Hello Elena

Thank you for answering the list's questions.  I have found all the recent 
milk banking posts very informative and thought-provoking.

I am involved in a non-profit milk bank, so have some experience in 
distributing milk.  I have a question about the syringes, which are a new 
addition in our system (the part that it out of our control, ie within the 
hospital).

I believe that our NICU nurses use syringes to draw up the individual 
amounts per baby from the pasteurised jars - one jar will of course feed 
several babies in one go, because they are taking such small quantities.  I 
have  always been concerned about the potential for contamination, which is 
why I was fascinated to see that you use syringes too, though you supply 
them frozen to the hospitals.  I see the convenience of the syringes, just 
wonder about how *sealed* they are from outside contamination.  The HMBANA 
guidelines recommends a "one-cap" container, which I think is meant to 
address the issue of not freezing in bottles with nipples attached.  I 
couldn't see anything addressing oral syringes.

Are you ever in a position to do the microbiology on such syringes once 
distributed to the hospitals and defrosted there?  This would be to see how 
uncontaminated the syringe content stays.  Are syringes commonly used to 
store foodstuff (or even medicines) long term in other situations?

I was also interested in your formulation explanation.  I'm unfamiliar with 
the research in using HUMAN milk ingredients to fortify milk for premies. 
Is there much of this research around, or have you had to do that yourself? 
Which leads me to the question of sharing/selling your protocols, 
information and research.  I think many of us would like to learn more YET I 
expect that as a for-profit company much of this would be seen as something 
best kept private.  I very much appreciated Naomi's letter about the 
differing focuses that a non-profit milk bank has compared with a company. 
By the way, does anyone know much about the Australian for-profit milk bank?

Just a comment, the real questions are finished :-))  We have yet another 
scenario possibly developing here - if a private hospital sets up its own 
milk bank for its own patients and presumably charges for the milk: would 
that be seen as "for-profit" milk banking, or merely serving a community 
need?

I see each type of milk bank as filling its niche, and I agree with Kristen 
that this all has the potential to boost the value of breastfeeding in the 
eyes of the public.  I'm not sure why, in this century, we look so askance 
at the idea of mothers selling their own product?  I certainly appreciate 
the potential for abuse, and know that the lactation community is 
resourceful enough to guard against that.  And besides, it's not like 
selling an irreplaceable kidney, but a truly renewable resource.

Best wishes
Jacquie Nutt
Associate of the South African Breastmilk Reserve

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