On December 9, the first Human Milk Bank in Northeast was inaugurated in Satribari Christian Hospital (SCH), Guwahati, Assam. It is the 15th such unit in India. The facility can store Human Milk for up to six months to six years.
Assam: A human milk bank has been set up at Satribari Christian Hospital in Guwahati.— ANI (@ANI) December 23, 2020
“We can collect milk from mothers who are willing to donate, pasteurize & store it for up to six months,” said Dr Devajit Sarma, paediatric & neonatal care specialist at the hospital (22.12.20) pic.twitter.com/qQttviHUtZ
Dr. Devajit Sarma, a pediatric and neonatal care specialist at SCH, said that breast milk is the best food for newborn babies. It is recommended to start breast milk within the first hour of birth. “To bring down cases of neonatal mortality and mortality below 5 years of age, exclusive breastfeeding for the first six months,” he added.
Sarma further added that in India, there are many cases where newborns cannot get enough milk in the first few weeks as the mother could be sick or have some infectious disease (such as Covid-19) or she is unable to produce enough milk. “The human milk bank will be the best option for such babies,” Sarma said.
The practice of wet-nursing in which someone in the family or an acquaintance breastfeeds the baby in such situations exists in India. However, doctors suggest that there are some drawbacks to the practice. For example, if the breastfeeding woman is suffering from some infection, it can get transmitted to the baby.
Dr. Sarma said that the babies should get pasteurized milk from a donor that has been stored professionally in a milk bank in such cases. “In the milk bank, we will collect milk from lactating women who are willing to donate. It will then be pasteurised and stored in deep freeze. The milk can be stored from 6 months to 6 years,” he added.
The hospital delivers around 100 babies every month. Sarma added that milk could be collected from some of those mothers who are willing to donate. “We will also encourage other lactating mothers to donate to the bank. In coming days, we might even include some incentives for the donors,” he said.
The milk bank was set up with assistance from Rotary Club. Rs 10 was donated by Rotary Club district 3240 to buy required equipment for the human milk bank in the hospital.
Human Milk Banks can improve infants chances of survival
According to the World Health Organization, every year, more than 20 million infants are born under 2.5 KG weight. Over 96% of them are in developing countries. The low-birth-weight (LBW) infants are at risk of retardation, infectious disease, developmental delay and death during infancy and childhood. Though WHO recommends that the infants should be fed by the mother’s own milk, but in case the mother’s milk is not available, the alternatives include breast milk from a donor or formula milk. Evidence has shown that untreated breast milk from a donor decreases the chances of severe gut disorder, necrotising enterocolitis, and other infections during the initial hospital stay after birth.
Theodor Escherich, German-Austrian paediatrician and a professor at universities in Graz and Vienna, after conducting a study for ten years (1902 – 1911) on different sources of nutrition and its effect on newborns, found that the breastfed newborns have significantly different intestinal bacteria compared to those who were fed by other means. During this period, in 1909, he opened the first Human Milk Bank. Another milk bank was opened in the following year in the Boston Floating Hospital, which was the first Human Milk Bank in the United States.
Human Milk Banks around the world
Europe, South Africa, America, Singapore and Australia have Human Milk Banks. Apart from these countries, Brazil has done exponentially good in the field. With over 217 milk banks, it has the most effective Human Milk Bank system in the world. The first such bank was opened in Brazil in 1985. Since then, the country has reduced its infant mortality rate by 73%, and Human Milk Banks have played a major role in it.
Human Milk Banks in India
Asia’s first Human Milk Bank was opened in India in 1989 at Sion Hospital in Mumbai. Since then, Guwahati’s Milk Bank has become the 15th such initiative in the country. Some of the notable milk banks in India include Vatsalya — Maatri Amrit Kosh, at Lady Hardinge Medical College, and “Yashoda” Human Milk Bank in Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune in Maharashtra.
In 2003, WHO published a paper [PDF] titled “Global Strategy for Infant and Young Child Feeding” in which the organization talked about the benefits of breastfeeding, challenges faced by the mothers and possible interventions of the government and non-government entities to ensure every infant gets human milk for the first six months since the birth. WHO said [PDF] that “every effort should be made to provide mother’s own milk to all newborns, including sick and vulnerable newborns, either directly through breastfeeding or by giving their mother’s expressed breast milk via cup or spoon feeding.”
Why do infants not receive breast milk?
There can be several reasons that can lead to the unavailability of breast milk for the infant. Low milk supply, medical condition, preterm delivery, adoption, surrogacy and unfortunate situations like the death of mother or separation of the infant from mother can contribute to the unavailability of breast milk for the child. In such cases, if a Human Milk Bank is available, the infant can receive professionally stored Human Milk, which will not only save the infant from possible infections but help in proper growth and development.
Lack of awareness of Human Milk Banks
Though India got its first Milk Bank in 1989, there is a lack of awareness around the subject that leaves the parents and families in doubt about the quality and safety associated with donated breast milk. On the contrary, the Indian Government’s National Health Mission has strict guidelines [PDF] in place for the storage and usage of Human Milk in such banks.
In India, Breast Milk Banks are known as Comprehensive Lactation Management Centres (CLMC) and Lactation Management Unit (LMU), depending on the level of health facilities where these units are established. The Indian government has set a target to ensure 70% of infants have access to breast milk by 2025. This target will be increased to 100% with time.
Who can donate milk?
A lactating mother can donate milk for such a bank only after approval from the authorities and proper screening. Any mother who has been approved by the authorities to donate milk should donate only if she has surplus milk after feeding her own infant. It must be done on a volunteer basis.
National health mission has provided a complete set of guidelines on collection, pasteurization and storage of Human Milk in such milk banks. There is a need to make people aware of the availability of such services, and the government should increase efforts to establish more Milk Banks in India to ensure all infants get access to Human Milk.