Dear Lactnetters: I just joined the list so that I can provide accurate
answers to some of your questions. Please feel free to e-mail me
privately as well.
Rachel had a question about donors and pooling. We do pool donor milk
from several donors but the donor ID# of each one is tracked through the
lot numbers. So, although the patient's name, donor # and health info is
only known to the milk bank, we can track the donor #'s to the finished
lot of processed donor milk.
Kathy's concerns below are valid ones and I'm happy to address them.
From Kathy:
"Here's my fear--a consistent formulation of 20-24 calories--just like
formula--may seem more attractive to many physicians and parents than
trusting to nature and the superiority of mother's own milk for her own
baby. This just doesn't feel right to me--the idea that the milk for
sick and premature babies needs to be "consistently formulated" by a for
profit company. And as many have poined out mothers donating are not
reimbursed. And how IS it formulated?"
Kathy Boggs, RN, IBCLC
Neonatologists want to use breastmilk. It's indisputable that babies,
especially sick ones, need it. We always tell the neonatologists and
parents that the mom's own milk is the best possible food for the baby.
But, the sad fact is that when there is no pumped milk available, most
sick babies are still getting artificial baby milk.
Because of this, many NICU's keep babies NPO for a very long time, causing
more problems. Neonatologists have stated that, if there is no mother's
milk available, they would like very small (1-2ml) doses of donor milk
for "trophic feeds" so that the babies' gut can be stimulated. The 20-24
calorie donor milk is only for babies who 1) don't have mother's milk
available to them or (2 mom is pumping but has either run short on milk
supply or the milk has not yet "cleared" of meds, etc.
When a mom's own milk is available, it sometimes lacks the needed protein
and caloric levels to facilitate growth of a baby that weighs less than
1,500 grams. In that case, they usually use human milk fortifier, which
has always been made from bovine protein. Now, they can use a human milk
fortifier made out of real human milk.
You are right, mothers who donate milk to milk banks in the US are not
compensated. For the most part, they are donating excess milk- stockpiles
that they have pumped and kept in the freezer. Often, they have so much
milk, they simply want to put their supply to a good use and not have to
discard it. Many have had preemies in the past and so they know how
difficult it is to maintain a milk supply when your baby is critically
ill. So, they donate (knowing that their milk will be tested, blended,
formulated, pasteurized and sold to hospital NICUs.) And they know that
the company doing this (Prolacta) is a for-profit company. Their main
concern is that babies who need breast milk will get it.
Your last question is on formulation. The milk is pooled and blended.
Then, it is tested to see the total protein, fat and carb. content. To
increase protein, concentrated human milk proteins are added as well as
human milk fat until the desired levels are reached. The total calories
cannot just come from fat, since these very low birthweight babies need
protein to grow. After the right levels are reached, the milk is
pasteurized, filled into oral syringes, frozen and kept in quarantine
until all final testing is done.
Please feel free to contact me if you have more questions. I hope this
answers the ones posted recently.
Elena Medo, CEO
Prolacta Bioscience
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