Human Milk Banks: A Narrative Review

Document Type : Original Article

Authors

1 ARSLVT, USF Marginal - R. Egas Moniz 9010, Piso 2, 2765-618 São João do Estoril, Lisboa, Portugal.

2 Serviço Pediatria Centro Hospitalar Vila Nova Gaia/Espinho - R. Conceição Fernandes 1079, Vila Nova de Gaia, 4434-502 Vila Nova de Gaia.

3 Serviço Ginecologia/Obstetrícia Hospital Senhora da Oliveira Guimarães, R. dos Cutileiros 114, Creixomil, 4835-044 Guimarães.

4 Serviço de Ginecologia/Obstetrícia Hospital de Cascais Dr. José Almeida - Avenida Brigadeiro Victor Novais Gonçalves 2755-009 Alcabideche.

Abstract

Introduction:
Not all mothers can provide sufficient milk, and infants admitted to a neonatal ward are less likely to be exclusively breastfed. Current recommendations are for the use of mother’s own milk (MOM), and pasteurized donor human milk (PDHM) is the next best choice. The present article was prepared as a tool to study the optimal organization of Human milk banks (HMB) and to contribute to the diffusion of the culture and promotion of breastfeeding and summarize current best practices for the handling of PDHM.
Materials and Methods:
PubMed, Embase and Cochrane were searched using the search term combination “human milk banks” OR “pasteurized donor human milk”.
Results:
HMB are responsible for human milk (HM) promotion, collection, processing, protection, quality control, distribution and support. The quality of expressed HM is the result of adequate hygienic-sanitary conditions, from expression to administration, and the evaluation of nutritional, immunological, chemical, and microbiological characteristics. It is essential a multidisciplinary team to support an HMB.
Conclusion:
In settings where donor HM supplies are limited, prioritization of infants by medical status is key. The manner in how investments in human milk feeding are applied should be targeted. The purchase cost of PDHM should be compared with the purchase costs of other nutrition interventions routinely used in care for critically ill neonates.

Keywords


  1. Borges MS, Oliveira AM d. M, Hattori WT, Abdallah VOS. Quality of human milk expressed in a human milk bank and at home. J Pediatr (Rio J). 2017;(xx). doi:10.1016/j.jped.2017.07.004
  2. Spatz DL, Robinson AC, Froh EB. Cost and Use of Pasteurized Donor Human Milk at a Children’s Hospital. JOGNN - J Obstet Gynecol Neonatal Nurs. 2018; 47(4):583-588. doi: 10.1016/j. jogn.2017.11.004.
  3. Buckle A, Taylor C. Cost and Cost-Effectiveness of Donor Human Milk to Prevent Necrotizing Enterocolitis: Systematic Review. Breastfeed Med. 2017;12(9):bfm.2017.0057. doi:10.1089/ bfm.2017.0057.
  4. Trang S, Zupancic JAF, Unger S, et al. Cost-Effectiveness of Supplemental Donor Milk Versus Formula for Very Low Birth Weight Infants. Pediatrics. 2018;141(3):e20170737. doi:10.1542 /peds.2017-0737.
  5. Affumicato L, Sánchez Tamayo T, Espinosa Fernandez MG, et al. Satellite center of human milk: Analysis of cost reduction. J Healthc Qual Res. 2018;33(1):3-9.doi:10.1016/j.cali. 2017. 12.005.
  6. Moro GE. History of Milk Banking: From Origin to Present Time. Breastfeed Med. 2018;13(S1):S-16-S-17. doi:10.1089/ bfm.2018. 29077.gem.
  7. Jahan Y, Rahman A. Human milk banking can be an innovative approach for developing countries. Heal Promot Perspect. 2018; 8(4):249-251. doi:10.15171/hpp.2018.34.
  8. Steele C. Best Practices for Handling and Administration of Expressed Human Milk and Donor Human Milk for Hospitalized Preterm Infants. Front Nutr. 2018;5(September):1-5. doi:10.3389/fnut.2018.00076
  9. Kwazulu-Natal DHP of K-N. Guidelines for the Establishment and Operation of Human Milk Banks in Kwazulu-Natal. 2014;(October). http://www.hmbasa.org.za/wp-content/ uploads/ 2015/02/ Human-Milk-Bank-KZN-Guidlines. pdf.
  10. Arslanoglu S, Bertino E, Tonetto P, et al. Amendment to 2010 Italian guidelines for the establishment and operation of a donor human milk bank. J Biol Regul Homeost Agents. 2012;26 (3Suppl):61-64. doi:10.3109/14767058.2010. 512414
  11. Hartmann BT, Pang WW, Keil AD, Hartmann PE, Simmer K. Best practice guidelines for the operation of a donor human milk bank in an Australian NICU. Early Hum Dev. 2007; 83 (10):667-673.doi:10.1016/ j.earlhumdev. 2007. 07.012.
  12. Schlotterer HR, Perrin MT. Effects of Refrigerated and Frozen Storage on Holder-Pasteurized Donor Human Milk: A Systematic Review. Breastfeed Med. 2018;13(7):465-472. doi:10.1089/bfm.2018.0135.
13.               Price E, Weaver G, Hoffman P, et al. Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society & Infection Prevention Society*. J Infect Prev. 2016; 17(2): 53-62. doi:10.1177/1757177415613566
14.               Gayà A, Calvo J. Improving Pasteurization to Preserve the Biological Components of Donated Human Milk. Front Pediatr. 2018;6(October):1-6. doi:10.3389/ fped. 2018.00288
15.               Fernández L, Ruiz L, Jara J, Orgaz B, Rodríguez JM. Strategies for the Preservation, Restoration and Modulation of the Human Milk Microbiota. Implications for Human Milk Banks and Neonatal Intensive Care Units. Front Microbiol. 2018;9(November):2676.doi:10. 3389/ fmicb.2018.02676.

16.               Simmer K. Human Milk Fortification. Nestle Nutr Inst Workshop Ser. 2015;81:111-121. doi:10.1159/000365808
17.               Rochow N, Landau-Crangle E, Fusch C. Challenges in breast milk fortification for preterm infants. Curr Opin Clin Nutr Metab Care. 2015;18(3):276-284. doi:10.1097/MCO.0000 0000 00000167
18.               Sauret A, Andro-Garçon MC, Chauvel J, et al. Osmolality of a fortified human preterm milk: The effect of fortifier dosage, gestational age, lactation stage, and hospital practices. Arch Pediatr. 2018;25(7):411-415. doi:10.1016/j. arcped.2018.08.006
19.               Kreins N, Buffin R, Michel-Molnar D, Chambon V, Pradat P, Picaud J-C. Individualized Fortification Influences the Osmolality of Human Milk. Front Pediatr. 2018;6(October):1-6. doi:10.3389/fped.2018.00322.