The importance of human milk banks

Human milk banks provide food to sick babies or parents who cannot produce milk, as well as vital support
29 March 2022

Interview with 

Natalie Shenker, Imperial College London and Human Milk Foundation

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Another way parents can get human milk for their babies is using a human milk bank, where donors with a surfeit of milk can make it available for others to use. Natalie Shenker from Imperial College London and director of the Human Milk Foundation explains to Julia Ravey the importance of donor milk and how it is processed. The milk for these banks is treated in a very different way to the delivery Julia received…

Julia - Oh, this must be the milk! Oh my goodness. So the postman must have come into my building and... Oh my goodness. What has been left at my door is a brown envelope with a pouch of liquid inside. I really wanted to speak to the postman, but maybe he knew what was in it and thought I don't want to interact with that person. So let's open it up. I've never felt dread like this opening in a package, if I'm honest. There's a cold pack, which is completely thawed out and, oh, it's a little bit cold, I guess. And then the milk itself is in a fridge bag, like a bag you put food in in the fridge and wrapped in tinfoil. I'm not going to unwrap that because I think I'll leave that to the professionals at the lab. This is the Clinical Microbiology and Public Health laboratory at Addenbrookes hospital in Cambridge that tests milk donated to the milk bank. And these donations are absolutely vital. Natalie Shanker, a research fellow at Imperial College London and co-founder of the Human Milk Foundation, which operates the UK's first charitable non-profit human milk bank, told me about how donated milk is used and also how it is screened.

Natalie - Human milk banks work a lot like the blood transfusion service. So mums will go through a screening process where they are interviewed, they have a questionnaire to fill in, and then they'll go through blood tests, which exclude infectious diseases that can be transmitted through milk. Milk is collected and brought into the milk bank where it's specially heat-treated, pasteurised and it undergoes microbiology testing to make sure that there's no harmful bacteria after that process.

Julia - Why is it now so important that we have these screens in place?

Natalie - The reason that milk banks have always had safety at their very heart is because over the last 40 years, donor human milk has primarily been used to feed very vulnerable, very low birth weight and premature babies, where even the slightest problem could cause a real clinical problem for that baby.

Julia - This milk can go to babies who are quite sick. Does it also go to other family situations? For example, if parents have adopted?

Natalie - Indeed. So we have just celebrated today sending milk to the 400th family that we've supported in our community program. And this is run through our charity, it's all entirely free to the parents. But what we have is a team of lactation consultants and breastfeeding counselors who are able to support breastfeeding journeys as best as possible, but also to provide that donor milk as of bridge. In those situations, we've supported over 60 families where the mother's been diagnosed with cancer and is undergoing cancer therapy, or the parents had bilateral mastectomy. Babies fed that after adoption, after surrogacy. It's giving the choice to the parents, but also enabling that baby to receive human milk for a little bit longer.

Julia - Hello. How are you? I come bearing some milk. Have you ever seen milk come to you like this before?

Lab Technician - No.

Julia - So this is breast milk, which has been bought from eBay...

Lab Technician - Oh right!

Julia - Natalie describes how human milk bought from the internet could cause problems if given to a baby...

Natalie - If that was coming through the post for my baby, I wouldn't be feeding it to my baby. And the reason for that is you've got no idea how that milk has been expressed, what equipment has been used, who's expressed milk and what might be in there. And there's also the problem of milk that isn't refrigerated or frozen quite quickly, not being of the quality that would be best to give to babies. And that's, that's incredibly worrying. Women across the country; if you ask during pregnancy, over 85% want to feed their own babies, but by a week, fewer than half are doing so on the latest data that we have. Now that's not for women not trying, it's for women being absolutely desperate and left to go through some really traumatic times, largely unsupported because there's been no serious investment in this sort of support for decades. Families are desperate and where they have no other option, some will choose to take this rather more risky path. And that's really where the work of the charity is coming in, because we want to make a nationally equitable service. That would mean that there would be an alternative and that we can help work with other third sector organizations and NHS healthcare professionals to make sure that no family has to resort this sort of approach to feed their babies.

Julia - Thank you so much. Bye bye. Bye.

Julia - The shock on her face when I said that this milk had been bought on the internet, never seen a sample quite like that before. So let's see what the results bring on Friday.

Chris - Stay tuned, and we'll tell you towards the end of the program, what turned up.

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