Midwives’ educational program in a human milk bank and breastfeeding counselling
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Human Milk Bank and Breastfeeding Department, Elena Venizelou Maternity Hospital, Athens, Greece
Publication date: 2023-10-24
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Ioanna Ioannou   

Human Milk Bank and Breastfeeding Department, Elena Venizelou Maternity Hospital, Athens, Greece
Eur J Midwifery 2023;7(Supplement 1):A208
It is widely agreed that the best source for nutrition for infants is the milk of their own mother. Human Milk Banks (HMBs) play an essential role to the health of infants by providing human milk and supporting breastfeeding as a bridge between mothers and their infants. These roles of HMBs has definitely positive clinical and physiological advantages for both mothers and their infants. According to the World Health Organisation (WHO)1, American Academy of Pediatrics2, UNICEF and European Society of Pediatrics Gastroenterology, Hepatology and Nutrition3 the feeding of preterm infants with mothers’ own milk is recommended as the first choice and when this isn’t available the use of human milk from other sources should be the first alternative. In those cases and especially in very preterm and very low birth weight infants (VLBWI), as well as other newborns in need, the preferred choice is pasteurised donor milk from an established HMB. The main benefits for preterm infants is the protection of two devastating medical complications, such as necrotizing enterocolitis and sepsis. Also, improves neonatal gut growth and maturation, neurodevelopmental outcomes, retinopathy and visual development. The sharing of human milk has existed since the beginning of time. Mothers have either breastfed children who weren’t biologically related to them or expressed and shared milk with a child other than their own. In early times, HMBs have been developed for offering safe human milk to infants who are in need. The first HMB was established 114 years ago in Vienna (1909) and over 700 milk banks have opened in 66 countries worldwide4. In Greece the first HMB was established in 1947, reorganised in 1985 and since then it has been operating according to the National Institute for Health and Clinical Excellence (NHS) guidelines (2010)5. How much do we as midwives know or are we educated about the operation and the role of a HMB? Milk Banks are health institutions responsible for the collection, screening, storing, processing and distribution of donor milk. Donor milk is breast milk that has been expressed by a mother and provided freely to a HMB to be fed to another mother’s child. Donors are healthy women usually nurse their own infants or breastfeed their babies and have a milk supply that exceeds theirs own infants’ needs. Donors are carefully selected and screened for Human Immunodeficiency Virus (HIV-1, HIV-2), Hepatitis B (HBV), Hepatitis C (HCV), Syphilis (VDRL or RPR) and Cytomegalovirus (CMV IgG and IgM). In the HMB handling, storing, processing, pooling and bacterial screening follow recommendations from European Milk Bank Association (EMBA). Pasteurisation – a heat treatment (at 62 oC for 30 minutes) of human milk kills any harmful bacteria or viruses that may be in the milk, but also diminishes cellular components, anti-infective properties, growth factors and nutrients. Nevertheless, the beneficial effects of donor milk remain significant for preterm infants or infants in need and remains the first choice for feeding them compared to formula6-8. One of the key roles of all scientists and especially those who treated preterm and fullterm infants hospitalized in Neonatal Intensive Care Unit (NICU) (e.g. neonatologists, midwives and nurses) is to support their growth and development during this critical period. In the same page, HMBs are organised to ensure that donor milk is made available for the benefit of vulnerable NICU infants.
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The Human Milk Banking Association of North America (HMBANA). Guidelines for the Establishment and Operation do a Donor Human Milk Bank. Fort Worth,TX:The Human Milk Banking Association of North America. 2018