Ireland's only human milk bank
By Deborah Condon
It is well known that Ireland has one of the lowest breastfeeding rates in Europe, with only around four in 10 mothers choosing to breastfeed their babies. However some mothers are willing not only to feed their own children in this way, but also to donate some of their breast milk to help sick and premature babies throughout the country.
"The mothers who do this are simply fantastic", says Ann McCrea, a lactation consultant who works in the country's only human milk bank.
Located in Fermanagh in Northern Ireland, the Sperrin Lakeland Milk Bank works in a similar way to a blood bank. Breastfeeding mothers who have excess milk and wish to donate, express the milk and then send it in insulated containers to Fermanagh, where it is checked for bacteria and pasteurised. The milk is then stored at the bank until it is sent to neonatal units around the country as required.
In 2005 alone, 163 donors provided breast milk, which was used to help 429 babies in 11 hospitals, including 26 sets of twins and one set of quadruplets.
Breastfeeding is already known to provide a number of health benefits. Children who are breastfed have a lower incidence of illnesses such as diarrhoea, asthma, diabetes, eczema and pneumonia.
They also have better health outcomes later in life. In fact, research indicates that they have lower blood pressure, lower cholesterol levels and a lower incidence in infections throughout childhood and adulthood.
However probably most importantly for premature babies, breast milk helps to protect against NEC, a life threatening condition that affects the baby's gut (bowel).
NEC (necrotizing enterocolitis) can affect all newborns, however it is much more common in premature babies. It can result in death and those that survive often require surgery.
While the cause is unknown, research has found that babies fed breast milk are at a reduced risk of developing this condition. However breast milk is not always available from the mother as she may be too ill, absent from her baby or her supply may not meet her baby's needs. It is at times like this when donor milk is used.
Tanya Cassidy and Conrad Brunstrum know all too well the dangers of NEC. One year ago, they lost their newborn son, Liam, to the condition. Tanya, originally from Canada, has been living in Ireland for 12 years. She had been visiting Canada and was on her way home to Ireland when she went into labour 10 weeks premature. She required an emergency Caesarean section and lost a lot of blood. As a result, she was not in a position to breastfeed.
Liam only lived for 16 days - he had developed NEC, which sadly led to his death.
When Tanya became pregnant again, she and Conrad did as much research as they could on the condition. While obviously hoping that their baby would not be born premature, they wanted to be as prepared as possible if that should happen. After discovering that premature babies who are given breast milk are significantly less likely to develop NEC, they decided that if necessary, they would use donated breast milk.
Unfortunately Tanya, who was attending the Coombe Maternity Hospital in Dublin, developed placenta praevia during her pregnancy. This is when the placenta is in the lower segment of the uterus, near the opening. Bleeding can be a symptom and if the placenta is totally obstructing the opening from the womb, a Caesarean is necessary.
As a result of her condition, Tanya bled throughout her pregnancy and again required an emergency Caesarean section. On February 15, 2006, just 30 weeks and three days into her pregnancy, her son, Gabriel, was born.
Tanya had lost so much blood, she was not able to meet the baby's demand for milk. Furthermore as she was still unconscious after the Caesarean, Conrad talked to the doctor about the couple's wishes for donor milk to be used.
As premature babies cannot suckle, the milk has to be expressed even if it is the baby's own mother providing it. Tanya gives Gabriel whatever she can, which is about one-third of what he needs.
"We are now past the dangerous stage for NEC and I'm thrilled to say Gabriel has developed no infections. When a baby is born at 30 weeks, the doctors warn you that they will get something, but he didn't. It wasn't all straightforward. He was only 3lbs when he was born and had a collapsed lung, but he didn't have to deal with the infections that a lot of premature babies do", Tanya explains.
Donor milk is not only provided to premature babies. It is also provided to babies with certain medical conditions who require it. For example, since 2005, the bank also provides milk to babies undergoing heart surgery, as they are also at an increased risk of developing NEC. Furthermore, those given breast milk tend to have fewer problems with things such as blood pressure.
So how does someone get involved?
"If any woman has extra milk and would like to donate, simply give us a ring. We will take a history and if there is no problem, you will have to undergo a blood test, usually by your own GP or maternity hospital", explain Ms McCrea.
If everything checks out, the milk bank will send an insulated container to the woman 'on the bus'. She will express the milk and send it back to Fermanagh, where it is pasteurised and stored.
"In the USA, milk travels with airline pilots. In Brazil, it travels with firemen. In Ireland, it travels with the bus driver! Women anywhere in the country can get involved. After pasteurisation, the milk is frozen and it has a shelf life of three months", she says.
It is sent to hospitals around the country when needed, where it is stored in freezers and defrosted as required. How long a baby needs to stay on the breast milk is decided on a case-by-base basis.
However not surprisingly, the bank can experience a shortage of donations.
"We supply about 80 litres of milk a month. In our busiest month, we supplied 92 litres. We have five freezers here, but currently only enough milk to fill three", Ms McCrea explains.
She points out that of the 163 donors last year, not all of their babies survived.
"We had 13 mothers contact the bank after their baby had died, due to extreme prematurity or foetal abnormality, offering their pumped milk for use by other babies. Other mothers collected milk in neonatal units, hospitals or their own homes and sent it on to the bank", Ms McCrea says.
Not surprisingly, Tanya and Conrad view women who donate breast milk as 'a Godsend'.
"My vision of these donors is women who care. If I had extra milk, I would give it back", Tanya says.
If you are interested in donating breast milk or would like more information, call the milk bank on 048 686 28333 (from Northern Ireland, call 028 686 28333) or email firstname.lastname@example.org
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