What is a Milk Bank?
By Laura Silvas, RN IBCLC
It only makes sense that a place that stores precious liquid gold would be called a "bank." However, with the recent formula crisis in America, Breast Milk Banks are becoming a more significant topic of interest in mom groups.
What Is A Milk Bank?
Milk banks are companies/services that collect breastmilk from carefully screened donors, who then further test the milk, pasteurize it, and then distribute it to babies worldwide. The pasteurized breastmilk is also sent to hospitals for use in Neonatal ICUs (NICUs) and is available for purchase or through a prescription. Many of these companies are non-profit and use excess money to continue operations. Mothers donate breast milk at varying stages of breastfeeding. Some women have an oversupply, and some donate the remaining milk after their child has weaned. Surrogate mothers and sometimes bereaved mothers choose to pump and donate following the loss of their sweet baby.
What is the donation and screening process?
Women wishing to donate their breastmilk can contact their milk bank of choice (see lists below), either by phone or online, to fill out a prescreening form. Questions will include:
The ability to donate blood.
Any health concerns.
Previous blood transfusions.
Caffeine use.
Medications (prescription and herbal).
Tobacco/alcohol use.
Any supplement use (including fenugreek).
Medications typically allowed include Tylenol, Motrin, and progesterone-only birth control. Some medications that may hinder donations include antibiotic or cold medicines. Fenugreek is usually restricted as well, as it lowers blood sugar. In addition, tests are required to check for any infection or viruses, including HIV, HTLV, syphilis, and hepatitis B and C (the Milk Bank typically covers the lab expenses).
Following approval from the Milk Bank, arrangements will be made to send the frozen breastmilk to the bank.
How Should Breastmilk Be Stored and Sent to the Milk Bank?
Breastmilk should be collected, stored, and sent to the bank as directed by that milk bank and its processes. Most milk banks require breast milk to be stored in a freezer and sent to the lab within a six-month time frame. The milk bank will also cover the packaging and shipping costs. Many milk banks expect a minimum donation of 100-150 ounces of milk donated throughout your breastfeeding journey to offset the cost of screening/packaging. If your milk is not used for donations, there are other purposes, such as clinical studies and laboratory calibration.
How Is Breastmilk Pasteurized?
With the arrival of the liquid gold, the milk is then defrosted. Further testing for any drug, alcohol, and infection, including any heat-resistant pathogens, is performed. It is then combined with other donors' milk samples (this process allows a more even fat content). The milk is heated to 62.5 degrees (Celsius) for 30 minutes, then placed in an ice bath to cool the milk and stop the pasteurization process. While this kills any bacteria in the milk, many benefits of breast milk remain intact. The protein, carbohydrates, and fat content remain the same after pasteurization. IgA (antibody part of the immune system) is about 70% intact.
Tests such as culturing are repeated on the end product before distribution to ensure the quality of the milk. If a culture has any growth, the milk is discarded. According to Mother's Milk Bank Northeast: "In over 40 years of modern milk banking, there has never been a documented case of an infant being harmed by donor milk." This is likely due to the strict processes surrounding the milk's storage, testing, and pasteurization.
How Do I Receive or Purchase Breastmilk from a Milk Bank?
If you are interested in obtaining breastmilk through a milk bank, start by finding the Milk Bank closest to you. HMBANA (Human Milk Banking Association of North America) has 31 locations, and the EMBA (European Milk Bank Association) has 281 sites. Most of the milk bank's milk is transferred to NICU and inpatient infants. If your child has a medical condition such as malabsorption, short gut syndrome, is preterm, or has cardiac issues, etc., you may also be eligible for this milk through a prescription. Many milk banks have a prescription form on their website, which your child's doctor can sign. If you do not qualify for breastmilk with a prescription, check with the milk bank for the availability of donor milk. Some offer a "one-time" donation to assist mothers as they wait for their milk to come in or help with low supply. The cost of donor milk typically ranges from $3-$5 per ounce. Some banks have financial assistance, scholarships, etc., available to assist if you cannot afford the cost of donor milk. Calling your insurance may be another option to check benefits and any coverage of donor milk.
Milk Banks in the U.S
If you are concerned or need help in any of these areas, please reach out to us here at Leva, and let us help you come up with a plan.