Some people are uncomfortable with the concept of donating breast milk, via a milk bank, but for premature and very sick babies it can be a godsend.
For 10 years, the lives of hundreds of sick and premature babies have been sustained and saved by the work of the Irvinestown Human Milk Bank. An incredible network of hundreds of mums north and south donate their milk, which is picked up everywhere from the steps of courthouses by lactation nurses or delivered in crates by the donors’ husbands.
Although it’s based in the north and funded by the NHS, it serves the whole island because the HSE concluded in a 2007 study that there was insufficient need for the service here, and the Fermanagh bank served the national demand adequately.
Despite the lack of a bank here, 22 other European countries have now established a network of milk banks. Brazil has 192, some of which have been established for over half a century, and Sweden has 27.
One mum who discovered the value of donated breast milk was Lisa Halpenny, from Ratoath, in Co Meath, after the birth of her son Harry at 26 weeks, weighing just 840g.
“I had had a tiny bleed and went into the hospital. My waters were bulging and then Harry’s foot came out. I was raced to have an emergency section.”
Harry was very premature and was brought straight to ICU. One of the major problems for premature babies is their inability to get adequate nutrition. Pre-term babies’ gastrointestinal tracts are immature and Total Parenteral Nutrition (TPN) is fed intravenously to sustain them.
Problems with prolonged use of TPN include an increased risk of infection due to the artificial opening used to feed the baby. Additionally, prolonged use can affect liver function, leading to jaundice. Harry was put on TPN in the intensive care unit.
“I wasn’t able to produce any milk. I did manage a couple of drops which kept him going for a few days,” explains Lisa.
The big challenge was to get Harry off intravenous TPN and on regular feeds. “He was only able to cope with tiny amounts of feed, around 45mls (three tablespoons) every three hours.”
Lisa and the hospital tried every type of formula but Harry’s tiny system couldn’t cope. “Blood was coming up the feeding tube and he couldn’t keep feeds down. He had a hernia operation, an eye operation, 11 infections and 10 blood transfusions. Doctors said he was one of the worst cases they had ever seen.”
Harry also developed Necrotizing Entrocolitis (NEC), a very serious infection of the intestine. When babies develop NEC, bacteria begin to attack the intestinal wall leading to bowel perforation. It often requires surgery and has a mortality rate of up to 15pc in babies it affects.
Pre-term babies are more prone to NEC than full-term babies but breast milk can significantly reduce the risk of the infection. One study found babies whose feed contained at least half breast milk had a six-fold decrease in NEC.
“Luckily a friend of mine who was breastfeeding her baby had heard of the Fermanagh milk bank. I mentioned it to the hospital the next day. The hospital was great and got in touch with them straight away. The milk was brought in immediately,” said Lisa.
“Harry could cope with the donor milk and could sustain it a bit longer. It was the only thing he could tolerate.” It took a heartbreaking eight weeks to get him on to full feeds.
“It took eight weeks alternating between formula and breast milk. He was so weak that when he was feeding he couldn’t breathe properly.”
As it took Harry so long to establish regular feeding, the TPN caused some liver damage. “Luckily the liver is very good at repairing itself so there was no permanent damage,” Lisa said.
After 12 weeks in hospital Harry was brought home on full formula feeds. “He is a happy and healthy little three-year-old now. The donor milk was a godsend. We are so grateful to those women who donated milk for Harry.”
The mum of two has come across some people who are unsure about the concept of donated milk. “Some people think it is a bit weird getting another woman’s milk, but if they saw him lying there in the incubator with his swollen tummy they would understand there was no other option,” she says.
Anne McCrea is manager of the milk bank in Irvinestown, Co Fermanagh.
She had the idea of setting up the milk bank when she worked as a lactation consultant in Enniskillen. “There was a mum in the hospital whose baby had developed NEC. All the mums on the ward were offering their milk but we had no facilities to screen or pasteurise the milk.”
Anne knew of human milk banks operating in the UK. “I phoned them and they said they didn’t have any to give us but they would gladly accept donations.”
It was at that point the light bulb went on for Anne and she decided to start a milk bank herself. “I went to the NHS looking for help and funding to get started and it all started to roll.
“We thought we would start supplying our own neo-natal units. Then everyone started looking for milk and we started sending it all over Ireland. We are now 10 years up and running,” she says.
On average 150 women donate a year but with demand outstripping supply Anne is always on the lookout for donors. “We ask mums to remember us when they are breastfeeding.”
There is a big cross-section of mums who donate. “We have incredible women whose babies have not made it but want their milk to go to someone it can help.”
If someone is interested in donating, the milk bank will take a full medical history and blood screening. “Everything in the bank is run on kits that we send by post once someone has contacted us,” Anne explains.
“After someone has donated we refund their postage and send a letter to them letting them know where the milk has gone. It is nice to know where all the hard work is going.”
The health benefits of breast milk for sick babies are amazing. “Breast milk is easier for sick babies to digest; it is brilliant for brain and eye development. For babies who have had heart surgery it puts less strain on their hearts, the drugs work better and there are less problems with bleeding,” explains Anne.
Mum-of-four Miriam O’Shea has been donating milk since having her second child six years ago. She lives in Coolaghy outside Portarlington with husband Chris and children Ciara (eight), Aisling (six), Eoin (three) and Cathal (10 months).
“When I had my second daughter someone mentioned it to me at a breastfeeding group. When my daughter was three months old I decided to go ahead with it.
“You only have to express as much as you want or can. Once the kids have all gone to bed I sit down most evenings with a cup of tea in front of the telly and express around 9oz,” Miriam says.
“My body produces that extra feed now in the evenings because of the whole supply and demand nature of breastfeeding. I express with a hand pump. The milk bank provides bottles which I freeze and then send them up when I have around 20.”
Maura Lavery is a lactation consultant in Dublin’s Rotunda Hospital. “Most mums decide to donate after they have left the hospital; they are in for such a short amount of time now.”
Maura explains the best time to express is morning time after a feed. “The volume of milk is highest in the morning. We will accept all milk here in the hospital for transportation to the milk bank.”
The lactation consultant says a mother’s own milk is the best option for babies but donor milk is the next best thing.
“It is so precious as it’s full of antibacterial factors and helps protect premature babies’ guts,” she explains.
The Human Milk Bank, co Fermanagh.
048 686 28333
Source: Irish Independent