LIQUID LIFESAVER
Human milk banks are helping nourish newborns. As more banks are set up across the country, mothers who once benefited are returning as donors, mobile van units are gathering breast milk at their doors
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When Rekha Chhaidwal visited Udaipur’s Rabindranath Tagore Medical College to get her daughter vaccinated in 2013, she saw a signboard for the Divya Mother Milk Bank.
Curious, the 27-year-old walked in, and manager Bhawna Joshi told her about how some mothers donate breast milk so that babies whose moms aren’t lactating can benefit. Chhaidwal decided immediately to become a donor.
After the initial tests, she found herself holding a pump and expressing excess milk into a bottle, knowing that it could save the life of a newborn in the hospital’s neonatal intensive care unit (NICU).
That thought excited her so much that she returned 299 times over the next twoand-a-half years and donated a total of 30 litres. Chhaidwal is now planning a third child, and will once again continue donating as long as she lactates.
Women like Chhaidwal are good news for non-lactating mothers, malnourished moms and those with premature babies.
Early initiation of breastfeeding and exclusive breastfeeding can prevent deaths due to diarrhoea and pneumonia. Five countries – China, India, Indonesia, Mexico, Nigeria – alone account for over 236,000 child death every year because of inadequate breastfeeding.
In India, the breastfeeding rate is improving and the latest National Family Health Survey (NFHS) 4 findings showed that 41.6% of children under 3 were breastfed within an hour of birth in 2015-16 as compared to 23.4% in 2005-06.
Close to 55% of country’s children are exclusively breastfed, a number that stood at 46% till about a decade ago. Milk banks are helping bridge the gap. The Divya bank was set up in 2013 by Devendra Agarwal, who ran a neonatal care centre in Udaipur and wanted to ensure that as many newborns were breastfed as possible.
The 74-year-old did some research and discovered that Mewar had a history of
dhais or nursemaids, chosen from the pastoral Gujjar community to breastfeed the king’s babies for additional nutrition. This gave Agarwal the idea of setting up a bank of donated milk.
“Even then, there was a strict selection process,” he says.
At the Divya bank, donors must undergo blood tests before they donate, to rule out any transmittable diseases or infections. The donated milk is pasteurised and kept at -20 degrees Celsius.
“Treated correctly, mother’s milk can be stored for six months,” says Dr BL Meghwal, the bank’s nodal officer.
Agarwal, meanwhile, has gone on to set up 10 other human milk banks, and is now adviser to the Rajasthan government on its mother milk bank project. Seven more are in the process of being set up. RETURNING THE FAVOUR There are now milk banks across the country, from Udaipur to Delhi, Mumbai and Pune. Among the grateful beneficiaries are Singapore-based management consultant Rakhi Saini, 36, whose first child was born premature, at 29 weeks.
“For about two weeks, I had no milk. I was so worried,” Saini says. “Then my doctor at Fortis La Femme told me about human milk banking and eased my mind.”
Fortis La Femme opened its milk bank last year and is already collecting enough milk to help sick babies at other hospitals.
“Ours is a public milk bank; we also send milk to other hospitals. But it’s difficult to sustain donations,” says Dr Raghuram Mallaiah, head of neonatology and founder of the Amaara milk bank.
Among the regular donors right now is Saini, who had a second child in May. “I thought of my premature baby and how some woman helped her, and I wanted to do the same for someone’s child,” she says. SAVING LIVES Of India’s 26 million births, 3.5 million are preterm, of which 300,000 die of associated complications. Breast milk can save an estimated 156,000 of these children a year.
The first human milk bank in Asia opened in Mumbai, in 1989, the brainchild of neonatologist Dr Armida Fernandez.
The bank operates out of the city’s government-run Sion hospital and is now one of six across Mumbai and Thane.
“At the Sion hospital, we explain to lactating mothers that they can help other babies if they donate excess milk,” says current head of neonatology Dr Jayshree Mondkar, who now runs the milk bank. “There are also mothers whose babies are in the NICU and need to express milk to ensure the output doesn’t drop by the time their babies are ready for it. All this goes into our bank, for free access by little patients who need it.” REACHING OUT With donations falling short across milk banks, Dr Sandhya Khadse, dean of the Rajiv Gandhi Medical College in Thane, suggests bringing the concept of human milk vans to Mumbai.
She helped BJ Medical College start one of Pune’s first human milk vans, which began door-to-door collection last August.
“These vans have electro pumps and sterilised storage devices and usually have medical staff on board. They go to the houses of women who have been recently discharged from neonatal care and have had the screening tests,” she says.
Within months, the van had helped double the amount of milk donated to the bank. “There is also the concept of informal milk sharing among mothers, but we do not recommend it at all,” says Dr Fernandez. “Screening tests are a must. The risk of contamination when expressing the milk has to be eliminated. The milk has to be pasteurised and cultured and stored correctly. Unless all these conditions are adequately met, the milk is just not safe for a vulnerable newborn.”