It’s imperative to give newborns and growing babies the best possible start to this journey we call life. Whether breast milk or formula are your preference, we thought that an in-depth interview with a pioneering milk bank here in New York was in order. If access to breast milk is a question, this two-part interview with the New York Milk Bank will help inform you and perhaps give you hope for its availability.
~Rebecca Conroy, Editor of A Child Grows in Brooklyn
Tell us about the New York Milk Bank…
Early in the twentieth century, milk banking blossomed and grew with increased use of donor milk for ill and premature infants. Mothers with abundant milk supplies were asked to provide milk for ill infants. Milk banks were established as collection and storage of milk was possible with the development of refrigeration and a greater knowledge of safe food processing. In 1909, the first milk bank was established in Vienna followed by many more worldwide. In 1985, the Human Milk Banking Association of North America (HMBANA) was founded in order to establish standards for North American milk banks. These standards, first published in 1990, are used by many other milk banks around the world and are updated annually by HMBANA.
In the mid 1980’s, with the recognition of AIDS, milk banking was dramatically affected. Concern for the unknown and the need for increasingly complex screening of donors and milk processing resulted in many banks closing, almost overnight. Donor milk banks in North America were reduced to about eight or nine by the end of the 1980’s.
By the 1990’s as mounting research on the importance of human milk and the effectiveness of safety procedures was published, donor milk banks again increased globally. In North America, the interest in donor milk banks has been growing. There are currently 22 HMBANA banks in North America and five more are in development.
Over the last one hundred years, the interest in human milk has come almost full circle with the understanding that human milk provides factors not replicated in any other source of nutrition. In addition, provision of a safe source of donor milk, supports breastfeeding by clearly indicating that human milk cannot be replaced. In the twenty-first century, donor milk banking is once again blossoming.
The New York Milk Bank has been a labor of love since 2009 when New York Milk Bank (NYMB) Executive Director, Julie Bouchet-Horwitz, FNP, IBCLC, realized that donor human milk was urgently needed in New York. Julie introduced PDHM into New York State that same year from a North Carolina milk bank, which has since let their NYS license lapse. Julie formed a working group of key volunteers who bring their experience and expertise in infant health care and nutrition to milk banking. Additionally, Julie invited various individuals who are leaders in the fields of breastfeeding, pediatrics and neonatology to join the NYMB’s Medical Advisory Board. The New York Milk Bank working group has worked tirelessly to establish a presence in our community by setting up milk depots (drop off sites) across New York State which make it convenient for approved donor mothers to donate their extra milk. The milk bank is in the process of receiving accreditation by The Human Milk Banking Association of North America and is licensed by the New York State Department of Health. The New York Milk Bank will be located just north of New York City in lower Westchester in the town of Hastings on Hudson. The New York Milk Bank is slated to open June 22, 2016.
What does the Milk Bank screen for? Is it 100% safe?
The New York Milk Bank is dedicated to improving the health and survival of infants in need by providing them with safely pasteurized donor human milk (PDHM) when their own mother’s milk is not available in sufficient quantities. Infants, especially premature infants, who receive an exclusive human milk diet have fewer potentially life-threatening infections, improved brain development and long term neurodevelopmental outcomes and decreased rates of chronic diseases including asthma, diabetes and cancer than those who are fed formula. However, not all women are able to produce enough milk for their own infants, especially those delivering prematurely who often have medical problems or complications. When a mother’s own milk is unavailable, the American Academy of Pediatrics recommends that preterm infants receive pasteurized donor human milk (PDHM).
Potential donors undergo thorough screening including verbal and written questionnaires, a blood test for HIV and other infectious diseases, and medical clearance from the donor’s and baby’s medical care providers. Once approved, donors may ship their frozen milk or drop it off at one of several milk collection depots across the state. The milk is pasteurized to kill bacteria and viruses, and then tested to ensure it is free of bacteria. Once testing is complete, the milk is distributed to hospitals when prescribed by a physician, to feed premature and sick infants. If surplus milk is available, it may be given to full-term infants in need.
An important goal of the NYMB is to reduce health disparities by providing safely pasteurized donor milk to all infants in need. Other goals include improving access to, and reimbursement for, donor milk across New York State.
Why are hospitals leaning toward offering human breastmilk to newborns now, rather than formula?
Breastfeeding has been shown to be a cost-effective preventive means to reduce infant morbidity and mortality, support proper growth and reduce the risk of several short and long-term health problems for infants and mothers. Many mothers of sick or premature infants are unable to produce enough milk to meet their infant’s needs. Contributing factors include infants’ extended hospitalizations and separation from their mothers, which interferes with establishing and maintaining an adequate milk supply, and maternal medical problems. A mother’s own milk is always best for her baby, but PDHM is the best alternative for these vulnerable infants when their own mothers’ milk is not available in sufficient quantity. PDHM is particularly critical for premature and sick infants who face the greatest health challenges and will benefit most from human milk. However, the availability of PDHM is very limited in New York State.
The American Academy of Pediatrics (AAP) recommended pasteurized donor milk for premature infants if mothers’ own milk is unavailable or is insufficient in 2012 because of the growing evidence supporting the role of PDHM in helping vulnerable infants achieve the best possible health outcomes. The Surgeon General called for a national strategy to efficiently and effectively address the issues involved in providing banked PDHM to vulnerable infant populations in The Surgeon General’s Call to Action to Support Breastfeeding.
Which NY hospitals do you work with?
New York hospitals that are currently using donor milk are Bellevue Hospital, NY; Crouse Hospital, Syracuse; Kings County Hospital, Brooklyn; Lenox Hill Hospital, NY; Maimonides Medical Center, Queens; New York Presbyterian Columbia, NY; New York University Langone, NY; Phelps Hospital, Sleepy Hollow; Queens Hospital, Jamaica; and Westchester Medical Center Maria Fareri’s Children Hospital, Valhalla. The New York Milk Bank is working with various other hospitals in the NYC metro area and across the state to help them implement a donor milk program.