Donor milk banking: One facet of breastfeeding promotion and support

Donor milk banking plays a significant role globally in infant health and breastfeeding promotion. The use of donor human milk provides infants with the most appropriate nutrition and immunologic protection when mother's own milk is not available, and clearly gives the message that human milk is the expected feeding for human babies. This is equally important in developed and developing countries and limits the “spill-over” effect caused by using human milk substitutes in clinical situations where mothers cannot breastfeed or provide their own milk. Often the donor milk is used as a supplement for mother's own milk until her supply is sufficiently established to exclusively provide her expressed milk for her preterm or sick infant. In some countries donor milk banks are a center for providing breastfeeding education and support as well as receiving, screening, processing and dispensing donor milk. Milk banks operate with similar underlying principles across the world; however, each country has unique practices suited to the population, the healthcare system and the social/political setting. In some countries governmental regulations define standards for screening and accepting donors and milk banking operation. In 1991, the Human Milk Banking Association of North America (HMBANA) was the first NGO to publish milk banking guidelines, and since that time several other NGOs have published similar guidelines. This presentation will address goals for donor milk banking, its role in breastfeeding promotion and support, similarities and differences in milk banking operations globally and typical recipients. The new International Milk Banking Initiative, that brings together milk bankers across the world via the web, will be described, and ethical issues that can arise regarding collecting and dispensing of donor milk will be presented within a global context of breastfeeding promotion, protection and support.