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BC Women's Milk Bank received government funding

Wonderful news! The BC Women's Milk Bank has received $65,000 in funding to expand to be the provincial milk bank and provide pasteurized donor mother's milk to all the NICUs in the province! Calling all possible donors - please call BC Women's at 604-875-2282. We need 2-3xs as many donors as we have had in the past. All those tiny babies are cheering... this will make them much healthier. Check out this video http://video.theloop.ca/home/watch/bcs-breast-milk-bank-expanding-province-wide/2287344081001/#.UWOJcb_jDF8

Getting Human Milk to Human Babies: The Role that HMBANA Milk Banks Play

Getting Human Milk to Human Babies: The Role that HMBANA Milk Banks Play

One of the wonderful things about the internet is having access to so much information. Need a recipe, driving instructions, or a referral for an electrician? It’s a click or two away.  The downside is that information isn’t always complete or accurate, and misinformation can spread.  The amount of media attention on the sharing of human milk has exploded in recent years leading to a certain amount of confusion.  We caught up with Frances Jones, Executive Director of BC Women’s Mothers’ Milk Bank in Vancouver, Canada and president-elect of the Human Milk Banking Association of North America (HMBANA) and have developed this “Milk Banking 101” blog in order to clear up some confusion about non-profit milk banks and open a conversation within the IBCLC community so that IBCLCs are positioned to support the choice that best meets the needs of breastfeeding families and their babies. We hope you’ll join in this conversation!

By Frances Jones RN, MSN, IBCLC

Photo used with permission from Indiana Mothers’ Milk Bank
Photo used with permission from Indiana Mothers’ Milk Bank

 

Background on Milk Banking

The first milk banks came into existence in the early 20th century as food technology evolved allowing for successful storage of human milk. Even in those early banks, donors and their milk were carefully screened. Fast forward to the 80’s and a post-AIDS era of caution. Those of us who believe in the power of human milk formed the Human Milk Banking Association of North America (HMBANA) to ensure safe standards for all donor milk banks in North America. The HMBANA guidelines, developed with the assistance of the Food and Drug Administration (FDA), the Center for Disease Control (CDC) and the American Academy of Pediatrics (AAP), have been used globally in the development of nearly all milk banking standards and are reviewed annually to ensure safety.

Milk that is subject to storage and transportation is not the same product as milk that is consumed straight from a mother’s breast (which is why Louis Pasteur is considered a founder of disease-prevention-science for figuring out how to reduce the pathogens in milk and wine through a technique that still carries his name today). HMBANA’s safety steps include screening donors through interviews and blood tests (for HIV, HTLV, syphilis, hepatitis B and C), pasteurizing the milk, testing for pathogen growth, tracking milk and implementing mock recalls.  Milk banks put huge effort into ensuring donor human milk is safe for the most vulnerable of infants.

Photo used with permission from Indiana Mothers’ Milk Bank
Photo used with permission from Indiana Mothers’ Milk Bank

 

What is the Difference Between “Milk Banking” and “Milk Sharing”?

Milk banking involves donating human milk to an intermediary (similar to a blood bank) who ensures the safety of the product and distributes it to those in greatest need.  Milk sharing involves sharing human milk with sisters, neighbors, and friends, and is a practice that has been going on for centuries as mothers have helped each other.  Today, the Internet has changed the way we communicate, enabling a rise in milk sharing outside of our closest circles. This capacity for expanded milk sharing may increase the risk associated with the transmission of disease and contaminants (e.g. drugs and alcohol). Several health authorities including the FDA, AAP, Health Canada as well as the French government have expressed concern over Internet milk sharing.

When supply is scarce, as it has been in recent years with a growing demand for donor milk,  HMBANA banks are limited to serving the most vulnerable and critical babies in our communities. In 2010, the CDC reported over 325,000 low-birth weight (LBW) births in the United States, of which over 55,000 were very low birth weight (VLBW) babies, weighing less than 1.5kg.  In 2011, HMBANA banks collected a little over 2 million ounces of donor milk, which averages only 7 ounces per LBW/VLBW baby. We simply need more milk to be able to meet the needs of these vulnerable infants. We recognize that many non-NICU infants (and even some adults!) would benefit from donor milk and that the cost of pasteurized donor milk in North America is a barrier to access for some (which is one of the factors contributing to the rise in milk sharing). This is why HMBANA supports many families through charity care and our leaders are working behind the scenes to try to shape laws so donor milk is covered by more insurance companies.  In Brazil, where the milk banks are part of the government health services (in contrast to the practices in North America), pasteurized donor milk is dispensed via prescription at no charge to the recipient. Access to human milk is an important public health initiative and future policies and programs should reflect this.  In the meantime, the more milk that HMBANA banks collect, the more families can be served.

What is the Difference Between Non-Profit Milk Banks and For-Profit Pharmaceutical Companies?

HMBANA defines a milk bank as  ”a service established for the purpose of recruiting and collecting milk from donors, and processing, screening, storing, and distributing donated milk to meet the specific needs of individuals for whom human milk is prescribed by health care providers who are licensed to prescribe.” There are also “milk depots” which are locations that collect and store milk and then transport it to a “milk bank” for processing and distribution.  These terms are used loosely and some sites that are actually depots label themselves as milk banks.

Increasingly, our non-profit milk banks have faced competition for donors from for-profit pharmaceutical companies that solicit donor milk and turn it into high-end products.  HMBANA milk banks are non-profit and keep processing costs associated with safety protocols as low as possible.  For-profit companies sell their products at a profit while relying on donor mothers to provide the raw human milk for processing. HMBANA banks count on additional funds through grants and in-kind donation to continue operating. Private companies must achieve profit from their products to satisfy investors.  Many IBCLCs and others who support breastfeeding mothers are confused because some of the for-profit collection sites have names that seem to indicate that they are association with non-profit banks (e.g. Milk for Wishes Milk Bank, Helping Hands Milk Bank). Ambiguity can sometimes mislead and confuse donors. Every donor should understand who is receiving their milk and what will be done with it (read this great blog post by a mom who felt misled regarding the generous donation of her milk).

Frances Jones

Frances Jones is the Coordinator of the Lactation Services and Milk Bank at British Columbia Women’s Hospital in Vancouver, British Columbia, Canada. Frances has worked with breastfeeding families for over thirty years and has been running the milk bank since 2000. She is the author of the HMBANA’s Best Practice for Expressing Storing and Handling Human Milk in Hospitals Homes and Child Care Settings and has spoken at many conferences on breastfeeding and milk banking topics. Most importantly, she is the mother of five sons and grandmother of one granddaughter – all breastfed.

In our next blog we’ll tackle some misunderstandings about milk-banking.  If you have questions you’d like answered, please leave a comment and we’ll do our best to find answers.  We’d love to hear about the resources you feel would help you to provide mothers with good information regarding their options when they have extra milk or are seeking milk for their infants. We look forward to continuing this conversation.

* A special THANK YOU to Indiana Mothers’ Milk Bank for permission to use their photos. For more of their photos, check out their Instagram profile.

Read the original of this article on http://lactationmatters.org/2013/03/26/getting-human-milk-to-human-babi…

What Breasts Are For - video from Baby-Friendly Newfoundland

Looking at breastfeeding from the perspectives of everyone ranging from young children to grandmothers, childless young women to fathers, this video is ideal for pregnant women and their support partners in a prenatal setting. There is someone for everyone to identify with as we explore the importance of breastfeeding and the risks of formula feeding. This video will lead viewers to think about "what breasts are for."

Courtesy of Baby-Friendly Newfoundland

World Breastfeeding Week: World Alliance for Breastfeeding

Action (WABA) is pleased to announce the theme/slogan for WBW 2013 - 'BREASTFEEDING SUPPORT: CLOSE TO MOTHERS' focusing on Peer Counseling, which was discussed and decided at the WABA Global Breastfeeding Partners Meeting (GBPM) held in Delhi, 5-6 December 2012.

The WABA Mother Support Task Force, led by Anne Batterjee, has been appointed Key Writer for the WBW 2013 Calendar Announcement and Action Folder, working with small team of WABA SC members, and Core Partner representatives.

As Anne notes: "Fifty six years ago, seven breastfeeding mothers came together and realized that their abilities to breastfeed their own infants came from being provided with information, education and emotional support from each other. That so many other mothers who longed to breastfeed could be enabled to do so if only those around them, their Peers, had the knowledge and skills to be supportive. La Leche League International was launched, and Mother to Mother support was born... Women's social networks have major impact on their health related decisions. Women are often drawn to other women with whom they share life experiences, especially when those experiences relate to parenting. When new mothers have someone who can understand and identify with their experiences, they can better enjoy and cope with parenthood. A peer counselor is an invaluable partner with mothers in their journey through parenthood, helping them gain confidence in their ability to breastfeed. Peer Counselors model the idea of seeking information from others, which will help moms realize that the breastfeeding journey is a learning process for us all…"

Milk banking

The BC Women's Milk Bank is having a mini renovation which will result in two new double sided freezers being added as well as some much needed space for an office and storage (and dedicated computer extra phone etc). In 2012 we processed almost 70,000 ounces and would have processed more but we had problems getting enough donors.

 

The Human Milk Banking Association of North America (HMBANA) is holding their next conference in Victoria BC at the Empress Hotel on April 28/29 2014. Save the date!

There is a new milk bank in Toronto- the Roger Hixon Ontario Human Milk Bank. It is located in My Sinai Hospital and will be distributing milk by early spring 2013. Canada now has three milk banks - Vancouver, Calgary and Toronto.The BC Women's Milk Bank is having a mini renovation which will result in two new double sided freezers being added as well as some much needed space for an office and storage (and dedicated computer extra phone etc). In 2012 we processed almost 70,000 ounces and would have processed more but we had problems getting enough donors.

The Human Milk Banking Association of North America (HMBANA) is holding their next conference in Victoria BC at the Empress Hotel on April 28/29 2014. Save the date!

There is a new milk bank in Toronto- the Roger Hixon Ontario Human Milk Bank. It is located in My Sinai Hospital and will be distributing milk by early spring 2013. Canada now has three milk banks - Vancouver, Calgary and Toronto.

Introduction of solids

January 2011: Media has been covering an article published in British Medical Journal “Six months of exclusive breast feeding: how good is the evidence? 

Found at: http://www.bmj.com/content/342/bmj.c5955.full

RESPONSES:

1. Randa Saadeh

World Health Organization

 

WHO's global public health recommendation is for infants to be exclusively breastfed for the first 6 months of life to achieve optimal growth, development and health. Thereafter, infants should be given nutritious complementary foods and continue breastfeeding up to the age of 2 years or beyond.

 

WHO closely follows new research findings in this area and has a process for periodically re-examining recommendations. Systematic reviews accompanied by an assessment of the quality of evidence are used to review guidelines in a process that is designed to ensure that the recommendations are based on the best available evidence and free from conflicts of interest. 

 

The paper in this week's BMJ is not the result of a systematic review. The latest systematic review on this issue available in the Cochrane Library was published in 2009 ("Optimal duration of exclusive breastfeeding (Review)", Kramer MS, Kakuma R.

 

The Cochrane Library 2009, Issue 4). It included studies in developed and developing countries and its findings are supportive of the current WHO recommendations. It found that the results of two controlled trials and 18 other studies suggest that exclusive breastfeeding (which means that the infant should have only breast milk, and no other foods or liquids) for 6 months has several advantages over exclusive breastfeeding for 3-4 months followed by mixed breastfeeding. These advantages include a lower risk of gastrointestinal infection for the baby, more rapid maternal weight loss after birth, and delayed return of menstrual periods. No reduced risks of other infections or of allergic diseases have been demonstrated. No adverse effects on growth have been documented with exclusive breastfeeding for 6 months, but a reduced level of iron has been observed in developing-country settings.

 

2. Comment by Adriano Cattaneo to the BMJ Rapid Response (Adriano Cattaneo is Consultant Epidemiologist and Co-ordinator of the Unit for Health Services Research and International Health, Institute of Child Health “IRCCS Burlo Garofolo”, Trieste, Italy, a WHO Collaborating Centre for Maternal and Child Health.)

 

The evidence provided by Fewtrell and collaborators to challenge the WHO 6-month recommendation is no better than the one provided by WHO. It is in fact slightly worse. The WHO recommendation is based on two RCTs and 16 observational studies. All the studies published after 2001 on infection, nutritional adequacy, allergy and coeliac disease, and outcomes in the longer term that Fewtrell and collaborators cite to question the 6-month policy are observational. The only two RCTs they cite are ongoing and can not be used to argue against the WHO 6-month policy. Until further evidence becomes available, I prefer to stand by the WHO recommendations (and hope the UK and Italian DoH will agree with me). Incidentally, the WHO recommendation has never been meant to apply to all infants. It is a public health recommendation to be used for national and professional policies and regulations (for example, on labelling of baby foods). Infants in fact do not wake up the day they reach six months and ask for solids!!! Readiness to eat the first solids is distributed as any other biological variable, a Bell shaped curve that in my opinion (because no research is available to know the real shape) has a mode at six months and is skewed to the right (i.e. more infants are ready after than before six months). Why don't we concentrate on physiology and neuromuscular development to advise mothers on when to start solids, instead of wandering in search of doubtful evidence? Finally, I am amazed by the rapid spread into the popular press and media of the questionable messages posted by Fewtrell and collaborators in their paper. Less than 24 hours after publication, newspapers in Italy (and I guess in UK and other countries; TV will follow suit) are already talking about a "new study" showing that exclusively breastfeeding infants to six months may be dangerous. Am I wrong if I ask the authors to make a quick public statement to transparently say that theirs is not a "new study" but just a respectable opinion based on shaky grounds?

 

3. From Francesco Branca - Head of Nutrition at WHO.

 

WHO's global public health recommendation is for infants to be exclusively breastfed for the first 6 months of life to achieve optimal growth, development and health. Thereafter, infants should be given nutritious complementary foods and continue breastfeeding up to the age of 2 years or beyond.

WHO closely follows new research findings in this area and has a process for periodically re-examining recommendations. Systematic reviews accompanied by an assessment of the quality of evidence are used to review guidelines in a process that is designed to ensure that the recommendations are based on the best available evidence and free from conflicts of interes

The paper in this week's BMJ is not the result of a systematic review. The latest systematic review on this issue available in the Cochrane Library was published in 2009 ("Optimal duration of exclusive breastfeeding (Review)", Kramer MS, Kakuma R.

The Cochrane Library 2009, Issue 4). It included studies in developed and developing countries and its findings are supportive of the current WHO recommendations. It found that the results of two controlled trials and 18 other studies suggest that exclusive breastfeeding (which means that the infant should have only breast milk, and no other foods or liquids) for 6 months has several advantages over exclusive breastfeeding for 3-4 months followed by mixed breastfeeding. These advantages include a lower risk of gastrointestinal infection for the baby, more rapid maternal weight loss after birth, and delayed return of menstrual periods. No reduced risks of other infections or of allergic diseases have been demonstrated. No adverse effects on growth have been documented with exclusive breastfeeding for 6 months, but a reduced level of iron has been observed in developing-country settings.

 

4. From Elisabeth Sterken, INFACT Canada

Introduction of solids is in actual fact a learing and discovery of the tastes, textures, colour and feel of food and should do little breastmilk replacement at 6 months. If infants are started on the rice starch with iron fillings and a few B vitamins the replacement of valuable breastmilk is of concern.

 

-5 From Patti Rundall, Baby Milk Action UK.

Bear in mind the following:

·         Three of the authors receive funding from the baby food industry (Mary Fewtrell, Alan Lucas and David Wilson)

·         This is not a report on new data.

·         The argument to introduce solids at 4 months to prevent coeliac disease and allergies was summarised by ESPGHAN in late 2009 and were considered by many to be flawed. see our press release: http://www.babymilkaction.org/press/press23dec09.html .  At present it is observational only and there are RCTs in progress; pre-empting the results of these seems foolish.

·         The UK Scientific Committee on Nutrition (SACN) and the Committee on Toxicity ( COT) are reviewing the evidence on solid foods and coeliac disease. The draft opinion is NOT FINAL BUT Is on the SACN website with the Agenda papers for next week's SMCN meeting. See paper SMCN/11/01 downloadable from http://www.sacn.gov.uk/meetings/sub_groups/maternal_child_nutrition/190…

·         SACN use international growth charts to describe the optimal pattern of infant growth in the UK (UK-WHO charts). The mean age at introduction of solids to this cohort of breastfed infants was 5.4 months (or "..about 6-months").

·         The UK policy is to introduce at around 6-months and progress responsively, in line with individual babies' progress and acceptance. Not all babies need solids at the same time: in every aspect of infant development there is a wide range of normal. Very importantly the introduction of the new policy in 2003 was associated with a marked reduction in the numbers of mothers giving solids very early (i.e. before 4-months). Since almost everyone agrees that very early introduction carries greater risk (particularly of coeliac disease) the UK policy could be considered from this perspective a success.

 

With thanks to Betty Sterken of Infact Canada for comments 2-5..

 

Basically - the recommendation is exclusive breastfeeding until about 6  months. And like any guideline this was meant to be a GUIDE. There is nothing new at this point to suggest a change in this guideline.

What is BPA?

Bisphenol (BPA) is a plastics product found in polycarbonate and is an endocrine disrutor. Polycarbonate is a clear hard plastic that is used in a multitude of products including baby bottles, breast pump equipment and the linings of food cans including formula cans. In April 2008, Health Canada announced that they were taking a number of actions to reduce exposure to BPA focusing on infants and young children.
To read more about BPA check out the Environmental Working group website and their timeline on BPA found athttp://www.ewg.org/reports/bpatimeline as well as http://www.toxicnation.ca/bpaga

Keep in mind that there is alot of conflicting information available on the net - much of it from industry organizations. Check out sites for who are the members or sources of the information!


Health Canada advises...... re informal sharing or buying of human milk 
Health Canada has posted a warning about the risks of acquiring human milk through the internet or other casual means. As it is not possible to screen the donor or the milk there are many unknowns which may place the recipient at risk for illness and disease.

Health Canada advises:
There is a potential risk that the milk may be contaminated with viruses such as HIV or bacteria such as Staphylococcus aureus, which can cause food poisoning. In addition, traces of substances such as prescription and non-prescription drugs can be transmitted through human milk. Improper hygiene when extracting the milk, as well as improper storage and handling, could also cause these products to spoil or be contaminated with bacteria and/or viruses that may cause illness.

Health Canada also advices consumers to check with "their health care professional should they have questions about breastfeeding or if they are considering acquiring human milk from another source."

Too bad they didn't refer people to the HMBANA website ( www.hmbana.org) for a safe option for acquiring pasteurized donor milk. HMBANA banks like BC Women's have been handling, processing, screening and distributing donor milk collectively for over 200 hundred years. There has never been a child who became seriously ill from milk received from a HMBANA banks. This is not a claim that artificial baby milk companies can make. Spread the word about the safe sources of donor milk!! We need to ensure health care professionals have the correct information. 
Health Canada link 

Most Women Stop Breastfeeding by Six Months. Whose Fault Is That?

Oh bouncing baby boy, here comes the next round in the never-ending slugfest over the health benefits of breastfeeding:

The lives of nearly 900 babies would be saved each year, along with billions of dollars, if 90 percent of U.S. women breast-fed their babies for the first six months of life, a cost analysis says. ….The findings suggest that there are hundreds of deaths and many more costly illnesses each year from health problems that breast-feeding may help prevent. These include stomach viruses, ear infections, asthma, juvenile diabetes, Sudden Infant Death Syndrome and even childhood leukemia.

That's according to an AP article, covering a new study just released by the journal Pediatrics.

I bet a lot of bottle-feeding mothers are going to read that paragraph, sigh, and think: “Great. Now I’m being blamed for billions of dollars in health care costs and 900 dead babies.”

The AP writer must have anticipated such a reaction, because she goes on to quote not one but two doctors saying we “shouldn’t be blaming mothers for this.” Then she puts the blame elsewhere: “jobs and other demands” that prevent women from breastfeeding, and “many hospitals [where] newborns are offered formula even when their mothers intend to breast-feed.” CNN’s take on the study is even more explicit in pointing its finger at an apparently unsupportive medical-industrial complex:

Bartick says moms shouldn’t be blamed, because they receive mixed messages and often lack support from the moment their babies are born. Bartick says many hospitals delay immediate urgent skin-to-skin contact between mom and baby, which can make things harder for the newborn to act on its natural instincts to suckle. Moms also need to be better educated about the importance of breastfeeding and they need adequate support after they leave the hospital in case they run into problems because the newborn isn’t properly latching on and therefore not getting enough food.

This may sound progressive, but it’s not new. It’s the standard line from breastfeeding advocates, lactation consultants, et al: Breastfeeding is a medical miracle, but we shouldn’t blame mothers who don’t manage to do it long-term, because they surely would if the corporate patriarchy weren’t preventing them from doing so.

There’s some truth in this argument. Yes, breastfeeding does have health benefits (although we could argue all day about the magnitude of those benefits, especially given how complex and multifactorial the diseases listed in this article are – breastfeeding prevents leukemia?). Yes, many hospitals do send new mothers home with formula samples, and many workplaces make it difficult or impossible to pump breast milk during the day. Yes, mothers need “adequate support” (and that doesn’t just mean a visit from the local La Leche League rep) immediately after bringing a newborn home.

But it is simply silly to argue that all women would breastfeed for six months (or a year, or even two years, as the World Health Organization recommends) if only The Man weren’t keeping them down. Some women find breastfeeding immensely painful – they get infections; they get bitten; they wind up with babies who just can’t latch properly even after multiple consults with a lactation expert. Other women want desperately to breastfeed and have all the “support” in the world that should enable them to do so, but their breasts just won’t cooperate.

I was one of these. My hospital nurses knew all about “skin-to-skin.” My baby latched perfectly. My family and friends made sure I had all the support I needed throughout my luxuriously long maternity leave. My “supply,” to use the preferred euphemism, was at first so bountiful that my hospital’s maternity support group recruited me to demonstrate breastfeeding for other new moms. I threw out the doctor-provided formula samples like so many soiled diapers.

And then, at four months, the milk dried up. My daughter’s weight fell from the 25th percentile to the seventh. She was so hungry she couldn’t sleep at night. Still, I fought putting her on formula. I spent whole days in bed, futilely trying to nurse, until our pediatrician gently told me that this wasn’t my fault, and I should stop crying, because what my baby really needed wasn’t my milk: it was me.

We gave my daughter a bottle of formula that evening – I made my husband do it, because I couldn’t – and for the first time in weeks, she slept through the night. She is 13 months old now. She has never had a stomach virus or an ear infection. If someday she develops asthma or diabetes or, God forbid, leukemia, I will of course be sad. But I won’t feel guilty, and neither should anyone else in the same situation.

I know there’s no way to convey the emotional complexity of breastfeeding in an AP article. But it would be a good start if, when writing about why some women don’t breastfeed, the standard line went something like this: Breastfeeding has some health benefits, but we shouldn’t blame mothers who don’t manage to do it long-term, because not everyone can. Sometimes that is the fault of hospitals and corporate workplaces and formula makers. And sometimes -- it may be unsatisfying to say it, but it's true -- there really is no one to blame.