After mom, donor milk works for babies
It can provide low-weight babies needed protection
When it comes to feeding their newborns, nearly every new mom has heard the expression “breast is best.” But what happens if her baby is sick, or she can’t provide her own milk, or enough of it?
This is the case for many of the approximately1,500 low-birth-weight babies in neonatal intensive care units (NICUs) across Ontario each year. Their mothers’ own milk offers these infants the greatest protection from medical complications, but when it’s unavailable, donor milk is the next best thing.
Screened, tested and pasteurized to ensure it’s safe for medical use, donor milk is easily digested by the babies who need it. It can reduce their need for intravenous nutrition and offer immunological and anti-inflammatory benefits to help protect the babies from serious infections.
Preterm babies receiving care in NICUs are at risk of medical complications, including a condition called necrotizing enterocolitis (NEC), a devastating bowel condition that can lead to other serious illnesses or even death. Pasteurized donor milk helps reduce the likelihood of these problems.
In addition to providing life-saving nourishment while an infant is in the hospital, donor milk also has the potential to provide benefits after baby goes home.
Recently, I helped lead a team of researchers and clinicians across the GTA to look at the value of supplemental donor milk with respect to the overall health-related costs for families. We found that what a baby in the hospital eats in his or her first three months of life has downstream benefits throughout their first year and a half.
While there were similar costs to the health-care system if very low birth weight babies were fed donor milk or preterm formula while in the NICU, in the long run, the overall health-related costs after hospital discharge were lower for babies supplemented with donor human milk instead of preterm formula.
We factored in all of the expenses a family would have to account for, things like medication and visits to allied health professionals such as physiotherapists or occupational therapists. But what really drove the difference was parents losing time from work and the resulting impact on their incomes. We don’t know for sure, but we think the children in the donor milk group may have had healthier outcomes and thus cost their parents less to care for them. The results from this research study were just published in the journal Pediatrics.
Most moms in the NICU are highly motivated to breastfeed, and when that doesn’t go as planned, almost all of them try to express their milk using a pump. But a small, sick baby cannot feed directly at the breast and must be tube fed, leaving the mother no choice but to pump milk if they want to provide their own milk. It’s much more difficult to pump breast milk than to actually nurse a baby, and it isn’t always enough to stimulate sufficient milk production to support a growing, developing infant over time.
There are also other reasons why a mother with a baby in the NICU might not have a full supply of milk. These moms are often unwell; there’s usually a reason why their babies were born preterm. That, combined with the stress of having a newborn in the hospital can lead to significant issues with milk supply. And, if it’s a woman’s first baby and she delivered early, her mammary glands — the ones active in producing milk — may also still be maturing.
For moms who are able and choose to breastfeed, knowing their milk is helping their babies grow is rewarding. But your milk can also help other infants get their best possible start, too. Thinking of donating breast milk?
Located at Mount Sinai Hospital and supported by the Ministry of Health and Long Term Care, the Rogers Hixon Ontario Human Milk Bank screens donors from across Ontario in order to process and distribute donor milk to the majority of neonatal units within the province.
The requirements for handling milk to donate are different from what you would do when expressing or pumping milk for your own baby. One example of this has to do with the beneficial bacteria normally present in human milk. A healthy amount for your child can be too much for pasteurization to make safe for medical use and thus the milk bank asks that you follow their pumping recommendations to reduce the amount of bacteria in your milk.
Donor moms need to undergo bloodwork and screening to be approved to participate. You can find more information about becoming a donor at milkbankontario.ca.
For donation, milk can be kept in a fridge-freezer for up to three months, or in a stand-alone deep freezer for up to six months.
Dr. Sharon Unger is an associate professor in the Department of Paediatrics at the University of Toronto’s Faculty of Medicine. She is also a staff neonatologist at Mount Sinai Hospital, part of the Sinai Health System, and an associate staff neonatologist at the Hospital for Sick Children. As well, Unger is the Medical Director at the Rogers Hixon Ontario Human Milk Bank and an associate Scientist at the Lunenfeld-Tanenbaum Research Institute. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine.