It is so exciting preparing for a baby, and once your baby is born everything changes. If your baby is born prematurely, your world changes dramatically and unexpectedly. Your focus changes from making sure you have the perfect new-born photoshoot to the number of machines that are attached to my baby today and the pressure to express breastmilk is palpable.
You can only think of the NICU, breastmilk for the baby, and home and back to the NICU again and breastmilk for the baby.
For a NICU mom, there is an added emotional strain of needing to make life-saving breast milk for a baby that often can’t be held or latched to the breast directly, this impacting severely on breastmilk production.
Consequently, mothers with babies in NICU experience difficulties in expressing sufficient volumes to meet the need of the growing baby, the task can be relentless, as every time mommy visits the NICU, she is asked for breastmilk. Breast milk is the preferred milk to feed premature infants as it reduces the risk of Septicaemia and Necrotizing enterocolitis (NEC), the main illnesses, and causes for death for premature babies.
NEC causes the baby to distend because of intestinal blockage and infection often resulting in the removal of large portions of the gut and often times the infection is so severe it results in death. With all this pressure, sometimes a mom may need a little more time for her milk production to meet the needs of her baby, her body needs to recover and her mind to heal; during this time donated breastmilk plays a key role in meeting the gap and saving the lives of the more vulnerable extremely-low-birth-weight babies.
Did you know that, especially during the Covid-19 pandemic, human breast milk donation is considered an essential service? That the supply of donated breast milk continues to be essential to saving premature (infants less than 37 weeks, very low birth weight (< 1.8kg) or less than 14 days old) babies’ lives?
In the last 12 months, 3,100 premature babies and their family’s countrywide have benefitted from accessing donated breastmilk from the South African Breast Milk Reserve (SABR).
Numerous human milk banking initiatives in South Africa continue bringing the life-saving benefits of donated breastmilk to the most vulnerable babies. The SABR focuses on in-hospital human milk banking for premature babies, with 24 public sector human milk banks in five provinces and one reserve.
Breast milk is made available to premature infants and their mothers by a network of dedicated health care professionals and prescribing doctors. The lifesaving breast milk is donated to the SABR by mothers who have extra milk either attending the tertiary facilities with a SABR bank or online through the SABR website www.sabr.org.za.
The SABR ensures that all quality procedures and monitoring of cold-chain are of the highest standard. The donor application process is similar to that of donating blood, you need to complete a life-style screening questionnaire.
Only one out of six potential donors meet the inclusion criteria. Exclusion to donate is often due to the intake of medication which is contra-indicated for the donation of breast milk. Once a mother has the milk ready to donate, she will be visited by a phlebotomist nurse, who will take a blood sample for the screening of HIV and Hepatitis B and C.
Upon receipt of the donated breastmilk by the bank, the milk is quarantined and screened for bio-burden, in other words, the microbiological assessment of the quality of the storage and hygiene procedures. Cold-chain monitoring and ongoing bacteriological and virological surveillance of breastmilk ensure safety in human milk banking.
Once the milk exits quarantine it is pasteurised at 62.5º; the process destroys all lipid enveloped viruses and bacteria. The Miris micro-nutrient analyser is currently tested to inform the macro-nutrient breastmilk composition. The vision is to eventually have a nutritional label that will inform the fortification of breastmilk for premature babies.
The SABR distributes donated breastmilk using a logistic network of specialised transport, dry ice, and remote cold-chain monitoring.
In this time of a pandemic, we are all learning more about how infections are spread and how important it is to have steps in place to prevent the contagion from spreading. It is so important that breast milk not only is recognised for its lifesaving properties and immunological value, but also for the risks associated with informal milk sharing and communicable disease like Covid-19. Therefore human milk banks play a key role in ensuring the safety of (donated) breastmilk protecting recipient babies from disease.
I strongly believe that the mothers who donate breast milk, the staff who co-ordinate the donated breast milk, and the mothers whose baby receives the donated breast milk are really the most amazing people. They all are working to save premature babies’ lives.
If you would like to become a breast milk donor you will need to complete the application and screening with the SABR. Click here to apply.
I became a dietitian because of my interest in breastfeeding and nutrition. However, only when I had my two children both prematurely did, I realise how much help and support mother’s needs. No textbook can prepare you for NICU. My breastfeeding experience with my children is why I became a lactation consultant. I now help mothers in their homes with breastfeeding issues. Another of my dreams was to establish My Breastpump.