Health
While most mothers are willing to donate breast milk after counselling, often the families stop them.
Image for representation. By Tareq Salahuddin/Flickr

When Lalitha’s new born pre-term baby developed respiratory problems, the hospital in Pollachi referred him to the Special Neonatal Care Unit (SNCU) at the Coimbatore Medical College and Hospital (CMCH), well known as the Coimbatore GH. But the hospital did not allow the mother, who had pregnancy-associated hypertension, to travel with the baby. So, the grandmother accompanied the 1.5 kg baby to Coimbatore on July 31. 

Four days on, the baby’s health is settling, and he is also getting his supply of nutrients a new born should get from a nursing mother. The human milk bank that is part of the SNCU ensures that the infant is tube fed 15 ml of milk every three hours. 

Like Lalitha, Sindhuja’s baby too developed some health complications soon after birth. He was born on July 28 at the ESI Hospital in Coimbatore and had to be rushed to the SNCU at GH. Sindhuja could not accompany the baby because of her vulnerable state.

However, when Sindhuja joined her little one on July 30, she was happy on two accounts – not only was her baby was improving, he was also being given breast milk.

From that day, as soon as she is done nursing her son, she goes to the milk bank. “My baby got someone else’s milk when I was not there,” Sinshuja says. And, so she donates milk for infants who are orphaned, abandoned, or whose mothers are not physically fit to nurse them.

One of the seven centres in Tamil Nadu, Coimbatore GH was allotted a human milk bank in August 2015 by the state government. The hospital not only witness a large number of deliveries every day, but was also a major referral centre for neonatal critical care for nearby districts, and Palakkad in Kerala. 

Though the milk can be stored for up to two years, the milk bank at GH is just able to sustain the demand, and hence there is no scope for long-term storage. Since 2015, the milk bank has been instrumental in increasing the neonatal survival rate to 85%.  

Though it sounds and connotes something similar to a human blood bank, it is so much more different and difficult to manage and maintain, according to the Nodal Officer of SNCU, Dr V Bhooma. 

To begin with, donors are limited.  They can only be lactating mothers. The second difficulty is that the mothers who have just delivered fear that if they donate milk there will not be enough for their child. Hence, an important component of the milk bank is counselling.

As soon as a woman starts nursing she is called to the milk bank and counselled by the nurses or the lactation counsellor. She is made to understand that when milk is expressed it only leads to more secretion and hence there is no fear of depletion. It is also explained to her that it is more precious than blood and the initial fortifying is so necessary for the infant’s future. 

Once a mother is willing to donate, the milk is expressed using a hospital grade breast pump, and the expressed milk is screened under several parameters. The tested milk is sent for pasteurisation that helps in removing bacteria. It is then cooled and refrigerated in the deep freezer. Before use, it is thawed and again tested before the infant is tube fed or given via ‘paladai’(small cup to feed babies).

“Almost all of them empathise, understand and are willing to donate. But most of the times, it is the family that prevents them from donating. There is always a need for milk, and once a woman delivers she donates only during the period of hospital stay, which varies between three to five days, unless there are complications. So it is a challenge to maintain a satisfactory storage mark,” adds Dr. Bhooma.

This is so relevant to this year’s World Breastfeeding Week (Aug 1-7) theme of “Sustaining Breastfeeding Together”. The “together” in the theme is to show that the mother alone cannot sustain the breastfeeding practise, especially in the case of working mothers. Support from the family first, and then work place, is considered to be two major factors in ensuring that the mother could nurse a child up to two years.

The same analogy is drawn in the case of donors for the milk bank. Once the mother is discharged from the hospital, she is not allowed to donate milk. 

Dr. Bhooma says that though awareness about milk donation has increased, it is not enough. “People have to realise every drop is life-saving,” she asserts. It is because of this poor awareness that there are only a limited number of milk banks in India, and almost all in government hospitals. 

However, despite the hurdles in keeping up with the demand for breast milk, there are good examples too. Dr. Bhooma remembers a woman, Susan, who was a lactating mother of a three-month-old. She was recently in Coimbatore on a business trip from China, Dr Bhooma narrates. Her baby could not accompany her.

The entire fortnight that Susan stayed in Coimbatore, she made it a point to visit the bank almost every day to donate milk. She would breastfeed an infant and express the rest to be stored. The day she could not go to the bank, she would collect the milk in a clean container and send it through someone.  

There are also groups like the Coimbatore Parenting Network which are doing there bit to help create awareness about donating breast milk. The Network has over 1,000 lactating mothers as its online members.

“It is true that there is poor awareness about donating milk among the public. But what about lack of awareness among the doctors?  There are many women who tell us that the doctors were not able to advise them and hence they express the excess milk in the bathroom to go for a waste,” says the Network admin Sharanya Sargunan. 

The Network collects and donates one to two litres of human milk to the bank once every month. Some members also visit the bank to breastfeed the infants.