Banking Milk for Health

Canada's only human breast milk bank is threatened with closure.

Donor human milk banking is a service which collects, screens, processes and dispenses breast milk. Nothing is better than mother's milk right from the breast, but for those babies for whom this is not an option, donated human milk is far superior to formula.

The practice is not new only the name "milk banks" is. Since time immemorial women have been sharing their breast milk, and the practice of "wet nursing" has been as common as other social relationships. The famous Dionne quintuplets of the 1930s owe their survival to breast milk that poured in from across Ontario and even the northern bordering US states.

The United States has seven dispensing and one research human milk bank. The United Kingdom has at least 12, endorsed by the British Pediatric Association; France has 18 and Australia is now establishing milk banks.

Suspicion of breast milk in Canada, as irrational as that might be, was given a boost when the Nutrition Committee of the Canadian Pediatric Society made its unfounded recommendation to discontinue breast milk banks in Canada. The resulting public outcry from those who valued this important resource for mothers and babies, has kept the BC Children's Hospital Breast Milk Bank open to date, but moves are again being made against this valuable life-giving resource.

Although some human milk banks dispense milk to both premature and older infants, Canada's milk bank serves older infants and young children for whom there are no other feeding alternatives or for whom metabolic stress must be minimized. For example, infants with gastric surgery healed faster and had fewer complications. Donor milk has also been used in chronic renal failure.

Human milk places the least metabolic stress on failed kidneys, because of its ideal electrolyte balance. It also provides adequate nutrition for this group of infants who routinely have weight gain problems. Those who have cardiac anomalies or failure to thrive have also benefited from donated human milk as have those with feeding intolerance.

When an infant is intolerant of cow's milk proteins or other formulas, donated milk provides optimal nutrition as well as the opportunity to repair damaged tissues. For many high-needs infants multiple problems exist and the availability of human milk may be the difference between life and death.

Research on premature infants who received their own mother's milk or some donated milk indicates that long-term permanent damage may be alleviated. They had considerable less risk of development of necrotising enterocolitis

Milky Resistance

Despite the documented cases showing the valuable contribution of human milk, the Nutrition Committee of the Canadian Pediatric Society has produced a statement that virtually bans all human milk banks in Canada. This is why the only remaining milk bank remains under threat of closure. It is only with the advocacy of much letter writing and education on the issue, that the Children's Lactation Support Services still remains open.

The Lactation Support Services at the British Columbia Children's Hospital in Vancouver follows a series of strict guidelines to ensure a safe and reliable human milk supply. Milk donors are screened, tested for HIV and hepatitis and the milk is pasteurized before use. (Editor's Note: Pasteurizing breast milk, however, reduces the efficacy of the natural food. Heat destroys digestive enzymes as well as some vitamins and minerals essential for optimum nourishment.) No cases of any viral transmission through banked milk collected processed according to approved guidelines has ever been reported.

The hospital's spokesperson, Ms E Riley said the impending closure was due in part to inadequate demand and lack of education on the part of physicians.

"While we strongly support breast feeding, there is extensive clinical research documenting that formula fed newborns are not disadvantaged in their development and growth in comparison to breast fed babies," she said.

Ignoring the unique requirements of a wide range of high needs infants when mothers are unable to provide their own breast milk, will certainly cost the health care system millions more in long term costs, while children and their parents suffer the consequences.

Clinical Uses of Donor Human Milk

Nutritional: Prematurity, failure to thrive, malabsorption, renal failure, feeding intolerance, inborn errors of metabolism, post-surgical nutrition, burns.

Treatment for infectious diseases: Intractable diarrhea, gastroenteritis, ulcerative colitis, infantile botulism, sepsis, pneumonia.

Immunodeficiency disease: Patients undergoing immuno-suppression therapy, allergies, IgA deficiencies. Preventive: AIDS, Crohn's disease, colitis