Donor breast milk. Donor milk is a solution to the problem of lack of breast milk. Safety when choosing a breastfeeding mother and her little feeder

Hello, how is it done!

Recently, I had the opportunity to visit the only one in Moscow, but what is there, in all of Russia, a bank of donor milk and get to know its creators. I will now tell you about how it was created, how and where it functions, and who can use the deposits of this bank.

From time immemorial to the present day

The history of milk donation dates back to ancient times. Then, if a woman did not have the opportunity to feed the child on her own, she resorted to the help of a nurse, who could be a relative or just an acquaintance. It is known that this practice existed in ancient Egypt, Greece, the Roman Empire, and after the 11th century, the aristocratic and royal families of Europe used the services of nurses.

The transition from private services to milk collection and processing points was marked at the beginning of the 20th century. The first such institution was a milk bank, opened in Vienna in 1909 at the St. Anne's Hospital.

In Russia, in the 1960s and 70s, "donor points" operated at children's polyclinics to collect excess breast milk from nursing mothers and distribute it to needy babies under the age of one month. Subsequently, these institutions ceased to exist due to difficulties in milk quality control and the development of the infant formula industry.

Bank opening

In November 2014, a donor breast milk bank opened in Russia. The pilot project was created in order to help newborns, children undergoing treatment and rehabilitation in the department for premature and neonatal surgical units of the Scientific Center for Children's Health on Vavilov Street in Moscow.

Irina Anatolyevna Belyaeva (left), Doctor of Medical Sciences, Head of the Department for Premature Babies of the Pediatric Research Institute of the Federal State Budgetary Scientific Institution "Scientific Center for Children's Health" and Olga Leonidovna Lukoyanova (right), Candidate of Medical Sciences, began collecting scientific and practical data on the effectiveness and safety of the work of such a structure. Senior Researcher, Department of Healthy and Sick Child Nutrition, FSBSI "Scientific Center for Children's Health", doctor of the highest category. I took the photos from them. I was so carried away by communication, while in my thoughts I was in a hurry to Varyusha, that I didn’t even think to ask to be photographed with me.

In the department

Children in the wards are with their mothers. How else? Mom takes care of the baby, learns to use the device for food. Premature babies often lack a sucking reflex and are fed through a tube that goes into the stomach through the nose.

It happens that the children are alone, while the mother is on treatment. But the recovery of a weak body in premature babies is much faster when the mother is nearby. And especially if the mother has the opportunity to feed her breast milk.

But sometimes breastfeeding is just not possible. The reasons are different, mainly early childbirth, resuscitation, treatment or stress. Then donor breast milk can come to the rescue.

Indications for donor breast milk

Donor milk is prescribed only by a doctor as food and medicine at the same time. Not all children in a row, there are exceptions. A mother has the right to refuse donor milk and feed her baby with a formula for premature babies, but refusals are very rare in this department. At stake is the most valuable - life and health.

Which patients are shown donor milk in cases where maternal milk is not available? First, premature babies. I saw these kids in incubators. There is a tiny one weighing a kilogram and the size of an iPad Mini, or even the size of a palm. He feeds on donor milk while his mother is on treatment herself.

Milk is also indicated for children with metabolic disorders, after operations on the intestines, kidney failure, cardiopathy, immune deficiency and allergies to milk formulas.

When formula-fed, out of a thousand babies born with very low body weight, 21 babies die as a result of the development of necrotizing enterocolitis. If such children are breastfed, the mortality rate from this serious disease is 3-6 per thousand newborns.

How the breast milk bank is tripled

When I began to negotiate the possibility of getting into the breast milk bank, I imagined myself entering a separate building, a large separate building. In fact, the milk bank in this department has an area of ​​twenty meters, divided into three compartments.

Milk is brought to the first compartment of the mother. They can immediately wash their breast pump or take a clean container for collection.

Milk is expressed in such jars. They are reusable and sterilizable.

A bank employee accepts milk for bacteriological testing.

Then sends it for pasteurization. The pasteurization technology is very simple: for half an hour, the milk is heated in a water bath at a temperature of 62.5 degrees. This allows you to secure it, while protein, fat, carbohydrates, oligosaccharides, linoleic and a number of other acids, vitamins A, D, E, B12 are 100% preserved. Milk contains 75% folic acid, 65% vitamin C, up to 70% immunoglobulin A, and 91% of the total antioxidant activity is preserved.

Milk is stored frozen, but it must be cooled before being put into the freezer.

In the freezer, it is stored in bags. They are disposable, sterile and simply compact. Frozen breast milk can be stored for three to six months.

Security issue

As I wrote above, the breast milk bank project is experimental. So far, you can’t just come from the street to donate or receive milk. There is not the slightest doubt about the effectiveness of treatment and nursing of small patients with the help of milk, and the closest attention is paid to the issue of safety.

A contraindication for donation is not only a history of infectious diseases, but also, for example, tattoos, acupuncture or dental intervention in the last six months.

Mass donation

I learned one interesting fact about mass donation in Brazil, where it is very well developed. Initially, they gave money for the delivery of milk. Thus, donation was encouraged. But after some time, the reward system was canceled. The fact is that low-income mothers handed over all their milk, depriving their own children of the most valuable product.

It is too early to think about when milk donation in Russia will become massive, says Olga Leonidovna. The bank is already ready to expand and accept those who want to donate milk. Mothers who are not able to feed on their own are not yet ready to take this very donor milk. And for those who feed themselves and have excess breast milk, I advise you to create your own bank at home. This requires a breast pump, storage tanks and a freezer. Strained, cooled, then frozen. Within six months after the end of breastfeeding, there will still be an opportunity to make, for example, milk porridge.

Breast milk is the best food for a newborn baby and toddler up to 2 years of age. Most women can feed on their own. It is important to organize the right approach to lactation and have good nutrition. There are few cases when a child really needs supplementary feeding. At the same time, most mothers use an adapted mixture as an additional portion of food. Few people think about what could be supplemented with breast milk. A breast milk bank - personal or donor - will help in this.

When might a breast milk bank be needed?

A breast milk bank may be needed in such cases:

• mother fell ill and her body was severely depleted in order to continue breastfeeding;
• there is a need for treatment with potent and toxic drugs;
• a woman goes to work or goes to study;
• mom needs to go shopping, to a meeting or just relax;
• , and doctors forbid to continue lactation.

Additional portions of milk may be needed for women who have been diagnosed with infectious diseases that are not compatible with breastfeeding. Donor milk can be used by mothers who are completely forbidden to feed their children.

Rules for creating at home

To create your own milk bank, you need daily. Milk should be collected gradually, as an increase in demand creates an offer. Active pumping in large volumes can lead to hyperlactation. To create your own bank you need:

• the ability to express the breast (by hand or with a breast pump);
• freezer (it is desirable that it has a separate door);
• milk storage containers.

Preparation

1. Before pumping, it is necessary to wash the breast and prepare a breast pump with containers.
2. Previously, all containers that come into contact with the baby product must be sterilized.
3. To facilitate pumping before the procedure, you can pour warm water over your breasts and drink hot tea. This will expand the ducts and speed up the flow of milk into the container.
4. Hand pumping takes longer, so it’s more convenient to take a breast pump to create your own bank.

Freezing and thawing

The procedure and breast milk requires compliance with the following conditions:

• milk is collected in a container and placed in the refrigerator for 1-2 hours;
• the container is sent to the freezer (it is recommended to make a record of the pumping time and volume on it);
• when the need arises, the milk in the container is thawed in the refrigerator;
• after receiving a liquid homogeneous substance, it is heated and given to the child.

Storage

Store milk in the freezer preferably near the back wall. If the refrigerator has a self-defrosting function, contact with the side surfaces must not be allowed.

Important! Permissible shelf life of frozen milk is 6-12 months.

Donor breast milk bank

A breast milk bank is a kind of laboratory in which breast milk is collected, tested and processed from different women. In the future, the distribution of children's food to babies who need it.

The first donor milk bank was founded on the basis of the Scientific Center for Children's Health of the Russian Academy of Medical Sciences. It has been active since the fall of 2014. The second bank was opened 3 years later in Ufa. Both organizations are closed. This means that only those babies who are being treated in these institutions can receive valuable nutrition. In this case, only the mother whose child is undergoing therapy in this organization can become a donor.

In other countries, breast milk donation has long been practiced. At the same time, there are not only closed, but also open organizations. This provides an opportunity for all willing women whose children need breast milk to receive a valuable product.

In addition to two closed banks in Russia, there are Internet platforms through which women exchange milk. Transfer conditions are negotiated in each case individually.

Who are they for?

Donor milk banks operating in Russia are intended for children who are being treated in medical institutions that organized this system. Premature babies often undergo rehabilitation at the Republican Children's Clinical Hospital of Ufa and the Scientific Center for Children's Health. They cannot consume mother's milk because they are still very weak. All feedings are carried out through a special tube. If a mother has breast milk, she can express it for her baby. However, after a premature birth, most women have difficulty with this. Lack of breast milk or the need to use strong drugs requires a temporary baby. Donor milk bank comes to the rescue.

Breast milk is much healthier than. It allows the baby to get stronger faster, organizes the proper functioning of the gastrointestinal tract, prevents infectious diseases and provides strong immunity in the future. For this reason, experts insist that weakened babies must receive breast milk.

How safe is donor milk?

Foreign breast milk may contain dangerous infections: HIV, CMV, hepatitis B and C, Epstein-Barr virus, pathogenic and opportunistic microorganisms. Numerous experiments show that when children's food is heated quickly, the immunodeficiency virus and some dangerous bacteria are destroyed. Banks use this method of pasteurization.

Candidates who have repeatedly undergone examinations during pregnancy become milk donors in organized closed banks. The product is accepted from women who have been tested for HIV, syphilis, hepatitis, herpes and other infectious diseases. Storage of biological fluid is carried out in accordance with standard norms for a strictly specified period. Moms whose babies are breastfed in institutions don't have to worry about the product being dangerous.

The situation is different in informal banks, which involve the exchange of baby food through Internet sites. Despite the fact that women are usually examined during pregnancy and before childbirth, the risk of infection of the baby through milk cannot be excluded. Do not forget about substances that penetrate the product from drugs and food.

Important! When purchasing milk from a stranger, you need to be sure of her health, lifestyle, nutrition and the absence of bad habits.

Where can I get donor milk

Donor milk can be taken in two closed medical institutions if you get there for treatment with a baby:

• Moscow, Lomonosovsky prospect, 2/62;
• Ufa, st. Stepan Kuvykin, 98.

Milk exchange can be done on specialized sites - this is available to all women.

Who can become a donor

A lactating woman can become a breast milk donor if she does not have infectious diseases that can be transmitted to the child. A donor candidate must lead a proper lifestyle and have good nutrition. She should not have bad habits and diseases that require regular medication. Donors should not take drugs whose active substances are absorbed into the blood.

If we talk about sites on the Internet, on the basis of which the exchange of breast milk is carried out, then almost every nursing mother can become a donor.

Breast milk bank video - pediatrician's opinion

Online milk exchange

On the Internet, women can give and receive breast milk. In most cases, the exchange is carried out without preliminary examinations and conclusion of a legal agreement. For many years, such sites have been operating in foreign countries. However, getting breast milk from there is expensive, inconvenient and unsafe.

In Russia, there are de largest sites:

• milk mom organized in 2013. Milk is given free of charge in different cities of Russia.

Nekrasova Anastasia Mikhailovna

Pediatrician, pediatric cardiologist

Ask a Question

Everyone understands the value of breast milk for a baby, but not all mothers have the opportunity to feed their baby with their own milk. Such a problem may arise in front of the mother due to the incorrect organization of the feeding regimen of the newborn, which led to the "burning" of milk, due to the intake of medications, traces of which may affect the health of the infant during breastfeeding and other temporary obstacles.

A mother who understands the value of breastfeeding will definitely try to look for ways to restore lactation, and for this period she will continue to breastfeed her baby. Donor milk will help her provide the baby with useful substances.

Donor milk is a lactation product of a woman who is not the mother of the baby.

The history of such donation has deep roots - breastfeeding women have always helped to feed babies left without a mother, or children whose mothers do not have milk.

Even in Rus' there was the concept of "milk" brothers and sisters - that is, children who are not blood relatives and fed by one woman. The need to feed newborns with “foreign” milk arose if the woman in labor died.

In the 18-19th century, it was considered bad form for noble women to feed their children on their own, since, in their opinion, breastfeeding greatly deteriorates the shape of the mammary glands. To feed the baby, among the serfs and poor townspeople, a “donor” was sought out - a woman who had recently given birth, who, for a fee or even for food, fed both her own and the “lordly” baby.

In the Soviet Union, milk donation took on a colossal scale and was controlled by the state: surpluses were collected from nursing mothers on a voluntary basis in dairy kitchens. Donated milk was pasteurized and distributed to those in need on coupons from a pediatrician.

When should you look for a milk donor?

There are cases when the use of formula for the baby will not bring enough benefit, and then it is necessary to resort to the services of milk donation.

1. The gastrointestinal tract of premature babies is not ready for the processing of mixtures, therefore, when they are fed with an artificial product, they experience intestinal disorders. Breast milk contains a number of bacteria and enzymes that populate the digestive system and start its work in the correct mode.
2. Prematurity, or rather its absence, can also affect the mother's lactation. A pregnancy that has not ended as expected leads to the fact that the mammary glands are not yet ready to produce colostrum. It will take a lot of time to clear them, and a premature baby simply does not have the strength for this, he needs to learn how to suck on an already “working breast”.
3. If a mother is diagnosed with infectious diseases or serious inflammatory processes that require the use of strong antibiotics, she cannot temporarily feed her baby with her milk. A mother who wants to keep breastfeeding and feed her baby with natural nutrition should regularly express herself “into the sink” and give donor milk to the baby.
4. If you built the feeding regimen incorrectly, and this caused the milk to “burn out”, or lactation stopped due to stress, but you want the baby to eat breast milk, you will need donor milk.
5. Sometimes mothers need temporary assistance in the form of someone else's milk when their own breasts are not enough to feed the baby. This happens after brief breaks in breastfeeding, for example, due to the mother taking certain medications or ailments when she had to pump. If the frequency of pumping differed from the usual diet for the crumbs, the volume of lactation could decrease significantly. Until the mother disperses the mammary glands so that the baby has enough milk, the baby can drink donor milk.
6. Donor milk may be required by parents who have adopted a baby and want him to eat exactly the product of lactation.

Before making a final decision to apply for milk donation services, be sure to consult with your pediatrician.

Where can I find a milk donor?

Breast milk banks

Abroad, it is widely practiced to collect excess breast milk from nursing mothers with its subsequent testing for infections, pasteurization and provision to needy children. But even in foreign banks of breast milk, it is not enough to provide for everyone, since few women are willing to spend time pumping and transferring the lactation product to the center.

There is only one breast milk bank in Russia, and even that bank is closed. It is based on the basis of the NCCH and helps only small patients of the center.

Forums

Nursing mothers unite on thematic forums where they offer their milk to those in need, often completely free of charge. If you need to use the services of a donor, you can search on such Internet sites for a woman from your city who could donate her surplus to you.

Familiar

Surely in the hospital you met other women in labor and exchanged contacts with those who live near you, so that later you can walk together. If your new girlfriends are lactating well, you can ask them to pump and freeze excess milk for your baby.

Advantages and disadvantages

• Since donated milk from a wet nurse can contain germs and bacteria, it is important to pasteurize it upon receipt, but this procedure greatly reduces the value of the product;
• it will be good if the donor can provide you with certificates of the sterility of his milk, the lactation product can be checked for infections for free by receiving a referral for analysis from a pediatrician;
• you will not be able to control the nutrition of the donor woman, because she can eat something that your crumbs will become allergic to or get gassy;
• milk received from a donor can be stored for a very long time - a freshly expressed product does not deteriorate at room temperature for about 8 hours, in the refrigerator - no more than three days, and when frozen, it will not lose its properties for up to three months;
• as already mentioned, the advantage of breast milk over the mixture is that it contains enzymes, antibodies and lactobacilli that are important for the health and digestion of the baby;
• artificial formulas are expensive, and donors offer their breast milk for little or no money.

1. Be sure to discuss her nutrition with the donor woman. Try to keep food diaries with her, in which she will write down what she ate on a particular day, and you - the baby's reaction to her milk. So you can adjust the menu of the "nurse".
2. Since the baby will drink donor milk from a bottle, you must help him satisfy the sucking reflex - give your empty breast or pacifier. The process of sucking is very important for the baby, since during this process the correct formation of the facial skeleton and jaw functions occurs.

The traditions of breast milk donation are rooted in the distant past - a child of the first weeks of life could not survive if he received not human milk as food, but animal milk or decoctions of herbs and grains.

Mother's milk is a unique product. It contains all the nutrients necessary for a newborn in an easily digestible form, protects against infections, including necrotizing enterocolitis, because the child receives antibodies and other biologically active substances with milk. Modern breast milk substitutes, despite the efforts of manufacturers, cannot fully reproduce living biological fluid.

So far, 3 official donor milk banks have been opened in Russia - in Moscow (Scientific Center for Children's Health), Ufa (Republican Children's Clinical Hospital) and Chelyabinsk (Regional Perinatal Center). These are domestic banks - milk is donated and received by mothers of children who are being treated in these hospitals.

You can also find a donor on breast milk exchange sites (links below).

The exchange of milk from mother to mother is called informal. It should be exactly an exchange, and not a sale / purchase - for safety.

Why do parents choose to breastfeed?
Because breast milk is the natural food for a human baby.

Who can be a donor?
Any healthy woman who has no contraindications.

What are the contraindications for donation?
- Some diseases (HIV, hepatitis B and C, syphilis, any acute infections, mental disorders).
- Treatment with drugs incompatible with hepatitis B (for example, cytostatics).
- Damage to the skin of the breast and nipples.
- Smoking and other bad habits.

How to check if your potential donor has any contraindications?
- Get to know each other personally, discuss frankly what worries the host family.
- Ask for the results of tests taken during pregnancy, or ask for tests just before the start of the donation - and do not be shy to ask questions, sincerely explaining why you are asking them.

Who is donor milk suitable for?
All children in need of supplementary feeding. But first of all - to premature and weakened babies.

How is the exchange between families?
Parents get to know each other, discuss their concerns (mother's health, milk storage, etc.), and agree on logistics (when and how to transfer milk).

How is donor milk prepared for feeding?
If milk is frozen, it must be thawed beforehand.
To ensure safety, donor milk is pasteurized (disinfected) in a water bath.

What happened to donation in our country before?
In the USSR, breast milk donation was commonplace. Dairy kitchens were involved in the collection, pasteurization and distribution of donor breast milk. With the onset of the HIV epidemic, dairy kitchens were repurposed to serve breast milk substitutes.

Why are people afraid of milk donation?
People are afraid of the selfish interests of donors (which is why many oppose the sale of breast milk).

In fact, milk can simply be given and it will be safer, because most often they give the milk that was prepared for their own child.

Many people are not aware of the safety rules when exchanging breast milk.

Where can I find breast milk donors?
For example, on the website of the Volunteer Movement “Dairy Mom” is an association of people who support the gratuitous exchange of donor breast milk.