionally analyzed, drug tested, and cultured for bacteria post-pasteurization. We offer a number of types of milk to serve the needs of the babies that you care for:

• Term milk: 20, 22, 24 kcal per ounce
• Pre-term milk: Milk expressed in the first 30 days post-partum by a parent delivering at 36 weeks gestation or earlier.
• De-fatted milk: Milk that has been mechanically skimmed. Fat content of 1% or less.
• Cream: The byproduct of the skimming process. Varies in nutritional content. Contact us for more information.
• Specialty diets: Milk that that is donated by mothers with dairy restricted or soy restricted diets. Please note that while such donors are often following these diets because of the health of themselves or their babies, the milk bank cannot verify the diets of d onors.
• Colostrum: Milk expressed during the first 4 days post-partum.

Interested in learning more about our services?

Pasteurized donor human milk in the outpatient setting

Mid-Atlantic Mothers’ Milk Bank provides pasteurized donor milk for both medically necessary and discretionary use in outpatients. A prescription is required for quantities over 40oz/1200ml (total per recipient, not per order).

Medical need describes a situation where a child has a condition that is known to be improved by the use of donor milk or has a formula intolerance that is creating adverse symptoms and suppressing adequate growth.

Discretionary use refers to the use of donor milk in circumstances where there is limited or no access to the mother’s own milk, but the infant has no medical issue that would prevent them from tolerating formula. Examples of discretionary use include scenarios such as adoption, breast surgery, maternal medications, or low milk supply.

Historically, our milk bank has maintained a reliable, ample supply to fulfill all donor milk requests, for both medical needs and discretionary use in our geographical service region. Should a time of shortage arise, hospitals will be prioritized, followed by outpatients with medical needs. For a full explanation, read our distribution policy.

1. Prescription

Per Pennsylvania state law and the guidelines of the Human Milk Banking Association of North America (HMBANA), the distribution of donor milk requires a prescription or hospital order from a licensed healthcare provider with prescription writing privileges who is caring for the recipient child.

You may use our prescription forms or provide your own. Prescriptions must include:

• Recipient child’s name
• Recipient child’s date of birth
• Current date
• The medical reason donor milk is required
• Amount of donor milk required per day (in ml or oz)
• The number of weeks donor milk is required, up to 24 weeks

If the prescription is for a small volume of supplement in the healthy newborn of a breastfeeding mother, bridge milk/insufficient maternal supply can be listed as the reason.

Submit your prescription:

Click here to complete an online prescription form

Click here to upload your own prescription or to alert us that you will be faxing a prescription to 412-281-4236.

If the order is for discretionary use or private pay donor milk the prescription is all that you must provide. For medically necessary donor milk that is to be covered by insurance, pre-authorization must be sought by the prescriber.

2. Insurance pre-authorization

Medically necessary donor milk may be covered by insurance, including Medicaid and commercial plans. Most health plans require pre-authorization, which must be requested by the prescribing healthcare provider. Per health plan protocols, the milk bank cannot request the pre-authorization.

A letter of medical necessity is usually required. You may use your own, or for your convenience, we have a template that you can fill out online and print or save to submit to the insurance plan. It is strongly recommended that you use our template because it includes information that is most commonly required by insurance plans.

If the recipient is currently an inpatient but will require donor milk at home, please have the case manager pursue pre-authorization prior to discharge.

Click here for the letter of medical necessity template

Availability

Our organization relies on the generosity of our donors. Distribution is prioritized by medical need. First priority is given to neonatal intensive care units and hospitals, then outpatients with medical needs, and finally bridge milk and discretionary use. Read our distribution policy.

If you have any questions please contact our Distribution Team at orders@midatlanticmilkbank.org

Donors are healthy lactating mothers who are willing to donate milk beyond their own baby’s needs. It is because of their generosity that we are able to provide our lifesaving service to the tiniest and most fragile residents of the Mid-Atlantic region.

We strictly follow the guidelines of HMBANA which include specific policies that ensure the well-being of the donors and their babies, as well as the donor milk. HMBANA prohibits donor compensation of any type due to ethical and safety considerations.

Donors go through a thorough four-part screening process that includes:

1. Interview: a short phone interview with a donor screener. Medication and supplement use, risks factors for bloodborne pathogens, and other important health related questions are asked.
2. Completion of the application packet: The packet is completed online. The application contains more detailed information regarding medical history, medications, diet, pregnancy, and birth.
3. Statements of health: A one page “statement of health” is completed by the healthcare providers of the donor and her baby.
4. Bloodwork: If no reasons for exclusion are found in steps 1-3, the potential donor goes through blood screening which includes HIV, HTLV, Syphilis, and Hepatitis.

Currently, the milk bank contracts with Quest Diagnostics, Lab Corp, and CORE to ensure that all donors in the region have a convenient option for blood testing. Blood work is repeated in six months if an approved donor wishes to continue donation.

The milk bank’s screeners stay in close contact with donors throughout the time that they donate. Donors are given instructions regarding pumping hygiene, storage, and when to contact us (new medication, illness, etc.).

All donor screeners have maternal child health experience and lactation related education.

Given the fragility of the population served by milk banks, extra precautions are taken to ensure safety. The most common reasons for deferment are medication and supplement use. Anti-hypertensives are prohibited and are a common reason for deferment for donors with babies in the NICU. Certain anti-depressants and other medications, both prescription and OTC, are compatible with donation. Thyroid medication is generally acceptable. The milk bank maintains an updated list of acceptable medications.

HMBANA’s Guidelines Committee meets regularly to assess new medications and screening related concerns. Mid-Atlantic Mothers’ Milk Bank has a Medical Advisory Board of regional experts which includes neonatologists, pediatricians, and infectious disease specialists.

Donation practices are an important consideration when choosing a supplier of donor milk. Using a particular milk bank or company is support and endorsement of the practices of that organization. Exploitive and unethical policies, such as excessive ounce requirements or predatory recruitment practices can compromise donor milk safety and greatly impact the donor family, even undermining optimal nutrition for the donor’s own baby. When ethical, compassionate policies are in place, milk donation can be a very positive and rewarding experience for donors and their families.

We are as equally committed to our donor families as we are to our recipient families. If a mother under your care pursues donation, be assured that she and her milk will be cared for with respect and gratitude.

Important questions to ask about donor practices

Q: Are donors paid? If so, how much?
A: All donors are unpaid volunteers. The milk bank pays for all screening and shipping costs. Storage bags are available upon request. All HMBANA accredited milk banks are strictly prohibited from providing compensation to donors due to ethical and safety considerations.

Q: May I see your recruitment materials?
A: Absolutely! Download our donor info card. Be sure to review the Donor section of this site as well. Social media is a common way that donors find out about our milk bank. Check us out on Facebook, Instagram, and Twitter.

Q: Are mothers required to sign a contract?
A: Never.

Q: How many ounces are mothers required to donate?
A: Mothers are required to donate 150 ounces over several months. This minimum amount helps offset the costs of blood screening. There is no pressure for donors and they are told in writing and verbally that the needs of their baby and family always come before donation. The minimum amount is waived for bereaved donors.

Q: How do you know that a donor’s own baby is receiving all of the milk that he or she needs?
A: Our milk bank has policies in place to help ensure that the donor’s baby is receives all of the milk that he or she needs. The donor and the healthcare provider of the donor’s baby are asked specific questions regarding the donor’s supply and her baby’s growth. A donor’s baby’s human milk needs are always the first priority, even if the baby has weaned from the breast. Due to the reliance on self-reporting from mother to both the milk bank and healthcare providers, we avoid any incentivization of milk donation.

Q: What about bereaved donors?
A: Donation after a perinatal loss can be very healing for some families. We have several programs in place to support bereaved donors and their families. Please visit our Bereaved Families section for more information.

In addition to the testing required by Human Milk Banking Association of North America, Mid-Atlantic Mothers’ Milk Bank performs drug testing and macronutrient analysis on each milk pool.

Drug Testing

Milk Pools are tested for the presence of common substances of abuse including opiates, cannabis, and nicotine. Pools testing positive for any of these substances will be discarded.

Macronutrient Analysis

Mid-Atlantic Mothers’ Milk Bank uses the Miris Human Milk Analyzer, the first and only FDA approved device, to measure the macronutrient content of human milk. All milk pools are tested for kcal, protein, fat, and carbohydrate content.

Bacterial Culturing

Per Human Milk Banking Association of North America guidelines, a random bottle from each batch of pasteurized donor milk is sent for bacterial analysis. Mid-Atlantic Mothers’ Milk Bank uses a third-party certified lab to preform this critical testing. Batches that show any bacterial growth are discarded.

Human milk is a bio-active, dynamic tissue that provides the perfect nutrition for newborns. The less processing of milk, the better. The Holder Method of Pasteurization (62.5°C for 30 minutes), which is the only method approved by HMBANA, eliminates pathogens while retaining much of the bioactivity and important components of human milk.

Milk processing begins with thawing frozen milk overnight in refrigerators. The milk of up to five donors is pooled together to even out nutritional variations and to increase the immunological profile of the milk. Pooled milk is gently mixed and poured into BPA free bottles with tamper resistant caps. Filled bottles are pasteurized in a hot water bath using automated human milk pasteurizers from ACE Intermed.

A random bottle from each processed batch is sent for bacterial culturing. If a batch shows any growth it is discarded.

For a visual explanation of the process, please visit How It Works.

Human milk is not just calories and protein. It contains bioactive components that provide important immunological and microbiome support. While raw milk is best, the fragility of the population served by milk banks necessitates the elimination of pathogens. Retention of bioactive properties is an important consideration in human milk processing, and Holder Pasteurization is one of the best ways to ensure safety while minimizing the destruction of essential human milk components.

Pasteurization refers to a relatively low heat treatment that destroys pathogens. It does not eliminate all of the vegetative microbial population, so pasteurized foods must be refrigerated or frozen to minimize microbial growth. Commercial sterilization involves subjecting food to a high temperature for a sufficiently long time to eliminate all forms of microorganisms and destroy or inhibit enzymes.

Retort sterilization is widely used in food production to create shelf stable storage. This high heat, short time process that requires temperatures above boiling has recently been used for donor milk (121°C for five minutes) processing. While retort sterilization is a very effective way to eliminate bacteria, new studies suggest that retort processing may significantly alter, or even eliminate, bioactive components that are important for the immune system and microbiome.

Read a summary of the research regarding shelf stable products and bioactivity.

Donor milk is stored frozen and transported by courier or shipped by FedEx for overnight delivery. We encourage all facilities to order a copy of HMBANA’s 2019 Fourth Edition of Best Practice for Expressing, Storing and Handling Human Milk in Hospitals, Homes, and Child Care Settings.

Mid-Atlantic Mothers’ Milk Bank is accredited and inspected by the Human Milk Banking Association of North America and follows all applicable state laws in its general service area of Pennsylvania, West Virginia, New Jersey, Maryland, and Delaware.  The milk bank is licensed in the Commonwealth of Pennsylvania and holds tissue bank licenses in Maryland and New York. Federally, donor milk is regulated as food processing, a designation requiring registration with the FDA and is subject to FDA inspection.