Kids on the coast

Human milk for human babies

The value of breast milk is well-documented. It provides optimal nutrition for babies and immunological protection against many organisms and diseases. No manufactured product can reproduce the complexity of breast milk which adapts as the baby’s needs change. Formulas do not contain the antibodies, enzymes, hormones or essential nutrients that breast milk provides.

The Australian Government recognises the importance of breast feeding to maternal and child health. An Australian Senate 2007 enquiry, ‘The Best Start’ endorsed the recommendation of the World Health Organisation (WHO) and UNICEF that infants be breastfed for the first six months of life. Concerned about the falloff in breastfeeding rates between hospital discharge (83%) and six months on (18%), the government has committed substantial funding to education and support initiatives to promote breastfeeding. The enquiry also accepted the WHO/UNICEF resolution which stated: “Where it is not possible for the biological mother to breastfeed, the first alternative, if available, should be the use of human milk from other sources. Human milk banks should be made available in appropriate situations.”

The enquiry concluded: “It is clear to the committee that a national network of publicly funded milk banks would give Australian babies a healthier start to life, reduce health care costs and provide real support for mothers who are unable to provide their baby with breast milk.”

Dedicated health professionals and a team of volunteers and supporters have established the first Australian human milk banks, one at the King Edward Memorial Hospital in Perth and, closer to home, the Mothers Milk Bank on the Gold Coast. The Perth milk bank now receives state government funding, but the Mothers Milk Bank receives no government funding, either state or federal.

The Mothers Milk Bank

Marea Ryan, then the nurse unit manager of the birthing unit at John Flynn Private Hospital at Tugun, was so inspired by a presentation on milk banking at the International Lactation Consultants Conference in 2003, she decided to set up a milk bank in Queensland. By 2005, with the help of other medical professionals and many volunteers, it was up and running. Marea is now working at the Tweed District Hospital as a lactation consultant/midwife and nurse. She is also the director of the Mothers Milk Bank, now situated in Banora Point. It is run as a private not-for-profit company, staffed by volunteers and supported by individual and corporate donations and fund-raising efforts. The unit struggles to survive financially despite its proven success in improving health outcomes for the next generation and its potential to save millions of health care dollars. Since 2005, it has been under constant financial pressure, sometimes on the brink of closure, kept afloat only by the determined efforts of volunteers and generous supporters.

One mum’s gift to another

Marea’s belief that mothers who produce excess milk would rather donate it to mums unable to breastfeed their sick or premature babies than pour it down the sink, proved correct. There was, and still is, no shortage of donor mums.

Therese Hoi from Robina is mum to five-month-old Sofia and has been donating her excess milk to Mothers Milk Bank for three months. Therese had an abundant supply of expressed milk in the freezer and didn’t want it to go to waste. She went online, found Mothers Milk Bank and contacted them to offer her milk. Therese wants to encourage other women to donate. “To be able to help other mums is very rewarding,” she says.

Robina’s Lisa Nielsen, a primary school teacher, is now mum to Isabel, 4, and Alexander, 22 months. When Isabel was born at 32 weeks gestation and needed to be fed every three hours, Lisa’s milk was slow to come in and her milk was supplemented temporarily with formula. When she was able to breastfeed her daughter fully, she found herself with “a bountiful supply and throwing a lot away”. A midwife suggested she consider donating the excess milk to Mothers Milk Bank and Lisa became one of the early donors to the fledgling service. Lisa continued to donate milk after the birth of her second child and says it is very little extra work. “I was expressing the excess milk anyway,” she says. “It has become a part of my routine.”

Lisa is now a co-director of Mothers Milk Bank and also volunteers with the Australian Breastfeeding Association. How does a busy mum manage to volunteer so much of her time to help other mums? “Do what you can when you can is my motto,” Lisa says. She is passionate about supporting mums in their desire to provide their babies with the best possible start – their own breast milk, or donor milk as the next best option. The milk donated by Lisa and other donor mums is collected, screened, pasteurised and then frozen into small amounts for distribution by the Mothers Milk Bank.

Lisa believes that all Australian women should have this choice available to them. “Unfortunately, Mothers Milk Bank doesn’t have the ability to pasteurise the quantities of milk that we could if we had paid staff in the centre,” Lisa says. Fellow Director Marea says there are freezers full of milk going to waste and a long waiting list to access it, but government funding is needed to process and deliver larger quantities of milk.

‘Liquid gold’ for vulnerable babies

Families, often fathers, contact the milk bank wanting human milk for their sick or pre-term babies. Premature and sick babies have first priority because breast milk is vital to their survival and long-term health. There may also be a history of allergies in the family, making formula a risky choice. Mothers may not be able to feed for a variety of reasons such as having cancer or other medical conditions. They may have had multiple pre-term births, be suffering post-natal depression or be on medication contraindicated for breastfeeding. Sometimes mothers cannot feed their infants because they are under too much stress to produce enough milk.

Diane and Matthew Beswick from Springfield are currently receiving donor milk from the Mothers Milk Bank for their 10 week-old twins, Abbey-Rose and Hannah. The twins were born at 31 weeks and Diane wanted to breastfeed to give their babies the best chance for short and long-term healthy development. Unfortunately, Diane’s milk supply was insufficient to feed the babies and donor milk was suggested. Matthew says it was comforting to know that the donor milk was available while dealing with the emotional issues of his wife’s faltering supply and concerns for the babies’ health.

Diane and Matthew took their babies home at six weeks but Abbey-Rose returned to hospital a week later. Diane was able to feed Hannah both donor milk and her own milk at home. Matthew stayed with Abbey-Rose in hospital. Donor milk saved Abbey-Rose from bouts of vomiting and protected her fragile gut. Small amounts of breast milk (Diane’s or donor milk) allowed Abbey-Rose to tolerate some formula.

Having weathered the worst, financial considerations are now causing concern. It costs the milk bank $60 per litre to process the milk and this must be passed on to the client. Matthew says that family finances may dictate tapering off the donor milk, despite its benefits.

Milk banks – an important public health investment

For centuries, babies whose mothers cannot feed them have been breastfed by other lactating mothers, a practice known as ‘wet-nursing’. Since the invention of refrigeration, milk banks have operated in Europe but during the 1980s many were closed during the HIV/AIDS scare for fear of transmitting disease through donor milk. The fear proved unfounded as there has never been a case of virus transmission in donor milk. Research has since shown the effectiveness of pasteurisation techniques in eliminating HIV and other viruses and milk banks are now known to be a safe source of human milk.

Milk banks now operate across Europe, Asia and North and South America and governments consider that they receive a good return on investment. The Brazilian Government, for instance, estimated in 1999-2000 that the milk banks had saved the government $620 million.

In Australia, Professor Peter Hartmann of the King Edward Memorial Hospital in Perth told the Senate enquiry into breast feeding that if a premature baby in the hospital is given breast milk instead of formula, the recovery period is shortened by two weeks with a cost saving of $18,200. Multiply this figure by the number of premature babies born in Queensland each year (around 4700), and a few million invested in milk banks looks like a bargain.

The National Breastfeeding Strategy 2010-2015, while promoting breast feeding, ignores the fact that thousands of families are unable to provide breast milk for their babies. It supports the idea of milk banks but neither the federal or state government is willing to invest in it. As a step in the right direction, the Mothers Milk Bank has suggested that the State Government could contract it to supply breast milk to the major public hospitals instead of buying formula or cow’s milk. A healthy return on investment guaranteed!

The Member for Tweed Geoff Provest told the NSW Parliament in March of the vital work of the Mothers Milk Bank. He called for financial support from the Government, saying that the constant fundraising “has kept the wolf from the door” but lack of funding is restricting the ability of the bank to service many who need help. He described the State Government’s unwillingness to fund the bank as “short-sighted”.

Why use donor milk?

Donor milk offers many of the benefits of human milk for an infant, including:

Optimal nutrition that confers health advantages that persist later in life

Easy digestibility – some babies cannot tolerate formula or cow’s milk

Immunological protection against many organisms and diseases

Infection-fighting components such as immunoglobulins

Human milk also contains growth factors that can:

Protect immature tissue

Promote maturation, particularly in the gastrointestinal tract

Promote healing of tissue damaged by infection

(Source: Mothers Milk Bank: www.mothersmilkbank.com.au)