May 15, 2010
In preparation for our inclusion in this week’s Pregnancy Awareness Month Nutrition Newsletter, we asked Pauline Sakamoto, President of the Human Milk Bank Association of North America, to answer some questions we thought moms might have about the next best choice to mom’s own milk: donor milk. For information on the screening and processing of donor milk, please see www.hmbana.org. For more about alternatives to breastfeeding, see What is Next Best?
1) How do I get donor milk? Who typically writes the prescription for donor milk? Do most physicians know about donor milk? What is being done to educate health care providers about donor milk? Donor milk is available by prescription only. The prescription is usually written by the Neonatologist or Pediatrician. There are a few Family Practice Physicians that order human milk. Considering that the AAP (American Academy of Pediatricians), CDC (Centers for Disease Control), ACOG (American College of Obstetricians and Gynecologists), AAFP( American Academy of Family Physicians), for example, supports HMBANA milk banks, I believe the increased use of donor milk is due to the strict adherence to standards that we uphold. These standards are routinely updated when the research is solid. In the early 2000’s, studies did show that most physicians did not know about the safety of donor milk and were reluctant to prescribe. However, once the hospitals’ staff started using donor milk, almost all are able to include donor milk secondary to mom’s own milk as the feeding regimen of choice. HMBANA members continue to do outreach and conferences to educate health care professionals. April 12 and 13th in Cambridge, HMBANA hosted the third International Congress of Milk Banks. We are pleased to have nationally known speakers on infant nutrition and breastmilk coming to present the latest research on human milk. It is the 25th Anniversary of HMBANA and the 100th Anniversary of milk banking in North America.
2) How many hospitals/maternity centers (of 3,000 in U.S.) keep a supply of donor milk on hand if additional supplementing is medically indicated?
It is hard to get the names or numbers of hospitals that keep a supply of donor milk. Most hospitals want to keep that data confidential. However, on our WEB site you can see that there are just a few states that do not have hospitals using donor milk. (The US map with all the dots shows the cities where the hospitals are that use donor milk in 2005.) In 2009, 814,960 ounces were distributed to NICU’s in North America. That is a tremendous increase if you consider that in 2005, the HMBANA milk banks distributed a total of 745,000 ounces. ( we distributed 648,511 oz to outpatient older infants in 2009) The 2009 number is astounding when you think that ¼ of an ounce is sometimes a “meal” for these infants.
3) Once a parent has a prescription for donor milk, is the milk provided free of charge? If not, is it covered by insurance? Is there a limit to how much is provided (will it be provided for 6 months or a year–that’s a lot of milk!) Is it only provided in extreme circumstances or any time there is a prescription? The donor milk is donated. However, there are specific and rigorous screenings on the milk and donor that have to be done plus the shipping charges before a prescription is honored. Each independent milk bank charges their own processing fees for the milk. We are finding more insurances are covering milk for specific medical conditions. Sadly, this is a very small proportion of our clientele. Policy has been developed for insurance companies to cover donor milk, however, the practice has yet to be adopted by all insurance plans. Depending on the diagnosis and the volume of milk available, we could (and have) serve(d) a child with donor milk for the long term. All requests for donor milk must be accompanied with a prescription from a medical doctor, doctor of osteopathy and/or nurse practitioner working with a physician.
4) Who pays for the processing of donated milk? The clients pay for the processing of donor milk.
5) How many milk banks are there and will there be more? We have 11 milk banks, 5 coming up in Oregon, Boston, Florida, Kansas City, and Ontario Canada. New interest in Tennesee and New York.
Please let us know if you have any questions, and we will do our best to get them answered and posted!