We've never been to the point where we had too much milk and had to stop
accepting donors, but please don't let that discourage you. Perhaps Denver
or San Jose could accept your milk. In Austin, we are currently not
accepting out of state donors because of the high shipping costs.
That said, I want to vent a little about milk banking issues.
As a milk banker, it is extremely frustrating for me to have to turn down a
baby because their need is not high up enough on the priority list. As I am
writing this, I took a call from a father whose breastfed son is not
regaining his birth weight and, rather than give him formula, he and his
wife want to use donor milk. Should that baby have donor milk? You betcha.
Do I want that baby to have donor milk? You betcha. Can we provide donor
milk for that baby? Sorry. Donors ebb and flow and there are weeks when I
wonder if we will have enough milk to pasteurize. Then there are times when
we have plenty of milk to pasteurize but staffing and budget constraints
prevent us from adding extra pasteurizing sessions. But supply is not really
the problem. The wonderful donor moms will always be there. It is amazing
how they respond to stories about us in the media, and even more amazing how
just when we need milk, the door will open and here comes a mom with a
cooler full. When mothers hear there is a need, they produce.
I see the issue more in terms of demand and reimbursement. As professionals,
we need to create the demand. I am preaching to the choir when I talk to
this group about donor human milk being preferable to formula. But as long
as there are neonatologists out there willing to be quoted in a national
news story on milk banking saying, "I would never use banked milk - you
don't know what's in that milk. They may get milk from drug addicts.", we
have a problem. It is the physicians who will write the order for donor milk
(all banks dispense on prescription) and there is a persistent attitude
amongst the majority that there is no benefit, and even potential harm, in
using banked milk over formula -- despite research to the contrary. We must
use every opportunity to convince physicians of the superiority of donor
milk over artificial subsitutes.
And at the same time we need to work on the insurance companies, for whom
this should be a no-brainer. Premies fed human milk go home faster than
premies fed formula, up to 14 days sooner in one study.One week's worth of
donor human milk for the average premie will run between $250-400 compared
to I don't know how much for one week of NICU care. Slam. Dunk. Yet few
insurance companies get it. In Texas, Medicaid pays for donor human milk --
until the baby turns 11 months, at which time the baby is supposed to get
over it, I guess. Moreover, I hear that hospitals are complaining about how
much they are spending on donor milk. This makes me nervous. Will they
someday stop ordering because they think it is too expensive? They probably
wouldn't if they could bill the insurance companies for the cost of the
milk. If demand drops, income drops and our ability to pasteurize more milk
drops too.
In terms of reimbursement, though, I am not talking about the parents
paying. It wouldn't be ethical to choose one recipient over another based on
ability to pay. Nor would we refuse service because the parents cannot pay.
I don't know any parent that could pay the entire bill -- a one-month supply
of donor milk for an out-patient baby would cost over $2400. But if the
parents, can't pay, and the insurance companies won't pay, and the hospitals
stop ordering, well, where does the money come from to pay the extra people
to pasteurize more milk?
Sorry for the long post. Just needed to get a few things off my chest.
Kay Rybiski, RNC, IBCLC
Mothers' Milk Bank at Austin
----- Original Message -----
From: "Fiona & Steve Dionne" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, April 10, 2002 2:52 PM
Subject: donating milk
> I called to donate my own milk. they explained to me that they were over
> run with milk and were not accepting any donations unless you were on a
> dairy free diet. I kinda felt dissuaded.
Doesn't that kind of say something? I.e. that they need to get more
people processing the milk, or open up another bank or something? There
are so many babies who could profit from human milk, and a lot of them
are turned down, even if they want to pay the hefty sum for it, just
because they are not the first priority (i..e not preemies, or babies
severely allergic to all formulae). :-(
That aside...you can always look into personal donation I guess. :-) A
lot of moms are willing to go that route.
I donated to a mom who had had a breast reduction for 8 mos. She was
never able to give ONLY human milk to her baby, even with my 4-8 oz per
day, but she figured that less formula was better than more.
Fio
ressource person for Allaitement Québec
Mama to Sandrine, 2yo! and #2, 11/2002
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