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376:, have been shown to transmit through breast milk. However, as mentioned above, breast milk donors are screened very carefully. In addition, each batch of milk is screened and pasteurized and retested for the presence of bacteria. "There have been no documented cases of disease transmission from donor milk provided by a milk bank operating under standard practice." (Arnold, 1999, p. 3) All of the milk banks listed below abide by the Guidelines of HMBANA. Potential donors are excluded from donating under the following circumstances:
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121:(UNICEF): "The best food for a baby who cannot be breastfed is milk expressed from the mother's breast or from another healthy mother. The best food for any baby whose own mother's milk is not available is the breastmilk of another healthy mother" (UNICEF, p. 48). "Where it is not possible for the biological mother to breast feed, the first alternative, if available, should be the use of human milk from other sources. Human milk banks should be made available in appropriate situations" (Wight, 2001).
319:, milk banks sometimes use newspaper, television and radio ads to solicit donors, especially when supplies are low (Arnold, 1997). NICUs with successful breastfeeding promotion and support often have mothers with excess milk, and they are frequently given information about how to donate their milk. In addition, mothers of infants who die sometimes choose to donate their milk.
246:
p. 243). At the end of pasteurization, another sample of milk is tested to make sure the treatment was effective. Colony counts should be zero and no bacterial growth should be detected (Arnold, 1997). Containers for pasteurizing must be able to withstand heating and cooling without breakage or leaking. Most containers are recyclable, usually
106:, although some are free standing. Members of HMBANA follow the annually revised "Guidelines for the Establishment and Operation of a Donor Human Milk Bank" which include protocols for soliciting donors and collecting, processing, and distributing the milk. In addition, some states have required standards for donor human milk banks. However, the
283:
obtained otherwise. Community fundraising and grants also help milk banks meet expenses. The guidelines ensure that no one is denied donor milk for lack of ability to pay. For non-hospitalized recipients, the milk bank will often work with the family to obtain coverage for processing fees (Arnold, 1997). However,
282:
The HMBANA Guidelines stipulate that donors not be paid for their milk. However, hospitals and recipients are required to cover some of the cost for collection, processing and distribution of milk which may be from $ 3.00 to $ 5.00 an ounce. This remains a much lower cost than pasteurized milk can be
157:
are growing, thriving, and under six months of age when they begin (Arnold, 1997). Some milk banks accept milk from mothers whose baby is up to two years old. Women who have given their baby up for adoption, acted as a surrogate, or are a bereaved mother may also donate. Because there is some risk of
144:
travelled to Boston to learn from the successful programme at the
Directory for Mother's Milk, Inc., set up by Dr Fritz Talbot. It was "a miniature dairy with all modern appliances". The quick freezing of fractions of an ounce of breastmilk had been perfected earlier that decade by researchers at
865:
Private milk donation is an alternative arrangement to milk donation through the Human Milk
Banking Association of North America. Private donation is a less formal method of donation that involves direct connection between mothers donating milk and the families receiving donations. Many families
245:
and pasteurizers for processing milk. Most milk banks have two freezers, for unprocessed and processed milk. The HMBANA guidelines state that "all milk should be heat treated for 30 minutes at 62.5 °C. Heat treatment of milk occurs at 62.5°C for 30 minutes (Holder pasteurizing)" (Arnold, 1997,
273:
Breast milk content of mothers of premature babies differs from that of mothers of full term babies (Wight, 2001). Therefore, most milk banks separate "preemie milk" – milk collected in the first 30 days after delivery of an infant less than 36 weeks gestation – from "term milk."
221:
Methods of collection and types of containers used vary among milk banks. Donors are educated about hygienic milk expression and given containers in which to express their milk. Some milk banks have collection points where couriers pick up donations, some have mothers deliver the milk to the
213:, she must wait out an "exclusion period" of six hours for one drink or 12 hours for two drinks before expressing milk for donation. For a premature or medically fragile recipient baby, even a tiny amount of alcohol, medications, or herbs in the milk may be problematic.
310:
Communities with milk banks use different methods to educate and solicit donors including brochures in doctors' offices and hospital information packets. Referrals also come from childbirth educators, nursing mothers groups, and
292:
145:
Borden Labs. The women recruited were paid by the ounce, and visited daily by a nurse, as most would not have had refrigeration at home. The
Maternity Hospital kept a stock of about 1000 frozen ounces.
270:(NICU) for premature or critically ill babies. Sometimes, however, donor milk is shipped to recipients' homes. In these cases, it is frozen, packed in special containers, and shipped over night.
490:
are stable at pasteurization temperatures. The lower the temperature at which safe processing can take place the better (Arnold, 1999). HMBANA Guidelines reflect careful research in this area.
1081:, "Donor Milk Banking". Chapter 33 in Core Curriculum for Lactation Consultant Practice, 2nd ed. Patricia J. Martens, Walker Marsha, editors. Sudbury, MA: Jones and Bartlett Publishers, 2008.
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engaging in private milk donation, include blood testing and complete donor screening while involving a supportive care provider. This is a modern continuation of the ancient concept of the
186:(Arnold, 1997). After administering a verbal or written questionnaire, healthcare providers for the mother and her baby must sign statements confirming that both are in good health.
1053:
Arnold LDW, "How to order banked donor milk in the United States: What the health care provider needs to know," Journal of Human
Lactation, 1998, 14(1) pp. 65–67.
99:
110:(FDA), states that "the FDA has not been involved in establishing these voluntary guidelines or state standards." Some of these protocols are described below.
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and billed through the hospital. In these cases, insurance companies are much more likely to cover the processing fees than for outpatients (Arnold, 1997).
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process. However, many are not. "Donor milk retains its bioactivity despite partial or complete loss of some components" (Arnold, 1999, p. 3). The
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Arnold LDW, "Use of Banked Donor Milk in the United States," Building Block for Life, Pediatric
Nutrition Practice Group, Volume 23 No. 1 Winter 1999.
567:
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Two concerns are often raised by potential donor milk recipients and health care providers regarding potential risks of using banked human milk:
1050:
Arnold LDW, "How North
American donor milk banks operate: results of a survey, Part 2," Journal of Human Lactation, 1997,13(3) pp. 243–246.
1047:
Arnold LDW, "How North
American donor milk banks operate: results of a survey, Part 1," Journal of Human Lactation, 1997,13(2) pp. 159–162.
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Griffith, D. "A father’s quest: After his wife’s death, he seeks insurants coverage for breast milk," The
Sacramento Bee, December 6, 2002.
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Besides the individual milk banks in the above states/provinces, HMBANA has sent donor milk to hospitals in 39 states and 3 provinces.
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Arnold LDW, "Cost savings through the use of donor milk: Case histories," Journal of Human
Lactation, 1998, 14(3) pp. 255–258.
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rarely cover donor milk, except under unusual circumstances (Griffith, 2002). In some states, and under some circumstances,
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349:-compromised. Preliminary research indicates that breast milk can have nutritive, immunologic and palliative effects for
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486:) appear to be most affected by the heat. However, immune factors are less sensitive to heat and growth factors and
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238:. Some milk banks pool milk before testing it, others test each mother's milk as it comes in before it is pooled.
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recipients can also benefit from the immunologic powers of breast milk. More research is needed in these areas.
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babies and mothers who cannot nurse their healthy babies use banked milk as well, often at their own expense.
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mothers who are not biologically related to the recipient infant". As of
November 2019, there are 28
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170:, donors must undergo a medical screening and a blood test to rule out infectious diseases such as
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Wight, Nancy E. "Donor human milk in preterm infants," Journal of Perinatology, 2001, 21:249-254.
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facility, and others ask women who live far away to freeze and ship their milk to the milk bank.
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Premature infants are the most frequent recipients of donor breast milk. Full term babies with
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Currently, many of the milk banks will receive milk from donors in states throughout the
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United Nations Children’s Fund (UNICEF), Facts for Life, New York, 2002 available at:
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depending on their supply. Donors should always contact the closest milk bank first.
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When there is milk available some milk banks will distribute it to adults who are
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is "a service which collects, screens, processes, and dispenses by prescription
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Barrett, Caroline V. (1939). "The Collection and Preservation of Breast Milk".
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When hospitals order banked milk for their NICUs it is often brought into the
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In addition to careful screening of donors, each batch of milk is tested for
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Banking on the Body: The Market in Blood, Milk, and Sperm in Modern America.
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Some of the worthwhile components of breast milk are compromised in the
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Radetsky, P. "Got cancer killers?" Discover, June 1999, pp. 68–75.
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will cover the costs of using banked milk (Arnold, 1999, Wight, 2001).
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from the recipient's physician. Often, it is used within the hospital
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Milk donors are new mothers who are in good health, whose
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patients (Radetsky, 1999). Adults with GI disorders and
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A 1930s breast pump in action on a hospital patient
338:also sometimes receive banked milk. Occasionally,
1126:- Peer to Peer Milk Sharing Milk Bank Alternative
209:, she can still donate her milk. If she consumes
1114:- Peer to Peer Milksharing Milk Bank Alternative
1061:www.cdc.gov/breastfeeding/compend-milkbanks.htm
719:WakeMed Mothers' Milk Bank and Lactation Center
100:Human Milk Banking Association of North America
1075:Cambridge, MA: Harvard University Press, 2014.
499:Below is a list of states/provinces that have
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596:Mothers' Milk Bank of the Great Western Lakes
8:
1479:South Georgia and the South Sandwich Islands
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142:Royal Victoria Montreal Maternity Hospital
66:Learn how and when to remove this message
431:) who do not supplement their diet with
29:This article includes a list of general
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401:or systemic prescriptions (replacement
568:Presbyterian/St. Luke's Medical Center
394:or its equivalent in a 24-hour period.
113:According to a joint statement by the
102:(HMBANA). They are usually housed in
390:Regular use of more than 2 ounces of
7:
811:Mothers' Milk Bank of South Carolina
761:Rogers Hixon Ontario Human Milk Bank
140:described in 1939 how nurses at the
972:"Eligibility for Human Milk Donors"
695:Heart of America Mothers' Milk Bank
1160:Human milk banking in the Americas
1086:http://www.unicef.org/ffl/text.htm
35:it lacks sufficient corresponding
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833:Mothers' Milk Bank of North Texas
681:Mothers' Milk Bank of Mississippi
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1322:Saint Vincent and the Grenadines
707:(Mothers' Milk Bank of Montana,
416:and/or pharmacologically active
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797:Three Rivers Mothers' Milk Bank
540:BC Women's Provincial Milk Bank
336:gastrointestinal (GI) disorders
847:The King's Daughters Milk Bank
512:NorthernStar Mothers Milk Bank
379:Receipt of a blood product or
119:United Nations Children's Fund
1:
733:OhioHealth Mothers' Milk Bank
582:Mothers' Milk Bank of Florida
526:Mothers' Milk Bank of Alabama
226:Screening and processing milk
825:Mothers' Milk Bank at Austin
775:Northwest Mothers' Milk Bank
653:Mothers' Milk Bank Northeast
268:Neonatal Intensive Care Unit
108:Food and Drug Administration
909:Centers for Disease Control
747:Oklahoma Mothers' Milk Bank
600:Elk Grove Village, Illinois
262:Donor milk is dispensed by
205:. If she or her baby has a
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921:"Donate Extra Breast Milk"
815:Charleston, South Carolina
667:Bronson Mothers' Milk Bank
624:Mothers' Milk Bank of Iowa
387:within the last 12 months.
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1464:Saint Pierre and Miquelon
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1112:Human Milk 4 Human Babies
1059:CDC, "Human milk banks,"
935:"Use of Donor Human Milk"
861:Milk banking alternatives
409:hormones are acceptable).
115:World Health Organization
1484:Turks and Caicos Islands
1108:- informational resource
1020:. HMBANA. Archived from
501:HMBANA member milk banks
98:that are members of the
1124:HappyBelliesHappyBabies
1120:- Milk bank alternative
789:CHOP Mothers' Milk Bank
566:(Mothers' Milk Bank at
50:more precise citations.
1399:British Virgin Islands
976:www.milkbankontario.ca
892:, covers other regions
399:over-the-counter drugs
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1312:Saint Kitts and Nevis
996:"Milk Bank Locations"
482:in breast milk (e.g.
193:or regularly use any
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1101:HMBANA official site
685:Flowood, Mississippi
361:Risks and mitigation
189:The mother must not
1489:U.S. Virgin Islands
1332:Trinidad and Tobago
1177:Antigua and Barbuda
530:Birmingham, Alabama
285:insurance companies
241:Milk banks require
1242:Dominican Republic
1018:"Who Do We Serve?"
954:The Canadian Nurse
941:. 3 November 2018.
657:Newton Upper Falls
554:Mothers' Milk Bank
503:in North America:
414:mega-dose vitamins
166:to babies through
138:The Canadian Nurse
135:
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1071:Swanson, Kara W.
885:Human breast milk
851:Norfolk, Virginia
383:, or a tissue or
381:blood transfusion
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385:organ transplant
149:Screening donors
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1459:Saint Martin
1366:Dependencies
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1022:the original
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258:Distribution
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1558:Neonatology
1548:Breast milk
1444:Puerto Rico
1371:territories
1317:Saint Lucia
1252:El Salvador
1002:17 November
699:Kansas City
677:Mississippi
643:New Orleans
488:fatty acids
425:vegetarians
392:hard liquor
317:blood banks
207:common cold
195:medications
176:hepatitis B
168:breast milk
86:donated by
48:introducing
1542:Categories
1439:Montserrat
1434:Martinique
1429:Guadeloupe
1227:Costa Rica
1028:2014-03-13
981:2016-03-10
837:Fort Worth
801:Pittsburgh
550:California
495:Milk banks
330:Recipients
217:Collection
174:-1 and-2,
160:infections
117:(WHO) and
92:milk banks
84:human milk
56:March 2014
31:references
1514:Caribbean
1424:Greenland
1347:Venezuela
1292:Nicaragua
1262:Guatemala
1182:Argentina
1167:Sovereign
1106:MilkShare
897:Footnotes
868:wet nurse
671:Kalamazoo
634:Louisiana
628:Iowa City
544:Vancouver
459:hepatitis
446:products.
405:and some
232:bacterial
104:hospitals
1379:Anguilla
1327:Suriname
1302:Paraguay
1277:Honduras
1237:Dominica
1222:Colombia
1192:Barbados
1079:Tully MR
998:. HMBANA
960:: 14–18.
880:Wetnurse
874:See also
843:Virginia
743:Oklahoma
737:Columbus
709:Missoula
691:Missouri
663:Michigan
592:Illinois
564:Colorado
558:San Jose
450:Silicone
433:vitamins
403:hormones
300:pharmacy
289:Medicaid
243:freezers
184:syphilis
158:passing
1409:Curaçao
1394:Bonaire
1389:Bermuda
1342:Uruguay
1282:Jamaica
1257:Grenada
1247:Ecuador
1202:Bolivia
1187:Bahamas
765:Toronto
757:Ontario
723:Raleigh
705:Montana
606:Indiana
578:Florida
522:Alabama
516:Calgary
508:Alberta
480:enzymes
444:tobacco
438:Use of
412:Use of
370:Viruses
340:adopted
315:. Like
252:plastic
211:alcohol
164:viruses
155:infants
125:History
88:nursing
44:improve
1297:Panama
1287:Mexico
1267:Guyana
1212:Canada
1207:Brazil
1197:Belize
1169:states
829:Austin
771:Oregon
572:Denver
484:lipase
429:vegans
423:Total
418:herbal
351:cancer
347:immuno
306:Donors
33:, but
1384:Aruba
1272:Haiti
1217:Chile
821:Texas
278:Costs
248:glass
201:, or
199:herbs
191:smoke
1449:Saba
1369:and
1307:Peru
1232:Cuba
1004:2016
729:Ohio
620:Iowa
463:HTLV
291:and
182:and
178:and
162:and
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293:WIC
250:or
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