The American Academy of Pediatrics advises that “the potent benefits of human milk are such that all preterm infants should receive human milk. Mother’s own milk, fresh or frozen, should be the primary diet. If mother’s own milk is not available despite significant lactation support, pasteurized donor human milk should be used.”
The Clinical Case for Pasteurized Donor Human Milk
Human milk is important to the health of all infants, but its effects are even more profound on the morbidity and mortality of preterm infants. This nutrient-rich milk is easily digested, but nutrition is only one of its many functions. Its other functions -- including improving host defense, enhancing immunomodulation and speeding gastrointestinal and neurological development -- may be even more important to premature infants.
Most mothers of premature infants know how important their milk is to their baby. However, many struggle to produce the volume of milk their baby needs. Research indicates that mothers of preterm infants are about three times more likely to have low milk production than term mothers.
Due to the health risks associated with the use of infant formula, in the absence of mother’s milk, pasteurized donor human milk is needed. Even after processing, donor milk provides many of the same protections as mother’s own milk. Feeding preterm infants formula rather than donor human milk more than doubles the risk of necrotizing enterocolitis (NEC). Human milk feedings utilizing pasteurized donor human milk (PDHM) is an essential component of any NICU nutrition program.
Is pasteurized donor human milk (PDHM) cost effective?
The anti-inflammatory and anti-infective factors in human milk have been found to protect medically fragile preterm infants against both NEC and sepsis. A dose-response relationship has been determined with a greater percentage of human milk consumption associated with lower rates of NEC and infection, including meningitis, thus reducing the length of hospitalization for many preterm infants.
In contrast to formula, human milk contains a wealth of protective factors including antibodies, enzymes, growth factors and antioxidants, which all serve important protective functions. In addition to reducing the length-of-stay for many NICU babies, early human milk consumption is associated with fewer hospital readmissions during the first year and better neurodevelopmental scores after 30 months.
After a thorough review of the research, the Surgeon General wrote in her 2011 Call to Action to Support Breastfeeding: “Use of infant formula introduces multiple health risks, such as NEC, in addition to the inherent health risks of prematurity and low birth weight…Human milk is vital to the survival of vulnerable neonates and plays an important role in addressing the substantial burden imposed by NEC on affected families and in reducing health care costs associated with NEC.”
How safe is pasteurized donor human milk?
To ensure the safety of pasteurized donor human milk, our Milk Bank follows strict screening, processing and dispensing guidelines established by the Human Milk Banking Association of North America. These guidelines were established under the advisement of the Center for Disease Control (CDC), the Food and Drug Administration (FDA), and the blood and tissue industries.
Potential donors provide complete medical and lifestyle histories and undergo blood tests similar to the screening for blood banking industries as well as having their personal physician and baby's physician recommend and approve their participation. After frozen donor milk is collected and thawed, it is pooled and pasteurized to eliminate any bacteria or viruses. Before being dispensed the milk is cultured in the CHKD microbiology lab to confirm that it is free from bacteria.
Is there a governing organization for milk banks?
The King's Daughters Milk Bank at CHKD is one of only 26 non-profit milk banks that are members of the Human Milk Banking Association of North America. HMBANA is a multidisciplinary group of health care providers that promotes, protects and supports safe donor human milk banking. It is the only professional membership association for non-profit milk banks in Canada, Mexico, and the United States, and sets the standards and guidelines for donor milk banking in those areas.
Can CHKD provide pasteurized donor human milk to my hospital?
Yes, CHKD can provide your hospital with pasteurized donor human milk. Please call (757) 668-6455 (MILK), or email KDMilkBank@chkd.org for more information.
Who supports the use of donor human milk?