Human Milk Banking

Definition of Human Milk Bank

A human milk bank is a facility that collects, screens, processes, and distributes donated breast milk to infants in need, particularly preterm or medically fragile babies who cannot receive their mother’s own milk.

Importance of Human Milk Banking

1. Optimal Nutrition – Provides essential nutrients, enzymes, and bioactive factors crucial for growth and immunity.
2. Reduced Morbidity and Mortality – Protects preterm infants from infections, necrotizing enterocolitis (NEC), and sepsis.
3. Alternative for Mothers Unable to Breastfeed – Supports infants of mothers with lactation failure, illness, or absence.
4. Supports Public Health Initiatives – Promotes breastfeeding culture and ensures milk availability for vulnerable neonates.

Criteria for Milk Donors

1. Healthy lactating mothers with surplus breast milk.
2. Free from infections like HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis.
3. Not on medications or substances contraindicated in breastfeeding.
4. Non-smoker, non-alcoholic, and drug-free.
5. Willing to undergo screening and adhere to milk donation guidelines.

Collection and Storage of Donated Milk

1. Collection – Expressed using a sterile breast pump into pre-sterilized containers under hygienic conditions.
2. Screening – Milk is tested for bacterial contamination and infectious diseases.
3. Processing – Pasteurization (Holder Pasteurization at 62.5°C for 30 minutes) to eliminate pathogens while preserving nutrients.
4. Storage – Stored at -20°C to maintain safety and nutritional quality.
5. Distribution – Provided to neonates based on priority, especially preterm or sick infants.

Nutritional Composition of Human Milk

• Macronutrients: Proteins (whey & casein), fats (DHA, ARA), and carbohydrates (lactose).
• Micronutrients: Vitamins (A, D, E, K, B-complex), calcium, iron, and zinc.
• Bioactive Components: Immunoglobulins (IgA), lysozyme, lactoferrin, and oligosaccharides for immune protection.

Physiology of Lactation

1. Hormonal Regulation:

• Prolactin – Stimulates milk production.
• Oxytocin – Triggers milk ejection (let-down reflex).

1. Stages of Lactation:

• Colostrum (Day 1-5) – Rich in antibodies and proteins.
• Transitional Milk (Day 6-14) – Increased fat and lactose content.
• Mature Milk (After 2 weeks) – Balanced nutrients for infant growth.

1. Milk Ejection Reflex – Suckling stimulates oxytocin release, leading to milk flow.

Indications for Human Milk Banking

1. Preterm and low birth weight infants.
2. Neonates with feeding intolerance or NEC risk.
3. Babies with maternal contraindications to breastfeeding (HIV, chemotherapy, severe illness).
4. Orphans and abandoned newborns.
5. Post-surgical infants unable to breastfeed.

Conclusion

Human milk banking is a critical initiative ensuring safe and adequate nutrition for vulnerable neonates. It enhances survival rates, reduces morbidity, and supports breastfeeding practices globally.