Might the Mothers of Premature Babies Feed Them and Devote Some Milk to the Milk Bank?

Abstract

The breast milk is the gold standard food for the feeding of the premature baby: it is the natural way to provide excellent nutritional, immunological, and biological nutriment so as to facilitate a healthy growth and the development of the infants. When the breast milk is not available, the alternative is represented by the donated milk. The mothers of premature infants are important opportunity if we consider the fact that they could devote some milk both because they provide a food which is closer to the needs of the vulnerable category of newborns and because it is, for the mothers, a way to overcome the detachment and the psychological trauma of a premature birth. There are no data on this kind of donation. The aim of the study is to evaluate the contribution of the milk donation to the HMB of CSS by women who gave birth to premature infants of gestational age <35 weeks and to analyze the macronutrient composition of the “preterm” donated milk. The CSS HMB has recruited 659 donors totalling 2236 liters of donated milk over a period of 7 years. 38 donors (5.7%) gave birth to a gestational age <35 weeks. Almost 20% of the donated milk comes from mothers of premature babies and this is a very important fact because it shows the huge potential belonging to this category of mothers. Taking into account the parameter regarding the birth weight, it was found that VLBW mothers contributed for 56% to preterm donation while ELBW mothers contributed for 41%. By evaluating the variable gestational age, about 40% of the average total donation derives from mothers who gave birth before the 25 weeks, while a contribution of 46% is attributable to the category of newborns with a GA between 25 and 32 weeks. Besides, some other exceptional examples can be outlined. Regarding the correlation analysis DM resulted in negative correlation with GA weeks (r=-0.31, p=0.058) and with BW g (r=-0.30, p=0.068) achieving values which are very close to the significance. The comparison between the donor volume averages of the preterm and full-term groups is statistically significant. The composition data are in line with the literature: there is an increase by 18 % in the protein component of the milk deriving from the mothers of the premature infants; the gap in carbohydrates is less significant (5-6%) and the gap in calories is similarly low being only 2% higher than the single donor milk and 11% more than the pooled milk. The data on the lipids line up to single donor term milk, while it grows by 24% compared to the pooled one. The study shows that even at very low or extreme gestational age it is possible to obtain an appropriate production of breast milk. This awareness becomes a fundamental starting point for the activation in a standardized way of all the strategies of promotion and support of food that have proven effective with the HM in NICU.

Questionnaire on the breastfeeding and the donation of 70 mothers\donors.

“…The second question about the reason of the donation is the altruism which is prevailing in 83,3% of answers. This datum is in line with the literature [19][20][21][22][23][24][25][26][27][28][29] and is a positive one even if we consider it together with the abundance of milk produced (23%), because it sheds light on mothers' sensitivity regarding pre-term babies; we should encourage them through information campaigns on this reality which is little known by the public opinion except for anecdotal cases that get into papers, media and on the Net.…”

“…The practices to support the donation of human milk are now included among those proven to be effective for the protection and promotion of breastfeeding [15][16][17][18]. It is widely demonstrated that the two things enhance each other and contribute to the improvement in a synergistic way of child health and survival, precisely through the exclusive feeding of all newborns, even the most vulnerable, with human milk [9][10].…”

The Revolution of Breast Milk: The Multiple Role of Human Milk Banking between Evidence and Experience—A Narrative Review

“…This is the experience of many banks like the one in Madrid [ 28 ], where there was a higher consumption of own mother's milk during the hospital stay, and the exposure to formula in the first 15 days of life was reduced from 50% to 16.6% and a higher rate of exclusive breastfeeding at hospital discharge (54% vs. 40%). That is also our experience [ 26 ] that we shared with a paper where we reported a doubling of the percentages of feeding with mother milk of VLBW and in another very evocative article [ 27 ], in its simplicity, of the facilitating role of the milk bank, where significant was the contribution to donation by mothers who gave birth at very low gestational age or at very or extremely low weight.…”

Human milk bank and personalized nutrition in the NICU: a narrative review

“…In a single-center study that evaluated the contribution of the milk donation to an Italian milk bank by women who gave birth to premature infants of gestational age < 35 weeks, the authors demonstrated the feasibility of using preterm DM for premature infants [47]. Mothers donated the excess of milk after feeding their own infants.…”