Human milk is liquid gold! Human milk is species-specific nutrition that promotes optimal growth and development for the first 6 to 12 months of an infant’s life. With thousands of immune factors, including antibodies that are not found in infant formula, it is superior nutrition for any baby.
Why use pasteurized donor human milk?
Studies show many important health benefits of breastmilk that extend even further into an infant’s life including resistance to disease and infection, along with prevention of diseases such as juvenile diabetes, multiple sclerosis, heart disease, and some cancers.
When mother's own milk is not available, pasteurized donor human milk is the next best option for infant feeding. Pasteurized donor human milk is heat treated to destroy bacteria and viruses. Many powerful immune factors are retained after pasteurization to protect against infection.
Bioactive Human Milk Factors
Bioactive Human Factors
Human Milk Oligosaccharides
Figure 1. Select immune factors in mom’s milk, pasteurized donor human milk, and formula
(Thanks to our sister milk bank, Mother’s Milk Bank of Western Great Lakes for sharing this table and data).
Pasteurized Donor Human Milk (PDHM) in the NICU
Preterm infants have fragile, underdeveloped gastrointestinal (GI) systems. Human milk reduces the risk of necrotizing enterocolitis (NEC), a dangerous GI condition associated with significant morbidity and mortality. When breastfeeding is unavailable, pasteurized donor human milk protects against NEC. Human milk also reduces the risk of sepsis and decreases the number of healthcare visits after NICU discharge. The American Academy of Pediatrics endorses the use of pasteurized donor human milk for preterm infants when mother's own milk is unavailable.
Common reasons for use of PDHM may include:
Infants susceptible to or recovering from necrotizing enterocolitis
Failure to thrive
Inborn errors of metabolism
Trophic feeds/gut priming
Pre- and post-surgical nutrition and immunological support
Treatment of infectious diseases (intractable diarrhea, gastroenteritis, infant botulism, sepsis)
Non-infectious intestinal disorders
Pediatric burn patients
Illness requiring temporary interruption of breastfeeding
Allergies or intolerance to cow and soy milk
Northwest Mothers Milk Bank, an accredited member of the Human Milk Banking Association of North America (HMBANA), prioritizes the most vulnerable patients to receive PDHM by serving more than 70 hospitals in the Pacific Northwest region. Our generous milk donors have assured that we can provide milk to infants outside of the NICU environment, promoting optimum health for infants in mother/baby care units as well as for infants at home when medical indication is present.
Donor Milk on the
Mother/Baby Care Unit & Post Discharge
The use of donor milk on mother/baby units for the healthy term infant population is fast becoming a standard of care. Studies have demonstrated that exclusive breastfeeding rates are higher at discharge when donor milk is available for supplementation. Establishing a donor milk program on the mother baby unit increases parental feeding choices and may improve patient satisfaction.
Indications for donor milk on the floor of mother/baby units include, but are not limited to: low supply, poor latch, hypoglycemia, weight loss, and hyperbilirubinemia.
Dr Mandy Brown Belfort has published valuable research supporting the use of PDHM in the mother/baby care unit setting
for Outpatients at Home
Donor milk may be used at home for a multitude of reasons including short term supplementation in the newborn period, maternal illness or separation, adoption, surrogacy, or low milk supply. Some parents use donor milk to provide a daily dose of antibodies and immune factors to complement baby’s other nutrition. Donor milk may be used in conjunction with mother’s milk or formula.
Although insurance companies do not routinely cover donor milk in the outpatient setting, Medicaid coverage is increasing in states around the US. Oregon Health Plan (OHP) covers the cost of PDHM from Northwest Mothers Milk Bank for infants up to 6 months of age (adjusted for gestational age) who meet all the following criteria:
Has low birth weight (<1500g) or severe underlying gastrointestinal disease;
Continued human donor milk through neonatal hospital discharge for a clear medical indication;
Has a persistent outpatient medical need for human donor milk due to ongoing severe concerns with persistent diarrhea or malabsorption, with improvement on breast milk compared to formula; and
The mother’s breast milk is not available, appropriate, or sufficient to meet the infant’s needs, despite lactation support for the mother.
of Donor Milk
Commercial milk processing companies are jumping into the field as they realize the benefits of human milk. These for-profit companies screen and process their milk differently than a nonprofit milk bank accredited by the Human Milk Banking Association of North America (HMBANA). Northwest Mothers Milk Bank uses the evidence-based Holder pasteurization process, (62.5 degrees C for 30 minutes) to ensure the safety and quality of our donor human milk. Commercial milk banks offer financial compensation to milk donors, as opposed to nonprofit HMBANA milk banks, who do not incentivize milk donation due to ethical and safety concerns.
Shelf Stable vs Holder Pasteurization
Common Diagnosis Codes used for ordering donor human milk
The following list is recommended by Northwest Mothers Milk Bank and the Human Milk Banking Association of North America.
AAP Policy on Breastfeeding and the Use of Human Milk, 2017
Impact of Donor Milk & NEC Rates
Donor Milk Use for VLBW Infants in the NICU
Donor Milk Use for Pre- term Infants
Formula vs Donor Milk for Pre-Term Infants
Supplementing Feedings in Healthy Term Neonate
CDC-Surgeon’s Call to Action to Support Breastfeeding, 2011
Partnering with NWMMB and becoming a Milk Drop has been an asset to the services we offer breastfeeding families. It makes our patients aware of the importance of breastmilk for the health and well-being of babies in our community.