"Booby Traps" in the NICU and How Donor Milk Can Help

I recently read an article from a great site, Best for Babes, that discussed challenges to breastfeeding that moms encounter when their baby must spend time in the NICU. The article was one of many in a series that brings to light societal challenges to breastfeeding that almost leave breastfeeding moms defenseless and defeated. In any case, one of the NICU challenges the article discussed mentions lack of donor milk.

The lack of milk available in NICUs is multi-facited. Some hospitals don't offer donated milk at all forcing moms of fragile babies to depend on artificial feeding if she experiences difficulty or is not allowed to provide milk herself via nursing or pumping. Some hospitals offer donated milk, but it may not be a feasible option if the patient's insurance does not cover the cost (despite the fact that treating illnesses that donated milk can help fight could cost hundreds of thousands of dollars more in comparison). Only a few hospitals provide donated milk (if the mother can't/doesn't provide it) regardless of insurance (at cost to the hospital) but typically this is based on the gestational age of the preemie. Fortunately this number of hospitals is growing, but it is still very low. The cost of donated milk itself can be daunting if insurance refuses to pay for it. Donated milk can cost $3-4 per ounce. That means if parents choose donated milk regardless of the insurance company's refusal to pay, parents could spend $16-60 PER DAY their baby is in the NICU. Depending on the age and development of the baby, that could be several months worth of milk. In addition, physically having the adequate quantity needed on hand to provide to babies is necessary as well, which is a huge concern considering that over the past several weeks, the milk bank I donate to was several thousand ounces short of requested milk. They physically could not supply what was needed by the hospitals they provide milk for.

Certainly, it is up to the administrations of individual hospitals to determine if they will make donor milk available to their patients, but likely lack of supply could be a leading factor in the decision. Obviously, one of the biggest contributing factors to helping babies thrive in the NICU is encouraging and supporting the moms to breastfeed and pump for their infants. Donor milk can help fill in the gaps to protect these babies from life-threatening diseases. The more moms that are willing to become donors and the more milk that is donated will help relieve some of the stress on hospitals meaning they have more to provide to their patients. If these hospitals are able to receive adequate supplies, perhaps more hospitals could be served by milk banks, helping more babies.

It's a lot of pressure when the big picture is examined, but every ounce counts - in more ways than one, and every donor can help new moms break free from a very common "booby trap."

Milk Shortages - How it All Adds Up

I recently received an e-mail update/newsletter from the milk bank i work with that described continued shortages of donor milk. The situation is so dire that they describe being short by several thousand ounces PER WEEK of the demand of the hospitals they work with. This situation is so bad, they are starting to offer incentives for referring donor moms.

To put things into perspective, let's look at how this divides up. They listed a shortage of 3000 ounces for this week. A baby weighing 6.5 lbs takes in 18 ounces per day. That amount that they are short could feed 166 babies in a day, or one baby for 166 days, or 5 babies for a month. Now take into consideration that most preemies that receive this milk are much smaller than 6.5 lbs and take in less milk. Think how far that amount goes. Or look at it and consider how desperate the need really is.

You may ask what the big deal is when formula is available. Well, the truth is, formula is inadequate. Babies in general stand the best fighting chance from receiving breastmilk to keep them healthy and protect them from pathogens. As many moms know hospitals and doctors offices can pose risks to young children with little or no immune system because that's where other children go to be treated for illnesses. Combine that with a pre-mature baby whose system isn't as developed as it should be and you aren't just dealing with a new immune system, but the whole body that is developmentally behind. Preemies are especially susceptible to necrotizing enterocolitis (NEC) which basically equates to death of their intestinal tract. The longer babies are kept in the NICU (neonatal intensive care unit) the longer they are at risk for getting NEC and the higher the mortality rate. The goal is to get babies as healthy as possible in the shortest amount of time possible so they can go home as soon as possible. The fastest way to do this is to feed breastmilk to these babies. Sadly, in many cases the early birth of the baby often doesn't allow the mother's system to catch up hormonally so she is making milk as she would with a full term baby. Also, given the need for the babies to be monitored and restricted from potentially harmful pathogens, these babies don't get the full benefits of skin to skin contact and unlimited access to the breast which also can inhibit optimum milk production for the mama. This means that donor milk is the preemies' best chance of getting to a healthy weight and developmentally mature enough to go home in the shortest amount if time (not to mention the immune components of breastmilk that help form a protective barrier from NEC).

Lives can be saved from donor milk, but if it is unavailable, in cases where the birth mom is unable to provide milk, formula must be used. This means the preemies may remain in the NICU for longer and don't have the added protection from NEC because formula cannot provide any immune components. Donors are vitally important. Spread the word to healthy nursing mamas you know that may be able to help. A little can go a long way.

Freezer Stash

My deep freeze is not typical. Most people have meat and other foods. My deep freeze? It has milk. Ok, sure, it has some of those other things too, but more space is taken up in my freezer by pumped milk than any other item. I have a collection of bagged milk for my own use. In addition, I have rows of containers for the milk bank. Granted, they are constantly rotated as I drop off donations every 3-4 weeks, but it certainly takes up space.

About 4 gallons waiting to be donated. I usually don't let
it build up this much, but my freezer is often stack two
high on this shelf. =)

If you are planning on donating, don't be daunted by the space it may take up. There are many things you can do. First, you don't need a deep freeze. A regular freezer is just fine, but you'll need to make sure that your samples are taken in more frequently. Remember, they have to be able to receive and process your milk before it expires. A deep freeze simply allows you to collect more at a time since you can hold onto it longer. The initial donation (at least for the milk bank I work with) is 100 oz. That equals out to about 20-30 storage containers depending on the size. The good thing about smaller containers is that they fit in more nooks and crannies making this a pretty easy task. After your initial donation, you don't have to worry about quantity and you can just make a donation when the milk starts taking up too much space.

After a couple months, you'll begin to start a system of how the containers all fit and where they "go" in your freezer. You'll figure out how to maximize space and how often you'll need to drop off your donations. You develop a system and the more you do it, the more routine it becomes. Happy freezing!