Milk (bank) of human kindness

399 out of 400 mothers agree to donate milk - Dr Armida Fernandez

The milk bank at LTMG hospital in Mumbai that feeds more than 25 sick and premature babies daily is one of its kind in the country, says Rita Dutta

While doctors advocate breast milk as the best nutrient for the new born for the first six months, the neo-natology department of Lokmanya Tilak Municipal General hospital (Mumbai) has moved beyond preaching by establishing the one of its kind milk bank in the country, which offers breast milk to around 25 babies daily, gratis.

The brainchild of the former dean Dr Armida Fernandez, the milk bank was founded on November 27, 1989 at a cost of Rs 2,50,000. Fortunate recipients of the pooled milk are premature babies requiring temporary intervention in case of delayed lactation of the mother, abandoned babies and babies admitted to the hospital with various kinds of ailments. The milk bank also comes handy for a baby whose mother is sick, say in IVP drip and not in a position to breast feed, or when the baby is estranged from her sick mother admitted in some other hospital.

“As incidence of low birth weight and pre-term babies are high in India, it is extremely important for the survival of these babies that we guarantee constant and adequate supply of milk through the milk-bank set-up. Though mothers donating milk on a humanitarian ground is quite prevalent in India, the trend is erratic and the shelf life of such milk is not more than 24 hours,” says Dr Fernandez. The milk bank can however pool, preserve and provide milk for nearly six months.

Emphasising on the need to have a milk bank, Dr Fernandez says, “The milk bank is an advanced form of wet nursing practised in the countryside. The milk bank assumes importance in light of the fact that it is the best nutrient for an infant.”

Even research based on a review of more than 1,000 children born in New Zealand in 1977 and followed through age 18 shows that children who were breast-fed when they were babies perform better in school and score higher on standardized math and reading tests. The authors, Professors David M Fergusson and L John Horwood of Christchurch School of Medicine, subscribe to the theory that fatty acids that are present in breast milk but not in formula promote lasting brain development. The authors found that the longer infants were breast-fed, the higher they scored in evaluations. The substance that makes breast-fed babies smarter is believed to be omega 3 fatty acid called DHA, found naturally in breast milk but not in formula milk.

While the novel idea is laudable, more so is the relentless effort of two lactation nurses who are entrusted with spreading awareness about the bank. “The nurses take it on them to inform each and every lactating mother admitted to the hospital about the milk bank, dispelling doubts and misgivings about donation,” says Dr Jayashree Mondkar, HOD, neo-natology. Collecting around four litres of milk every day, the bank is sufficient to cater to around 25 babies daily. Do mothers readily agree to donate milk or their babies being fed with somebody else’s milk? “Indian women when they see some other baby being deprived of milk, they readily agree to breast feed, so why would they not agree to donate milk?” quips Dr Fernandez. Emotions apart, according to a study conducted by a nursing student of the hospital, 399 out of 400 mothers agree to the scheme. The cost of running the milk bank is around Rs 50,000, which goes in pasteurization and freezing. Research to enhance the quality of the bank in underway, says Dr Mondkar.

The milk that is extracted is of three kinds. The colustrum extracted in the first four days is given to babies infected with diarrhea, malnutrition and suffering from burn injuries. The breast milk collected over the next five to ten days, ie, ‘transitional milk’ and milk collected thereafter called ‘mature milk’ are less in protein content. The milk, extracted with the help of a pump, ranges from 40 to 600 cc per mother. This is pasteurized at 56 degree centigrade for half an hour. The milk is then rapidly cooled and poured in an autoclave stainless steel container measuring 150cc, 250cc and 300cc and stored in deep freezer and at - 20 degree centigrade. Random culture is conducted where 2 cc of the pasteurized milk is sent for microbiological testing at the microbiological lab for HIV, history of jaundice and VDRL.

Acknowledging the good samaritans service rendered by the women-patient, the hospital authorities showers special care to the donors by offering extra glass of milk and food to the donors. This LTMG milk bank presents a stark contrast to milk bank abroad, where the donor need not be hospitalized. “Abroad, a donor can keep on donating milk even after she has left the hospital. The hospital authorities will either go to the donor’s house to collect milk or the patient can drop the milk in a shopping centre from where the hospital authorities will collect the packets.”

So why not more milk banks? “We need to create more awareness about it and motivate people before embarking on such a venture,” says Dr Fernandez. The success of this unique concept in Mumbai, has encouraged good samaritans in other cities like Hyderabad and Vadodora to come up with their own milk bank.