Order milk

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. In the event 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. Read our distribution policy.

If you have any questions please contact our business manager,
Sara Vins Bobish at 412-281-4400 ext. 111.

For families needing milk on an outpatient basis

There are many reasons why a family may order donor milk for outpatient use.

Babies 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 who are not thriving and growing adequately, even with a prescription formula. Donor milk can make a big difference for all of these babies.

Sometimes a small amount of supplementation is required for well babies in the first two weeks of life as mothers work on establishing their milk supplies or work through latching difficulties. We refer to this as “bridge milk” because it is bridging the gap as these issues resolve.

Costs

Donor milk processing fees ($4.50/oz) cover the costs of donor screening, milk testing, bottling, and pasteurization. Medically necessary donor milk may be covered by insurance.

Medical need vs discretionary use

Insurance may cover a documented medical need for donor milk. If insurance coverage is unavailable, families in our region with an infant with a documented medical need may also be eligible for the income based sliding scale discount program. A baby with a medical need for donor milk may have a condition that is known to be improved by the use of donor milk or a formula intolerance that is creating symptoms and not supporting adequate growth. Documented trials of formula, often 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 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, or low milk supply.

Ordering outpatient donor milk for your child

For orders of bridge donor milk or discretionary use donor milk for no longer than two weeks to be picked up at the milk bank or a local dispensary, follow the instructions of our Donor Milk in You Neighborhood Program. Please contact the milk bank at 412-281-4400 or orders@midatlanticmilkbank.org to arrange for pickup before filling out the form.

For donor milk use exceeding two weeks or for donor milk to be covered by insurance follow these instructions:

1. Contact your child’s healthcare provider
It is important for your child’s healthcare provider to be aware of supplementation that your child receives. A prescription is required for more than (12) 100ml bottles of donor milk (total over a recipient’s lifetime, not per order). The prescription must be written by a licensed healthcare provider (doctor, physician’s assistant, nurse practitioner) who is caring for your child.‌‌‌

If you are pursuing insurance coverage for donor milk, the prescribing healthcare provider must contact your child’s health insurance plan to request pre-authorization. Refer your child’s healthcare provider to our website or give them this Prescriber Info Sheet.

Please note: You do not need a prescription for small amounts of bridge milk. A prescription is only required for use beyond 40 ounces, total per recipient child, not per order.

2. Contact us
Complete our Outpatient Donor Milk Recipient Inquiry Form
or call us at 412-281-4400.

3. Complete the Recipient Family forms and make payment (if private pay)
A link to the appropriate forms will be sent to you after we have communicated with you and have learned of your child’s specific needs.

4. Arrange for pickup or shipping
Overnight shipping or pick up at our lab in Pittsburgh or a dispensary near you will be arranged.

For inpatient private pay

Occasionally, a family whose infant does not meet the hospital’s criteria but still chooses to use donor milk. In these cases, the milk processing fee is paid for by the family.

Most commonly, a well newborn has received a small amount of bridge milk as a supplement in the hospital and a family needs a few bottles to take home at discharge.

Each hospital orders a supply of donor milk and distributes it according to evidence-based guidelines developed by the clinical team of each institution. These guidelines may be based on gestational age, weight, or other risk factors. Under the most common structure of inpatient insurance reimbursement, it is typically the hospital that pays the milk processing fee.

If your family is using private pay donor milk on an inpatient basis you may pay here.