Call to action for equitable access to human milk for vulnerable infants

Israel‐Ballard, Kiersten; Cohen, Jessica; Mansen, Kimberly; Parker, Michael; Engmann, Cyril; Kelley, Maureen; Brooks, Elizabeth; Chatzixiros, Efstratios; Clark, David; Grummer‐Strawn, Laurence M.; Hartmann, Ben; Kennedy, Stephen; Kent, George; Mwangome, Mary; Nyirenda, Deborah; Perrin, Maryanne T.; Picaud, Jean-Charles; Reimers, Penny; Roest, J.G. van der; Romero-Maldonado, Silvia; Smith, Julie; Subrahmanian, Prasanth; Sunder-Plassmann, Anne; Weaver, Gillian; Zambrano, Paul Andrew

doi:10.1016/s2214-109x(19)30402-4

Cited by 36 publications

(33 citation statements)

References 8 publications

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“…Before the pandemic, the Oxford-PATH Human Milk Working Group emphasised the need to establish governance mechanisms and enact legislation for the safe and ethical use of DHM. 53 During the pandemic, a call to action by the Global Virtual Communication Network of Human Milk Banks and Associations concluded that milk banks are chronically under-resourced and deserve better protection in emergencies. 54 Unfortunately, implementation guidelines for human milk banks have not been endorsed by the World Health Assembly and few countries have Box 1 Case report of a woman with suspected COVID-19 giving birth to twins in Quang Ninh, Vietnam.…”

Section: Discussionmentioning

confidence: 99%

Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations

Hoang¹,

Cashin

Gribble

et al. 2020

BMJNPH

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IntroductionRecommendations for the clinical management of new mothers with suspected or confirmed COVID-19 and their infants are required. Guidance must weigh the risk posed by transmission of SARS-CoV-2 against the protection that maternal proximity and breastfeeding provide infants. Our aim was to review international COVID-19 guidance for maternal and newborn care, assessing alignment with WHO recommendations and the extent to which policy supported or undermined breastfeeding.MethodsGuidance documents from 33 countries on the care of infants whose mothers were suspected or confirmed as having COVID-19 were assessed for alignment with WHO recommendations regarding: (1) skin-to-skin contact; (2) early initiation of breastfeeding; (3); rooming-in; (4) direct breastfeeding; (5) provision of expressed breastmilk; (6) provision of donor human milk; (7) wet nursing; (8) provision of breastmilk substitutes; (9) psychological support for separated mothers; and (10) psychological support for separated infants.ResultsConsiderable inconsistency in recommendations were found. Recommendations against practices supportive of breastfeeding were common, even in countries with high infant mortality rates. None of the guidance documents reviewed recommended all aspects of WHO guidance. The presence of influential guidance conflicting with WHO recommendations and an undervaluing of the importance of maternal proximity and breastfeeding to infant health appeared to contribute to this poor alignment.ConclusionThose developing guidance in the COVID-19 pandemic and other infectious disease outbreaks need to appropriately consider the importance of skin-to-skin contact, early initiation of breastfeeding, rooming-in and breastfeeding to maternal and infant physical and psychological health. In weighing the value of recommendations of others in future guidance development, countries should consider past reliability and value placed on breastfeeding. Recommendations against maternal proximity and breastfeeding should not be made without compelling evidence that they are necessary, and less harmful than maintaining dyad integrity.

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Section: Discussionmentioning

confidence: 99%

Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations

Hoang¹,

Cashin

Gribble

et al. 2020

BMJNPH

View full text Add to dashboard Cite

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“…Access to DHM is important in NICUs. If MOM cannot be given for some reason, DHM is the next best option and is always preferable to infant formula (Israel-Ballard et al, 2019). In Sweden, shortages of DHM sometimes occur, possibly due to its short shelf-life which makes it difficult to store large amounts.…”

Section: Introductionmentioning

confidence: 99%

“Paying it Forward” – Swedish Women’s Experiences of Donating Human Milk

2020

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Background Human milk is recommended as the only nutritional source during the first 6 months of life. For preterm infants, the benefits of human milk are even more important and can alleviate the negative influences of preterm birth. Research aim To describe how Swedish human milk donors experienced the donation process. Method A prospective mixed methods mail survey was designed. It was sent to human milk donors ( N = 72) at two Swedish hospitals. Quantitative data are presented with descriptive statistics and qualitative data were analyzed using qualitative content analysis. Results The infants were between newborn and 17 weeks of age when the participants started their human milk donations, and the duration of the donation period lasted 1–24 weeks. The overall theme identified was the participants’ strong desire to help infants, often expressed as being involved in saving infants’ lives. Many participants experienced difficulties getting the information needed to become human milk donors; for others, expressing milk required both time and energy that they could otherwise spend with their own newborn infants. Conclusion Donating human milk can be experienced as a demanding and strenuous task. Therefore, it is important that women who donate human milk receive the practical help from health care staff that they feel they need. Furthermore, information and knowledge about the possibility of donating human milk, and how important human milk is for preterm and/or sick infants, are important in order to increase the number of women willing to donate human milk.

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“…2 This growth has led to calls for equitable access to human milk for vulnerable infants, such as low birthweight babies with necrotising enterocolitis. 3 Despite recommendations for donor human milk and the global expansion of human milk banks, little authoritative guidance exists on the implementation, operation, and regulation of human milk banks. The importance of safe operational guidelines and a coordinating body to collate and communicate data have been highlighted by the milkbanking community and emphasised by the current COVID-19 pandemic.…”

Section: Human Milk Banks: a Need For Further Evidence And Guidancementioning

confidence: 99%