PHILADELPHIA — Cora Conte was born three months premature, weighing less than 2 pounds.
She couldn’t breathe on her own, so she had a breathing tube. She had jaundice, a condition in which the liver doesn’t function properly. She received tiny amounts of mother Leah’s breast milk through a feeding tube.
Unable to directly breastfeed her daughter, Leah Conte pumped and stored her breast milk. Soon, she had stocked the freezer at the Hospital of the University of Pennsylvania, where her daughter lived for two months. She bought a deep freezer for her home in East Windsor, New Jersey. That, too, was filled with more breast milk. Soon, Leah realized her daughter, who’s now 3 months old and weighs 6 pounds 5 ounces, would never use all the breast milk she had frozen.
Instead of discarding the unused milk, Conte put it to good use — feeding medically fragile babies like Cora in hospital neonatal intensive care units throughout the country.
Earlier this month, Conte donated approximately 500 ounces of breast milk — enough for up to 166 feedings — to a new milk depot in Bensalem created by home medical supply company Acelleron Medical Products. That milk will go to a milk bank, where it will be pasteurized and then distributed to hospitals to feed babies like Cora.
“After being at HUP, I saw there are so many medically needy and premature babies that really need donor milk,” said Conte. “Breast milk for medically fragile and premature babies is so important.”
Dr. Diane Spatz, director of the lactation program at The Children’s Hospital of Philadelphia, which has a milk bank, explained: “Human milk can be the difference between life and death. Mom’s own milk is always, always, the best option for an infant. However, pasteurized donor milk is a bridge. Pasteurized is a much better option for a critically ill child than to give that baby formula.”
Sharing breast milk goes back centuries. Wet nurses — women who, after their own pregnancies, breastfed other women’s babies — were common until the 20th century, when concerns about disease transmission, difficulty finding wet nurses and the increased availability of formula led to a decline in the practice, according to the Human Milk Banking Association of North America.
In recent years, however, sharing breast milk is once again on the rise, not only through milk banks and hospitals, but also via informal online networks where women with excess milk supplies connect with moms struggling to breastfeed their own children.
“We have seen an explosion of milk banks in the last few years, and milk sharing in general,” said Ann Marie Lindquist. She’s the director of community relations for the Mothers’ Milk Bank Northeast in Massachusetts, the recipient of donations to the Acelleron milk depot. “People weren’t talking about milk sharing five or six years ago, and informal sharing has exploded.”
Banking on milk
The Mothers’ Milk Bank Northeast, one of two dozen nonprofit milk banks in the United States, provides pasteurized donor milk to 70 hospitals in 12 states, including in Pennsylvania and New Jersey.
Most of the nation’s milk banks are hospital-based or run by nonprofits such as the Mothers’ Milk Bank. There are also a handful of for-profit milk banks that pay for donor milk, which is mainly used to create milk-based products for feeding infants.
No non-hospital milk banks exist in New Jersey; in Pennsylvania, there is one, the nonprofit Three Rivers Mothers’ Milk Bank in Pittsburgh. And in February, the New Jersey Senate approved legislation that would require milk banks to register with the state Department of Health; a similar bill in the Assembly is in committee. There’s no such regulation in Pennsylvania.
The American Academy of Pediatrics recommends breastfeeding exclusively for at least the first six months of a child’s life, and breastfeeding in combination with other forms of nutrition after that, for the first year. Studies show breastfeeding reduces the risks for respiratory infections, allergies, obesity and other medical issues, the academy says.
Donor moms at milk banks certified by the Human Milk Banking Association must go through a strict screening process that mimics guidelines set forth by the American Red Cross for blood donations. They must provide health, lifestyle and medication histories; consent to a blood test; and provide paperwork from their physician and their baby’s pediatrician, among other steps. The milk also must be stored properly, in a deep freezer, before it can be donated.
The screening process can take up to three weeks, said Lindquist, and there is often no cost to the mother who’s donating. Mothers must be screened before they can drop off the milk at the donation depot.
When Faina Klyuzman gave birth to her son Brandon nearly a year ago, she didn’t want her milk supply to dry up as it did with her now 5-year-old daughter, Juliana, who was breastfed until she was 8½ months old.
“I went a little overboard,” the Northampton resident said. “I knew that was the case when I had my freezer full, my mom’s freezer, and I had to buy a freezer.”
Klyuzman said she considered donating to a milk bank but, as a working mom of two, she found the screening process too cumbersome. So she turned to Human Milk 4 Human Babies, a grassroots, online network for informal milk sharing. She has since donated more than 1,000 ounces to a couple who adopted a baby.
“I know how desperately so many women would love to have, not even an overabundance (of breast milk), but just enough,” said Klyuzman. “It’s not a million dollars, but to some people, it is. If I can help somebody out, why wouldn’t I? It takes nothing away from me. I’ve already done the work for it.”
Medical professionals and the U.S. Food and Drug Administration caution against informal milk sharing, due to health and safety concerns. They say donors might not be adequately screened for infectious diseases and other risks, and milk might not be properly stored.
“We do not recommend the casual sharing of human milk because the milk is not screened,” said Pamela Britland, a registered nurse and lactation consultant at Virtua Health’s neonatal intensive care unit. The South Jersey hospital refers moms interested in donating milk to the OhioHealth Mothers’ Milk Bank, which supplies donor milk to Virtua’s NICU.
Jenna Tress, administrator of Human Milk 4 Human Babies Pennsylvania, said the group urges moms to make an “informed choice” about breast milk sharing. It doesn’t regulate sharing, but it does provide a lengthy “frequently asked questions” section on its website that talks about things like health screening for donors and at-home pasteurization.
“I know there are families who require a blood test and everything else,” said Tress, of Worcester, Montgomery County. “There are some families who say, you fed your baby with this milk, and you love your baby more than you love my baby, so that’s good enough for me. There’s varying levels of trust. It’s an informed choice each family has to make.”
Emily Green, of Mansfield, New Jersey, said she was ready to provide health information to the three moms, including one who had breast cancer, who accepted her breast milk donation.
“The first two asked nothing,” said Green, mom to 11-month-old Hudson. “Absolutely nothing. I offered the information, but they weren’t concerned. The last woman asked me every question you could think of: what type of food I eat, medication, any medical problems.
“I knew how important (breastfeeding) was to me,” she said. “I can’t even imagine not being able, knowing I don’t want to formula feed my baby. That’s why I chose to privately donate, rather than donate to a hospital. I wouldn’t have had that option (to choose a donor).”
Jenna Schwoyer, of Bristol Township, said she’s grateful to the donor moms who have allowed her to continue breastfeeding her son, Oliver, who was born six months ago following a “traumatic birth experience” involving an emergency cesarean section.
“I felt a sense of loss about everything I had dreamt his birth would look like,” said Schwoyer. “Providing him with breast milk was something I was determined to salvage.”
But that proved to be challenging, Schwoyer said. Despite her best efforts, she was unable to pump milk after she went back to work 12 weeks after Oliver’s birth. She produces enough to breastfeed her son directly, but not enough to feed him when she’s not home.
After speaking with a lactation consultant, Schwoyer said her main concerns were that the donor practiced hygienic pumping, with sterilized breast pump parts and a clean environment; that milk was properly stored, with refrigeration immediately after pumping and storage in a deep freezer for no more than six months; and that the donor was in good health.
So far, a donor has provided more than 500 ounces of milk for Oliver. Not only has that helped supplement her own breast milk, Schwoyer said, but she said it’s helped her heal from the trauma of the birth by removing the stress of not pumping enough milk.
“Being able to provide this for him with her help has been huge for me,” she said. “As much as it benefits him, it benefits me just as much.”
This story has been corrected to note that Three Rivers Mothers’ Milk Bank of Pittsburgh is the only non-profit, non-hospital milk bank in Pennsylvania, correcting earlier statement that no non-hospital milk banks exist in Pennsylvania.
Information from: Bucks County Courier Times, http://www.buckscountycouriertimes.com