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[ Originally published on: Monday, April 06, 2009 ]
Not that long ago, Naomi Bar-Yam recalls, she typically got a less than enthusiastic reaction from people when she'd bring up the notion of feeding babies donated breast milk: ''They'd say, 'Ewww, yuck -- why would you want milk from another mom?'''
Today, Bar-Yam says, she gets a very different response -- and not just because she points out to people that most of us already drink milk produced by ''another mom,'' and a bovine one at that. In recent years, public awareness of the many medical benefits of breast milk, as well as the health risks of baby formula, has increased dramatically. Those health benefits are especially important for premature and sick babies, whose mothers are often unable to produce breast milk, or at least not enough to meet their baby's needs in the early days and weeks.
That need drove Bar-Yam to begin working to create a breast milk bank for the region. Last summer, more than two years after she held an initial organizing meeting in her living room, the Mothers' Milk Bank of New England opened in Newton, Mass.
Currently, the MMBNE operates as a dispensary, providing donated milk to families around New England. The bank does not yet have a laboratory to process milk on-site, so the milk comes from the nearest existing milk bank, in Ohio. Bar-Yam, MMBNE's executive director, expects the bank to have a processing lab up and running by this summer; at that point, it will begin accepting donated milk from nursing mothers, who first undergo a strict screening process.
Right now, local mothers interested in donating milk can contact the MMBNE, which will connect them to the Ohio bank or the next-closest one, in North Carolina. Once the MMBNE has a processing lab set up, however, interested moms can donate closer to home -- including, for Valley moms, at a ''depot'' that will be located at the Northampton office of Northampton Area Pediatrics.
The Northampton site -- one of a number of depots planned around New England -- will be run by the Pioneer Valley Breastfeeding Task Force. Tanya Lieberman, a Northampton lactation consultant and task force member, says that when Bar-Yam brought her idea to the group a couple of years ago, ''we realized it would be a great resource to have in the area.''
Lieberman, a lactation consultant at Northampton Area Pediatrics, approached Dr. Peter Kenny, the practice's senior partner, with the idea of NAP hosting a local depot. ''They were very supportive,'' she says of NAP, which is donating space for the project. The task force also secured a freezer for the depot, donated by Springfield's Salemi Appliance.
Even without its processing lab in place, the MMBNE already dispenses 500 to 600 ounces of breast milk a week, according to Bar-Yam. How many babies that feeds depends on how big the babies are; while a full-term baby might eat 200 to 300 ounces a week, a premature or other small baby eats much less. And, Bar-Yam notes, the goal is always to have the mother breastfeeding as well, if possible, with the donated milk serving as a supplement if needed.
While milk banks do provide milk for full-term or healthy babies whose moms can't nurse -- such as adoptive babies or babies born of surrogates -- the majority of the milk goes to preemies or sick babies, often in neonatal intensive care units.
A prescription is required to get milk from a milk bank. But because there hasn't been a milk bank in the region for some time -- a bank at UMass Medical Center in Worcester closed in 2001 -- local doctors don't always think of it as an option, Bar-Yam says. Part of the MMBNE's work, she says, is educating the public and the medical community about the existence of the bank and the great benefits of donated milk.
''The main issue for physicians is: Is it safe, and how do we pay for it? And they're not unreasonable questions,'' Bar-Yam says.
Indeed, safety concerns led to the demise of many earlier milk banks. In the 1970s, there were about 30 milk banks in U.S. But when the AIDS epidemic hit, Bar-Yam says, ''most of them closed just about overnight,'' due to concerns about whether HIV could be transmitted through breast milk. Those concerns prompted the creation of the Human Milk Banking Association of North American in 1985. HMBANA developed guidelines for milk banks, such as donor screening and other safety protocols, and serves as a conduit for information about milk banking.
Today, HMBANA has 11 member milk banks in the U.S. and Canada, which follow those safety protocols. ''We screen mothers very carefully,'' says Bar-Yam. A potential donor needs to submit a detailed medical history, as well as letters from her and her baby's doctors confirming that neither would be adversely affected by her donating milk. Donors undergo periodic blood tests and cannot contribute milk if they smoke or take certain medications. Donated milk is both pasteurized and cultured before it's dispensed. And, Bar-Yam says, ''Even though it would be destroyed in the processing, we, of course, wouldn't take milk from an HIV-positive mother.''
While processing does reduce some of the breast milk's properties -- one reason milk banks stress the importance of babies being nursed by their moms when possible -- donated milk is still superior to formula, including the specialized formula given to premature or sick babies, notes Lieberman. ''What's remarkable is what actually stays intact,'' she says, pointing to research that shows that even processed donor milk preserves more of certain unique properties of breast milk, such as immunoprotective factors, than can be found in commercial formula.
But there are challenges to getting doctors to prescribe donated breast milk, including the fact that formula companies give hospitals free samples to use in their childbirth and neonatal intensive care units. It's a controversial practice that's come under scrutiny, as the public increasingly questions why hospitals allow corporations to use their facilities to market their products to families -- particularly when it's known that the product is inferior to breast milk. Lactation advocates point out that when a hospital gives away formula samples to new mothers, its breastfeeding rates go down.
Still, many hospitals are reluctant to give up the free formula. Banked milk, in contrast, would cost them: about $3 to $4 an ounce, Lieberman says. That sounds pricey, she says, until you consider how little a small baby actually eats. ''You're not talking about hundreds of dollars a day,'' she says.
And, in fact, babies fed donated milk develop fewer complications than babies fed formula -- a fact that advocates hope will sway hospitals and insurers, most of whom don't cover banked milk. A 2001 study in the Journal of Perinatology, for instance, found that use of donor milk reduced babies' length of time spent in a NICU, as well as reduced the risk of sepsis and necrotizing enterocolitis, a bowel infection that can strike premature babies. According to the study, for every $1 spent on donor milk, the hospital or health insurance company saves $11 in costs associated with health complications.
''When you look at it that way, banked milk is a bargain,'' says Bar-Yam. ''But you have to look at it that way.''
While the MMBNE does charge families processing fees, like all members of HMBANA, it will not turn away any family for lack of money. The bank largely relies on fundraising and grants; last year, Bar-Yam won $10,000 from ideablob.com, a Web site maintained by the credit card company Advanta, which asks the public to select the best idea submitted by small businesses and entrepreneurs. In-kind donations also help; the MMBNE operates rent-free out of a former school building owned by the City of Newton, and uses donated equipment.
Most of all, the bank depends on donations from nursing moms willing to share excess breast milk with babies who need it. Lieberman predicts there will be plenty of willing donors in the Valley. ''Breastfeeding rates in this area are high, and I expect we'll have a lot of moms out here who'll want to donate,'' she says.
For more information about the MMBNE, including information on how to donate breast milk, go to www.milkbankne.org or call (781) 535-7594.
MAUREEN TURNER has been a reporter and freelance writer living in the Valley since 1996.
