Why We Need More Human Breast Milk Banks

CC BY 2.0. Raphael Goetter

Human breast milk is sometimes called “liquid gold” by hospital staff, and any parent whose premature baby has been fed with donated breast milk knows how valuable it is. We all know that “breast is best” for healthy babies born without complications, but breast milk makes an even bigger difference for babies born prematurely. They have higher survival rates than when they receive formula, which often contains hard-to-digest cow’s milk.

For babies born before 32 weeks’ gestation, breast milk makes them three times less likely to contract a serious intestinal condition called ‘necrotizing enterocolitis’ (NEC), in which portions of the digestive tract perforate and die. In a two-year trial, researchers found that the rate of NEC dropped from 7 percent to 1 percent when premature babies were fed breast milk instead of formula.

Breast milk also reduces the risk of infections and allergies, while improving blood pressure and bone density. Pre-term babies who receive breast milk instead of formula are less likely to develop insulin resistance, obesity, and high levels of bad cholesterol.

With these kinds of obvious benefits, it would make sense for breast milk banks to be widely accessible, but they’re not. There are only 4 in Canada and 14 in the U.S., with 3 in current development. (There used to be 23 in Canada, but all except one were shut down in the 1980s amid fears of HIV transmission.)

I think that every newborn should have access to breast milk if his or her mother is unable to provide it, even if the baby is not born prematurely, but unfortunately the issue is more complicated than that.

First, people are squeamish. For some reason, it’s normal to milk a cow and drink its liquid, and yet human milk makes many people uncomfortable, especially if it’s distributed beyond one’s own child. More lactating mothers need to donate, but we need a society in which breastfeeding is openly embraced and encouraged, not just permitted.

For example, when a pregnant surrogate in British Columbia was about to give birth to twins, she advertised her incoming breast milk on Craigslist and Kijiji, in hopes of helping out any local families who would welcome the extra milk supply. The ads were pulled and a huge controversy ensued. The program coordinator of the B.C. Women’s Milk Bank was supportive, telling the Toronto Star:

“I suspect the number of babies in need of milk is way, way higher than the number we serve, because we don’t encourage people to call us because we don’t have a lot of milk.”

Second, there’s a lot of red tape and bureaucracy that goes into building a breast milk bank – and this is where the darker side of relations between medical practitioners and the formula industry come into play. Apparently the American Academy of Pediatrics has a questionable marketing agreement with Mead Johnson, and allows the company to send home formula samples and ‘educational’ material in hospital discharge bags, which new parents often perceive to be an endorsement from doctors.

The Academy of Breastfeeding Medicine points out that this “undermines consensus medical recommendations for exclusive breastfeeding for the first six months of life and is harmful to the health of mothers and infants.”

It is not uncommon for hospitals to have contracts with infant formula companies, which could be one reason why Toronto’s long-awaited breast milk bank took more than 3 years to build from the time of its initial announcement. Perhaps the companies applied pressure at the bureaucratic level:

“You have to wonder, if formula is going to be replaced by breast milk at the very earliest stages... if the mother is no longer exposed, the companies almost for sure have lost her as a potential future customer,” said Edith Kernerman, executive director of the International Breastfeeding Centre.

Third, banks are high-tech and costly to build. All milk donations receive biochemical testing, pasteurization, further microbiological testing, and frozen storage for up to six months. The $800,000 upfront price tag and $500,000 annual maintenance bill for Québec’s new public milk bank is well worth it, however, since the province expects to save $1.25 million in associated health care costs each year.

The growing number of banks is good, but North America continues to lag behind when compared to Brazil. There are 210 banks in Brazil that provided 165,000 litres of milk from 166,000 donating mothers to feed 170,000 babies in 2013 alone. Clearly we still have a long way to go before every baby can enjoy exclusive access to breast milk and ensure a healthier future.