Children's Hospital of the King's Daughters in Norfolk received approval last year to start a breast milk bank for babies in its neonatal intensive care unit, NICU. It started taking applications from milk donors in May and it plans to start processing milk received locally in June.
To date, CHKD has treated more than 100 of its tiniest patients — those born weighing less than 3 pounds 5 ounces and at under 30 weeks gestation — with breast milk from other milk banks.
"It's amazing. It was really a 5-year plan, but it's happened so quickly, in a year and a half," said spokeswoman Heather A. Kent.
Human milk protects against allergies and contains antibodies to fight disease along with containing growth hormones to help babies develop.
"Donor milk is easily digested and provides infection-fighting benefits and optimal nutrition in the absence of mother's own milk," according to the CHKD website. Consequently, there is a significant decrease in life-threatening complications.
The CHKD Milk Bank is the first in Virginia and one of only 17 in the nation. It follows the guidelines of the Human Milk Banking Association of North America, written under advisement of the U.S. Food and Drug Administration and the Centers for Disease Control, and the American Association of Blood Banking.
Donors must go through a triple-screen process, according to the bank's manager Ashlynn Baker, a NICU nurse. The process starts when a healthy lactating mother — some may be bereaved and donating as a legacy — has excess milk and calls the bank. A preliminary phone screening takes about 10 to 15 minutes. Baker then sends out a donor packet which asks for the mother's medical history and health habits. Questions are similar to those asked of blood donors by the American Red Cross, including HIV and hepatitis risk, piercing and tattoo history, and whether they have lived outside the United States or had blood transfusions. Any positive answers will trigger further investigation, she said, but not automatically eliminate someone from donating.
Information about their own baby's health is also requested and release letters are required from both the mother's doctor and the pediatrician to assure that donation would not adversely affect the mother's health or deprive the baby of needed nutrition.
The third screening element requires donors to have blood drawn to test for Hepatitis B and C, HIV and HTLV (human T-cell lymphotropic virus). Currently, donors must go to the diagnostic lab, though plans are in the works to have home visit tests in the future.
The CHKD Milk Bank covers all associated costs, including paying for screening, supplies, and costs of shipping for those outside Hampton Roads. The bank is funded primarily by the Norfolk City Union of the King's Daughters. The initial request for a milk "deposit" of 200 ounces, which Baker estimates can be accumulated in six weeks by a mother who expresses milk daily, allows the bank to defray costs by processing only large batches of milk.
The length of the screening process depends on how quickly the donor packets are returned and the doctors' letters received, said Baker. She anticipates initial turn-around time for approval at about two weeks, but hopes to cut it to a few days. Once approved, instructions are given on risky behaviors to avoid during donation — drug use, multiple sex partners, tattoos from a non-regulated site, etc. — as well as information on hand hygiene and how to store and freeze milk properly. The milk can be dropped off at the CHKD offices at the Medical Tower in Norfolk each weekday. For those outside the region, the bank will ship a cooler and pay for overnight return delivery.
Once received, the thawed milk will be mixed with five or six other batches before pasteurization. It will then be lab-checked for bacteria before being cleared to give to babies in CHKD's NICU, said Kent. After a year, the bank hopes to grow sufficiently to supply other hospitals in the region.
Baker is hoping to approve 150 donors in the first year, but received more than 25 calls in the first few days.
"At this rate, we'll easily surpass that," she said, noting that milk that has been in the freezer for less than six months is also acceptable.
Once an infant reaches its first birthday, the bank no longer accepts the mother's milk. "Some go up to two years, but there's not a lot of research on the quality of the milk after a year. The composition does change," said Baker, explaining that a 2-pound baby in the NICU requires the most nutrient-dense milk.
CHKD Breast Milk Bank
Who: Lactating mothers of infants less than one year old.
How much: 200 ounces initial donation.
Requirements: Must be generally healthy; not using medication or herbal supplements (some exceptions); be willing to undergo a screening, including blood testing, at the milk bank's expense.
To donate milk or funds: call Ashlynn Baker, 757-668-6455 (MILK), or email email@example.com; CHKD Milk Bank offices are located in the Medical Tower, off Brambleton Avenue, Norfolk.