Role of human milk banks amid COVID 19: perspective from a milk bank in India

Abstract

The COVID-19 pandemic has had a significant impact on the operation of donor human milk banks in various countries such as China, Italy and India. It is understandable that this impact on operations of donor human milk might hamper the capability of these milk banks to provide sufficient pasteurized donor milk to neonates who need it. Contrary to developed world, predominant donors in developing nations are mothers of hospitalised neonates who have a relatively long period of hospital stay. This longer maternal hospital stay enhances the feasibility of milk donation by providing mothers with access to breast pumps to express their milk. Any excess milk a mother expresses which is above the needs of their own infant can be voluntarily donated. This physical proximity of milk banks to donors may help continuation of human milk donation in developing nations during the pandemic. Nevertheless, protocols need to be implemented to i) ensure the microbiological quality of the milk collected and ii) consider steps to mitigate potential consequences related to the possibility of the donor being an asymptomatic carrier of COVID-19. We present the procedural modifications implemented at the Comprehensive Lactation Management Centre at Lady Hardinge Medical College in India to promote breastfeeding and human milk donation during the pandemic which comply with International and National guidelines. This commentary provides a perspective from a milk bank in India which might differ from the perspective of the international donor human milk banking societies.

Sequential interventions to maintain the safety and service provisions of human milk banking in India: keeping up with the call to action in response to the COVID-19 pandemic

“…During the baseline phase, a total of 9,165 ml of donor human milk was collected at our centre while the total pasteurized donor human milk requested and Bhasin et al International Breastfeeding Journal (2022) 17:85 disbursed to the adjoining NICUs was 13,130 ml (Table 1). Although, we adopted COVID specific modifications at our centre early in the pandemic [3], the situation did not improve and remained consistent with our previous observations. Due to the initiative, in the intervention phase, we overserved a 180% increase in the amount of total donor human milk collected at our centre which amounted to 16,605 ml in October 2020 (Table 1).…”

“…Early in the pandemic, the virtual collaborative network of human milk banks and associations published a call for action to ensure safety and service provisions of human milk banking [1]. In India, services provided by human milk banks which are established as Lactation management centres [Comprehensive Lactational Management Centre (CLMC), Lactational Management Units (LMU), Lactation Support Units(LMS)] are under regulation of national guidelines [2,3]. COVID 19 restrictions were imposed on 22 March, 2020 throughout the nation resulting in a steep decline in collection of donor human milk reported from India [3,4].…”

“…A set of changes were introduced in the centre to curtail the effect of COVID 19 [3]. We observed a decline of 62.3% in collection of Pasteurised Donor human milk (PDHM) at our centre (44,062 ml collected between Jan to March 2020 and 16,590 ml collected between April to June 2020) while the demand rose to 137% for a quarter (34,018 ml demanded between Jan to March 2020 and 46,911 ml demanded between April to June 2020).…”

Effects of a WeChat Mini-Program on Human Milk Feeding Rates in a Neonatal Intensive Care Unit During the COVID-19 Pandemic

“…One study mentioned that some hospitals have reduced orders for donated human milk, mainly due to financial and trust issues, and the pandemic also severely impacted how milk banks function ( 39 ). Another study also mentioned the impact of the pandemic on global breast milk banks, with a decrease in milk donations in some parts of India ( 40 ). In our study, the rate of exclusive MOM-DC was lowest in EP at 77.0%, but higher than the 35.2–46.0% mentioned by Ward et al ( 41 ) for VLBWI.…”

The impact of the Covid‐19 pandemic on North American milk banks

“…Building upon the growing literature on the effects of the pandemic on HMBs worldwide (Azevedo et al, 2020;Bhasin et al, 2020;Jayagobi & Mei Chien, 2020;Marinelli, 2020;Rigourd & Lapillonne, 2020;Shenker, 2021;Shenker et al, 2020;Shenker et al, 2021;Spatz et al, 2020), this study examines its impact on North American HMBs' personnel, work organization and DHM supply and demand, with the aim to propose law and policy reforms to better support HMBs and infant feeding emergency preparedness (Gribble, 2018).…”