Rachel
Thank you very much for replying with info about the Norwegian donor milk
policy and practice. Wonderful story about the Somali mother! Thanks for
explaining. I see now - mothers are screened for HIV at birth - so that it
would not be possible for an HIV+ mother to provide breastmilk without
having been screened - rather than testing the milk itself for that
particular virus. Makes sense.
What a wonderful system you describe. I'm green with envy!
Pamela
At 08:53 31/01/2006, Rachel Myr wrote:
>Pam asks how milk is tested for HIV. It isn't, to my knowledge, nor is it
>tested for any other viruses. If I am mistaken on this I will let you know.
>Milk is cultured for bacteria. Donors are tested for evidence of various
>viral infections, current or past. Women with no evidence of CMV infection
>are in demand as donors for the smallest, most premature babies, because
>they are only given banked milk from CMV-negative donors. If their own
>mothers test CMV-positive, the babies can still have their own mothers'
>milk. CMV isn't such a concern for babies of higher gestational age.
>
>I recently encountered a Somali woman whose baby was born at 33 weeks by
>emergency CS for cord prolapse. She vehemently refused to allow her baby to
>get donor milk when approached about it in the recovery area after her
>surgery under general anesthesia. She requested a clean container and
>promptly expressed enough colostrum to feed the baby then and there, and
>continued to do so from then on. I removed her staples on day 5 and asked
>her then about her attitude to donor milk, because I was curious. She
>explained that a woman who provides milk for a baby, becomes its mother, and
>her baby already had a mother, namely herself. "One baby, two mothers, not
>good!" was her explanation. "If I die, and of course I hope that I don't,
>insh'allah, then my baby would need another mother. But I am alive." Then
>she added as an afterthought, "Some men want to have two wives. I don't
>like that either."
>
>I have to say it is a lot more fun caring for immigrant women when we can
>converse about things, not to mention how much more I can learn from them
>under such circumstances.
>
>Our practice with regard to testing of donor milk reflects several things
>about Norway: the low prevalence of many serious viral infections in the
>childbearing population, the easy availability of testing for potential
>donors, and the high prevalence of lactation, making it possible for us to
>be choosy about whose milk is accepted for use by premature or ill babies.
>If this were a country with high prevalence of HIV infection, or even
>Hepatitis B and C, we would likely have different policies. Current policy
>here is to give HIV-positive women cabergoline when the baby is born and the
>option of breastfeeding is not considered for one moment.
>
>Rachel Myr
>Kristiansand, Norway
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