The use of human donor milk

Tran, Hoang Thi; Nguyen, Tuan T; Mathisen, Roger

doi:10.1136/bmj.m4243

Cited by 21 publications

(21 citation statements)

References 23 publications

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“…When mothers stay in the neonatal unit with their newborns for KMC, they are supported to breastfeed and taught how to express and store their breastmilk. As they received the early effective intervention to protect and promote their milk supply, they are a good source of donations [ 2 ]. Many of the donors started donating when their newborns were one week old and donated for several weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Even during the COVID-19 pandemic, with strict infection prevention control measures, early skin-to-skin contact for all newborns and KMC for preterm and low birthweight newborns were continued [ 39 ]. Both early, prolonged skin-to-skin contact and KMC are important to stimulate mothers’ own milk, reduce the duration and amount of PDM use, speed up breastfeeding and for encouraging these mothers to become donors [ 2 ]. For other sick newborns, mothers are usually encouraged to take care of their newborns whenever they are stable, and the mothers are available.…”

Section: Discussionmentioning

confidence: 99%

“…Breastfeeding is the most important intervention to reduce child mortality and morbidity, especially among sick or preterm newborns in the first 28 days of life. However, not all newborns have the same chance of receiving breastmilk from their own mothers because of the mothers’ death, absence, or inability to provide any or sufficient breastmilk because of certain diseases [ 2 ] or circumstances related to the childbirth or gestational age. To provide the best nutrition for these newborns, human donor milk is the alternative recommended by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam

Tran

Nguyen²,

Barnett

et al. 2021

Nutrients

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Background: Since 1979, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight (LBW) and preterm newborns as the ‘first alternative’ when mothers are unable to provide their own milk. However, they have not issued any guidelines for the safe establishment and operation of an HMB. This gap contributes to the demand for gathering experiences from HMB networks, especially those from lower-middle income countries. To fill this knowledge gap, this study examines the characteristics of donors, donation, pasteurization, and recipients during the first four years of operation in the first HMB in Vietnam. Methods: Data about the donors, donation, pasteurization, and recipients were extracted from the web-based electronic monitoring system of the HMB from 1 February 2017 to 31 January 2021. Results: In the first four years of operation there were 433 donors who donated 7642 L of milk (66% from the community) with an increased trend in the amount of donated milk, donation duration, and average amount of milk donated by a donor. Approximately 98% of the donated milk was pasteurized, and 82% passed both pre- and post-pasteurization tests. Although the pass rate tended to increase with time, a few dips occurred. Of 16,235 newborns who received pasteurized donor milk, two thirds were in the postnatal wards. The main reason for the prescription of pasteurized donor milk was insufficient mothers’ own milk in the first few days after birth. There was a decreased trend in the amount and duration of using pasteurized donor milk in both postnatal wards and the neonatal unit. Conclusions: The HMB has operated efficiently in the previous four years, even during the COVID-19 pandemic, to serve vulnerable newborns. Ongoing evidence-based adjustments helped to improve the operation to recruit suitable donors, to increase the access to and quality of raw donor milk, to improve the pasteurization process, and to meet the need of more newborns.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam

Tran

Nguyen²,

Barnett

et al. 2021

Nutrients

Self Cite

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“…However, not all newborn infants have access to their mother’s own milk in the first hour after birth and in the early newborn period. Common reasons include mother’s absence due to separation, sickness, death or abandonment; inability to breastfeed due to a medical condition or use of prohibited medications; and no lactation capacity including adoptive parents [ 7 ]. Wet nursing or informal sharing of other mothers’ milk is sometimes considered an antidote to this problem, but this practice increases the risk of infection transmission [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with the Use of Pasteurized Donor Milk for Healthy Newborns: Experience from the First Human Milk Bank in Vietnam

Tran

Nguyen²,

Giang

et al. 2021

Nutrients

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Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother’s own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns. Methods: Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM (n = 2440) and prolonged PDM use among those who used PDM (n = 566). Results: Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28). Conclusions: The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time.

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“…Tran and colleagues highlight the benefit of pasteurised donor milk in reducing the risk of sepsis, necrotising enterocolitis, and bronchopulmonary dysplasia in preterm infants 1. In addition, meta-analysis evidence suggests that receiving any amount of human milk, compared with exclusive formula feeding, protects against severe retinopathy of prematurity (ROP) and against any ROP in very and extremely low birthweight infants 2…”

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confidence: 99%

Human donor milk also protects against severe retinopathy of prematurity

Lambley

2021

BMJ

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The use of human donor milk

Cited by 21 publications

References 23 publications

Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam

Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam

Factors Associated with the Use of Pasteurized Donor Milk for Healthy Newborns: Experience from the First Human Milk Bank in Vietnam

Human donor milk also protects against severe retinopathy of prematurity

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