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