Can London's milk banks save premature babies?
- Carys Edwards
- Feb 9, 2017
- 6 min read
70,000 babies are born prematurely each year in the UK. Image by Peter Kirkeskov Rasmussen on Flickr (CC BY-NC-SA 2.0)
He was born at just 25 weeks. The size of a cauliflower and only 760g. Encased in an incubator surrounded by tubes and wires; unable to breathe on his own.
Emrys Kay was given a 50 per cent chance of survival and, even if he lived, there was a 50 per cent chance that he would have a physical or mental disability.
His mother, Angela Kay, sat in the Neonatal Unit at Queen Charlotte’s and Chelsea Hospital feeling "powerless".
She was told that all she could do to help her newborn baby was to try and produce breast milk.
For the 70,000 babies born prematurely each year in the UK, like Emrys, one of the highest risk factors is a serious infection, called necrotising enterocolitis (NEC), where tissues in the intestine become inflamed and start to die.
NEC is rare, occurring in 12 per cent of pre-term infants, but about 30 per cent of those diagnosed won’t survive.
There’s no direct prevention for the disease but researchers have found that human milk contains vital enzymes that reduce the chances of NEC developing. In 2001, the National Institute of Child Health and Human Development found that only 1.3 per cent of breast-fed children developed NEC, whereas formula-fed infants were 10 per cent more susceptible to infection.
But for many mothers, especially those who are traumatised by a premature birth, breastfeeding isn’t a possibility. As Angela experienced when she was unable to produce enough breast milk until six days after Emrys was born.
She said: "With Emrys being born so early, I guess my body just treated his birth more like a miscarriage so it wasn’t really in the place to want to make milk…It should’ve come in 15 weeks later."
This is why milk banks, which provide premature babies with donated breast milk, exist worldwide. There are over 200 in Europe and 17 in the UK. In London however, the provision of donor milk has become known as a "donor milk lottery" where access is dependent on availability within a certain geographical area. Emrys was lucky to be in a hospital with a milk bank on site - 1 of only 4 in the city’s 27 neonatal units.
Now, almost three years on, Angela and her husband, Tim, are amazed that he’s doing phenomenal things like riding a balance bike around a BMX track.
"We didn’t even know if we would take a baby home…without donor milk and donor blood, Emrys simply may not have been here today," Angela said.
Angela, from Ealing, admitted that she took the donor breast milk for granted and assumed it was offered to every baby who needed it but it is, in fact, only available at 5 per cent of hospitals in England. Angela said: "Imagine if donor blood was the same, and if you’re lucky enough to have an accident or an illness where you go into a hospital that has blood, then you’ll get it, otherwise you don’t."
Gillian Weaver, an internationally recognised milk-banking expert, with over 30 years of experience, was the director of the Queen Charlotte’s Milk Bank when Angela and Emrys were there. She’s now working to try and fill the gaps in the provision of donor milk in London and the South East by setting up Hearts Milk Bank. The UK’s first not-for-profit milk bank aims to provide all London hospitals with donor breast milk.
Gillian said: "Milk banks need to be appropriately staffed and resourced to be able to meet the growing demands for safe and assured supplies of donor human milk from hospitals."
Hearts Milk Bank will use bikes to collect and deliver the donated liquid based on demand similar to many delivery services we use regularly. ‘Deliverboob’ might just be the next big thing.
Despite this recent advancement, donating breast milk isn’t a new concept: The first milk bank at Queen Charlotte’s was set up in 1939. Even before then, "wet nurses" were employed to nurse other babies.
A study in 2015 by Netmums, a website created for women with children, found that 1 in 25 British mums are already wet nursing a friend or relative’s baby and two in five people would breastfeed a stranger’s tot.
Despite this, there is a lot of speculation about donor breast milk. fundamental. completed a survey of 100 Mums in London and found that, while 74 per cent of mothers would consider donating breast milk, only 59 per cent would be open to receiving it.
Angela said: "If it could make a difference, why would you withhold something that could be the difference between life and death."
Reasons for not wanting to receive donor milk included concerns over transmitting infections, not knowing the donor’s lifestyle or eating habits and thinking it was "just a bit weird and unnatural".
Dr. Stephanie d’Arc, Queen Charlotte’s Milk Bank Manager, believes this is due to a common misconception of milk banking. She said: "They’re probably not aware of the safety procedures involved. If they don’t know about it they may think you just take milk from one Mum and give it to another."
In order to become a donor, you have to fill out a lifestyle and health questionnaire and have a blood test to check for any infections or transmittable diseases. The expressed milk is then frozen to maintain its nutritional and microbiological quality, pasteurised and then rapidly cooled.
Angela believes the sometimes-negative feeling toward breast milk can be down to societal views of breastfeeding. "It can feel wrong to some people. And then if you take breast milk donations it kind of takes that possible weirdness that someone might think and exaggerates it," she said.
Only 4 of London’s neonatal units have a milk bank onsite. Image by Wellcome Images on Flickr. (CC BY-NC-ND 2.0)
Before having Emrys, she had never heard of donor milk. "I didn’t even realise it was a possibility. You think of blood donation but it’s just not a form of donation that you really consider," she said.
Her views were echoed in our online survey where only 80 per cent had heard of such a thing as a milk bank — but most did not know where to find one or how to go about donating and only three people had used the services.
Dr. d’Arc, who has managed the milk bank since May 2016, said: "There needs to be more publicity about milk banking…We don’t even have our own website."
Perhaps this lack of publicity of milk banks is a reason for the rise in donating and selling breast milk online. Websites such as OnlyTheBreast.com allow people to place adverts either seeking to donate or receive. The Craigslist-esque site even has different categories based on the baby’s age or the mother’s diet, including vegan and gluten-free.
The global Facebook page, Human Milk For Human Mothers, works in a similar way. Creamy, fresh and rich are common terms used to advertise the produce. Megan Brayton, has used the page to donate to a number of different women in need, since her baby, Sunny, was born at the start of November.
She has donated to a gay couple that wanted to provide human milk for their baby and believes it should be more of a common thing. Megan, from Leyton, said: "I wish they would revive the culture we used to have. I wouldn’t have any issues being a wet nurse and I’ve also fed a friend’s baby."
Similarly, Siobhan Brayshaw, who has an oversupply for her baby Eli, didn’t want the milk to go to waste so has donated to a girl who was born via a surrogate mother. She said: "I was starting to get depressed and feel like I couldn’t do anything properly and this made me feel like I was doing something right. I love the fact I can help other mums and babies."
The online phenomenon doesn’t involve any screening methods or testing and there are currently no specific regulations for milk banking in the UK meaning that anyone could set up a bank tomorrow.
Dr. Latha Srinivasan, the consultant neonatologist at Queen Charlotte’s, who works alongside Dr. D’Arc, thinks milk donation should be regulated like blood donation. She said: "I think milk donation should be regulated like blood donation."
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