Let’s talk donor expressed breast milk (DEBM)

Parenty’s resident paediatric dieticians, Kath Megaw and Nutripaeds, explain how DEBM can save the lives of premature babies in NICU.

World Breastfeeding Week is celebrated every year from 1 to 7 August to encourage breastfeeding and improve the health of babies around the world.  This year Nutripaeds is focusing on raising awareness on the importance of donor expressed breast milk (DEBM) on the health of premature babies in the Neonatal Intensive Care Unit (NICU).  This cause has a very special place in the heart of our dietician’s as we have seen first-hand the critical and life-saving role DEBM plays in the lives of premature babies, born too little and too soon.

Imagine if you were missing your eyesight, hearing or a limb or something else essential to your well-being and there was an option for you to get a donation to restore this missing essential element. I doubt anyone would hesitate. Life-saving procedures like lung, kidney, liver and heart transplants give people a second chance at life. Donating organs is life-giving and life-saving. DEBM in the NICU can be equally life-saving. 

Premature babies, those born below 37 weeks gestation, are a high-risk group and require special medical care on so many levels, but the most vulnerable group of premature babies are those little ones born below 28 weeks and/or under 1.5 kg.

These little warriors often spend many weeks to months in the NICU and face a brave battle daily adjusting to life outside of the womb. The gut of a premature baby is immature and therefore the method of nutrition plays a vital role. Premature babies, who are artificially fed rather than breastmilk, are at much great risk of contracting serious, even fatal infections. Artificial feeds sadly do not offer the same protection and unique healing benefits that breastmilk does and may add an additional risk factor for very low birth weight, premature babies (source: Milk Matters).

According to Milk Matters, mortality rates and the incidence of serious complications have shown to decrease in hospitals where only breastmilk – mother’s own milk or donor milk – is used. Amongst so many other benefits, breastmilk is readily digested, will help your premature baby’s immature gut mature and stay healthy. Breastmilk contains amazing antibodies to fight infections and promote health. Breastmilk also contains growth factors to help your baby grow and become stronger as well as contains unique fatty acids for optimal brain growth.

Breastmilk has been shown over and over to decrease the risk of a very dangerous and life-threatening gut condition known as necrotising enterocolitis (NEC). 

NEC is the most common and serious intestinal disease among premature babies and occurs when the tissue in the small or large intestine is injured or inflamed. This can lead to the death of intestinal tissue and in some cases a perforation in the intestinal wall. In NEC, the intestine can no longer hold waste, and so bacteria may pass into the bloodstream and cause a life-threatening infection.

Waste may also pass into the baby’s abdomen and make the baby very sick. The injured intestine, or sections of it, may die and need to be removed surgically. All of these complications are very serious in an already small fragile baby fighting to stay alive each day.

There are many contributing factors that can cause NEC. In most cases, a specific cause is not found. But experts believe the following may play a role:

  1. An underdeveloped immature intestine
  2. Too little oxygen or blood flow to the intestine at birth or later injury to the intestinal lining
  3. Heavy growth of bacteria in the intestine that erodes the intestinal wall
  4. Viral or bacterial infection of the intestine

Feeding method and choice of feed play a significant role in the development and treatment of NEC. Ideally, the choice of feed for premature babies is breastmilk. Sadly certain situations may arise which can hinder a mother’s ability to provide breastmilk for her baby. These may include the mother being unable to produce breastmilk, the mother being ill or the mother not being present. In the case of multiple babies such as twins or triplets, the mother may be unable to provide sufficient quantities to meet demand.

In these cases, the next best and safest option is DEBM which is provided by breastmilk banks such as Milk Matters.  Milk Matters, which is a community-based breast milk bank, pasteurises and distributes donations of screened breast milk from healthy donors to premature, ill and vulnerable babies.  DEBM will be generously donated from a mother, of either another premature baby or a healthy term baby, who has an abundance of breastmilk. The health of the mom is tested and the breastmilk is pasteurized and also tested for safety.

Sadly despite the high number of mother’s breastfeeding, there is continually a shortage of DEBM which may result in premature babies being fed infant formula which may increase the risk of NEC.

During this month of breastfeeding awareness, there are two important messages when it comes to DEBM:

  1. If you are in a position to donate, please consider giving the gift of live and donating breastmilk. No amount is too small and only 50ml of breastmilk can feed a baby under 1kg for 24 hours. 

  2. Should you ever yourself have a premature baby and your baby needs DEBM please sign consent as this will be one of the best decisions you make for your baby.

Make a difference in the lives of premature babies, fighting every day for a chance at life.  They didn’t choose to be born early. Donor milk: giving hope and life to premature babies fighting for survival.

For more information regarding donating, please contact Milk Matters:
www.milkmatters.org


Donor expressed breast milkKath Megaw (BSc Dietetics Hons, Diploma Paediatric Dietetics) holds four medical qualifications including a paediatric dietetic qualification from the prestigious Johns Hopkins University in Balitmore, USA. She has been published in the Epilepsia journal on the use of the paediatric ketogenic diet in third-world settings and frequently speaks to groups of both professionals and parents on infant and childhood nutrition. Kath is the author of Real Food, Healthy, Happy Children (Quivertree Publications), the co-author of Feeding Sense (Metz press), The Low Carb Solution for Diabetics (Quivertree Publications),as well as co-author of Weaning Sense and Allergy Sense (Quivertree Publications). Kath has been in private practice for over 18 years and is the founder of Nutripaeds, a paediatric dietetic practice.

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