Milk Banking

A human milk bank is a service which collects, screens, processes, and dispenses by prescription human milk donated by nursing mothers who are not biologically related to the recipient infant. There are currently eleven milk banks in North America. They are usually housed in hospitals, although sometimes they are free standing.

They are members of the Human Milk Bank Association of North America (HMBANA) and voluntarily abide by HMBANA’s annually revised ‘Guidelines for the Establishment and Operation of a Donor Human Milk Bank.’ The guidelines were developed with the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) and include protocols for soliciting donors, collecting, processing and distributing the milk.

The HMBANA Guidelines stipulate that donors not be paid for their milk. However, collection, processing and distribution of milk are expensive, and recipients are charged $3.00-$4.50 per ounce of milk to cover some of the cost. Community fundraising and grants also help milk banks meet expenses. The guidelines ensure that no one is denied donor milk for lack of ability to pay, but insurance companies rarely cover donor milk. In some states, and under some circumstances, Medicaid will cover the costs of using banked milk.

Donor referrals usually come from childbirth educators, nursing mothers groups, and La Leche League. Like blood banks, milk banks sometimes use ads to solicit donors, especially when supplies are low. In addition, mothers of infants who die sometimes choose to donate their milk.

Premature infants are the most frequent recipients of donor breast milk. Full term babies with gastrointestinal disorders also sometimes receive banked milk. Occasionally, adopted babies and mothers who cannot nurse their healthy babies use banked milk as well, often at their own expense.

When there is milk available some milk banks will distribute it to adults who are immuno-compromised. Preliminary research indicates that breast milk can have nutritive, immunologic and palliative effects for cancer patients. Adults with GI disorders and organ donation recipients also potentially benefit from the immunologic powers of breast milk.

Abbott (makers of Similac) sells an ‘immunonutrition’ product made entirely from purified, concentrated and pasteurized human milk. The product, called Prolact, is considered a human-milk fortifier, designed to be added to breast milk for premature babies weighing less than 2.75 pounds.

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