This article first appeared in the January/February 2018 issue of Your Baby magazine.
When Tayla Kruger was born at 31 weeks in June last year (2017), she weighed 995g. Soon after birth, her weight dropped to a mere 805g.
The stress of her daughter’s premature birth, two serious breast operations when she was younger and the fact that her body was not yet ready to feed her child, meant Elrize Kruger (30) could not breastfeed her tiny daughter. “Although my milk started coming in little by little, I could express no more than 4ml to 8ml at a time,” the Ballito mom recalls. “When I finally managed to express 22ml with a breast pump, I thought my milk was finally coming in, but by the next day it was completely gone again.”
Doctors were hesitant to give her micro-premature baby formula, because her underdeveloped digestive tract would not be able to handle it. “She was simply too small and could die,” Elrize says. Netcare offered to donate colostrum to Tayla until she reached 1.6kg and a nurse at the hospital suggested that Elrize reach out to breastfeeding friends to donate breastmilk. “Previously I didn’t even know this was possible,” she says.
The Krugers started a Facebook group asking for help and in no time, they were overwhelmed by the kindness of friends and strangers who were willing to donate breastmilk to help save Tayla. Slowly but surely the baby started to gain weight. “The hospital sent us home with twenty 250ml bottles of breastmilk collected through a breastmilk donor bank and the fantastic Stanger government hospital donated almost 40 bottles of milk by September.”
By mid-September three-monthold Tayla weighed 2.76kg and was flourishing. “Although I would have loved to breastfeed her myself, there are no words to express my gratitude to those willing to donate breastmilk when my child’s life depended on it. For the first time, I really understood why ‘breast is best’.”
“In the high-tech world of the modern neonatal ICU there is no substitute for breastmilk,” says Jenny Wright, the CEO of Milk Matters, a human milk bank in the Western Cape. “All over the world it is recognised
that only breastmilk offers premature babies the nutrition and protection essential for their survival.
When a vulnerable baby’s own mother is unable to supply breastmilk, a breastmilk bank can offer this lifesaving gift from another mother.” According to Stasha Jordan, a breastfeeding activist and the executive director of the South African Breast Milk Reserve (SABR), research has found that formula feeds were endangering children because it could not offer the same protection and benefits of breastmilk.
Milk Matters agrees that donor milk is the next best option if a mother cannot supply the breastmilk her baby needs, because it dramatically increases a baby’s chance of survival; protects against infections and serious complications; offers ideal nutrition; increases immunity and does not put added strain on the immune system. In hospitals where only breastmilk – from the mother or donors – is used, fewer infants die and cases of serious complications after birth drop.
The SABR’s vision is to decrease the number of infants dying due to necrotising enterocolitis (NEC), a serious intestinal disease among preemies, through the use of donated milk and to decrease mother-to-child transmissions of the HI Virus. Milk banks were initially started to feed the orphaned, but in recent years donated breastmilk has predominantly been used in neonatal intensive care units.
Donated breastmilk is prescribed for infants under 1.8kg, or those born at less than 32 weeks’ gestation; infants younger than 14 days, and for short term use (1428 days). The SABR does not advise prolonged use and recommends that mothers feed their children themselves after this period is over, if possible. In some cases, doctors can motivate the need for extended breastmilk donation.
Thousands of premature babies across the country have received milk donated to Milk Matters by more than 2 000 donor moms; while the SABR has set up, operated and handed over 52 human milk banks, serving more than 100 public and private hospitals across the country and feeding approximately 3 000 babies a year since 2003.
According to neonatologist Dr Alan Horn of the Groote Schuur Hospital, breastmilk donation is worth more than equipment and staff. “It is an intervention that most doctors themselves cannot give, but most mothers can – it completes medical care,” he says. “Donating breastmilk is an act that involves the least pain and most gain, compared to any other human tissue or organ donation.”
Every drop counts
“Just 50ml of breastmilk, a mere 2.5 tablespoons, can feed a baby of under 1kg for a full 24 hours,” says Jenny. “This means mothers do not need an abundant breastmilk supply in order to donate their milk.
Regular donations of 50ml or more can make the world of difference.” Newborn and premature babies only require a tiny amount (10ml or less) for each feed, adds Stasha. “For the most severely ‘micropremature’ infants, 1ml of breastmilk every three hours can make a difference between life or death,” Stasha explains. “This is why we say every drop counts.” Some donor moms make once-off donations of stock-piled breastmilk that is not required for their own baby, while other mothers donate varying quantities from between a few weeks up to a year or more.
Is it safe?
The safety of donated milk is of the utmost importance – from the screening of potential donors, to hygienically and safely expressing and storing your milk.
According to Twanette Lombard, operations manager of the SABR, donated breastmilk must be frozen when it reaches them. “If the cold chain has been broken, the milk can no longer be used.” “Milk is placed in a quarantine fridge when we receive it, before a sample is sent for testing,” says Twanette. “Approved samples are pasteurised in a specialised machine that reaches a temperature of 62.5°C for 30 minutes, before rapidly cooling the milk to 15°C.”
- Also see: The great breast milk swap
Why I am a donor
Stefanie Nothard (30) from Johannesburg’s son Ryan (18 months) was born prematurely and spent the first few weeks of his life in NICU.
She produced an abundance of breastmilk and because she understood the pressures of having such a small baby in hospital, wanted to donate milk to those in need. “The stress of having a child in the neonatal ICU is enormous and having to produce breastmilk creates added pressure.
In other instances, a mom’s life might be in danger. “Donated breastmilk gives a mom a day or two to wait for her own milk to come in, while she has the assurance that her child is being fed breastmilk. This peace of mind helps a lot. “So, you are not only giving the preemie a chance at life, you are giving another mom a chance to have support to produce her own breastmilk.”
Donating breastmilk gave her a sense of purpose after the birth of her son. “As a new mom you often feel like a milk machine who gets nothing else done but feeding and changing nappies. By donating breastmilk you feel that you are contributing to society by helping babies!” she says.
Stephanie says it only takes a little extra work to donate. “Obviously you have to add an extra pumping session to your day, but knowing you are saving lives with so little effort, makes it really worth it. “If you are lucky enough to carry your baby to full term, then why not donate? It’s your superpower!”
- Also see: Celebrating midwives and breastfeeding
How to become a donor
Who can donate?
Healthy, lactating women can donate milk their own babies do not need if they have access to a fridge and freezer. Donors are not remunerated.
How do I sign up?
Contact either the SABR (countrywide, but not in the Western Cape) or Milk Matters (Western Cape). The SABR has an online sign-up form, while Milk Matters will send you all relevant documentation on request.
What happens next?
Potential donors are required to complete a screening form and undergo an initial HIV and Hepatitis B blood test. Donors are not required to pay for this test. Donor moms will have to undergo a rapid HIV test (finger prick) every three months. A nurse from the milk bank will visit you at home to facilitate the collection of breastmilk.
How do I store my milk?
If you are approved as a donor, the milk bank will provide you with sterile containers (of 250ml each) and an airtight cooler box. Fresh, raw breastmilk for donation must be kept in a fridge and must be frozen within 24 hours of being expressed. Breastmilk can be dropped off at a milk bank in your area, or collected at your home.
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Have you ever been a breastmilk donor? What motivated your decision? Tell us your story by emailing to firstname.lastname@example.org and we could publish your letter. Do let us know if you'd like to stay anonymous.
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