If your institution would like to begin ordering donor milk from Mid-Atlantic Mothers’ Milk Bank, please email us at orders@midatlanticmilkbank.org to create a user name and password. You will find all of the information that you need including storage and handling guidelines and even sample protocols. If you have any questions or would like an information packet that includes samples of our patient education materials sent to you, please contact Executive Director Denise O’Connor at doconnor@midatlanticmilkbank.org or 412-281-4400 ext. 101.

A prescription is required for donor milk. The script must contain the recipient’s name, date of birth, reason for the need for donor milk, applicable diagnoses, and the amount of milk needed per day or week. You may use our sample prescription if you choose. Prescriptions should be emailed to orders@midatlanticmilkbank.org or faxed to 412-281-4236. Please instruct families to visit our ordering portal where they will find all of the information they need.

If applicable, we ask that you request an insurance authorization number. The HCPCS code for donor milk is T2101 “human breast milk processing, storage, and distribution”.  There is no CPT code for donor milk at this time.

There are many reasons why a family may directly order donor milk.

Children with certain conditions, such as malabsorption disorders, gastrointestinal disorders, congenital heart disease, and allergies, can greatly benefit from the nutritional and immunological support of donor milk. Occasionally, there are infants that are not thriving and growing adequately, even with a prescription formula. For these children, donor milk can make a big difference.

Sometimes supplementation is required for well babies as mothers work on establishing their milk supplies or work through latching issues. The use of donor milk to bridge the gap as these issues resolve may be a helpful tool to get breastfeeding on track.

If you think that donor milk may benefit your child, please contact your health care provider. Do not hesitate to contact us at orders@midatlanticmilkbank.org or 412-281-4400 if you have any questions.

Availability

While the Milk Bank currently has an ample, reliable supply, and expects to be able to fill all requests, we cannot control availability. Our organization relies on the generosity of our donors. In the event that there is a shortage of milk, 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.

Costs and Insurance Coverage

For hospitalized infants, hospitals purchase milk and use it according to the criteria developed by each individual institution. If a family wishes to have their infant receive donor milk but the baby does not meet the hospital’s inclusion criteria (often based on weight, gestational age, or condition), it is often possible to make arrangements to private-pay for donor milk. Please contact us at orders@midatlanticmilkbank.org to learn more.

Insurance may pay for outpatient donor milk when there is a documented medical need. Coverage for donor milk is evolving in our region, and we are seeing more cases being covered. In August of 2017, the Pennsylvania Department of Human Services added Medicaid coverage for medically indicated donor milk.

Donor milk may also be purchased using employee Health Flexible Spending Accounts. Parents need to contact their employer for more information.

The Milk Bank recognizes the high cost associated with long term use of donor milk. To assist families in PA, WV, NJ, and MD, we have an income based sliding scale discount program (10%-90% discount) for children with a medical need for donor milk. The program is made possible through generous donations. To apply for the program, please email us at orders@midatlanticmilkbank.org.

Medical Need Versus Discretionary Use

Insurance is most likely to cover a documented medical need for donor milk. This could describe many situations. A child may have a condition that is known to be improved by the use of donor milk, or a child may have a formula intolerance that is creating symptoms and suppressing adequate growth. Documented trials of formula, perhaps including a specialty prescription only formula, may be required.

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