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Got Milk? How Pasteurized Donor Human Milk Helps Babies Thrive

Shortly after giving birth at Thomas Jefferson University Hospital, Meredith Alley found herself visiting her son, Graham, in the neonatal intensive care unit (NICU). He had arrived earlier than expected and faced respiratory distress that required special care. To maintain his blood sugar levels, he needed human milk. However, as Alley struggled to produce milk in the few days following birth, the doctors presented her with a solution—pasteurized donor human milk.

“I wanted him to get out of the NICU as soon as possible, and the donor milk was the way for him to do that,” says Alley, a physician’s assistant at the Children’s Hospital of Philadelphia (CHOP). “I’m very thankful that they had that available.”

While pasteurized donor human milk may sound novel to some, it has been gaining recognition as the top alternative to
a mother’s own milk. According to the World Health Organization, when a mother’s milk is unavailable, pasteurized donor human milk is the next best choice for babies with low birth weights.

In early 2022, as the United States faced a formula shortage, nonprofit human milk banks gained visibility as they met the surge in demand. Since then, advocates have been raising awareness about the significance of pasteurized donor human milk and the need for expanded access for infants.

The Importance of Human Milk

For many babies, human milk serves as more than just nourishment; it can be a form of medicine. Human milk can bolster an infant’s immune system and help protect against diseases and infections. According to the Centers for Disease Control and Prevention, babies who receive human milk also have a reduced risk of conditions like asthma and type 1 diabetes. Human milk is particularly important for medically fragile infants. Numerous studies have shown that premature babies experience better outcomes when fed human milk and are less likely to develop necrotizing enterocolitis—a serious intestinal disease and one of the most common causes of death for preterm infants.

While the value of human milk for infant health is clear, an estimated five to 10 percent of mothers are unable to produce human milk entirely, while many more report insufficient milk production. Like Alley, many parents utilize pasteurized donor human milk as a temporary solution, bridging the gaps when they are unable to supply their own.

“Most women, depending on how they deliver … usually we’ll start to see milk on day two or day three,” explains Meghan Devine, clinical supervisor for the Lactation Program at CHOP. “Just getting them through that time frame could certainly help.”

“That’s the most important time in the first few days,” adds Donna Sinnott, lactation consultant and doula at Main Line Health. “What goes into their mouth, in their stomach and in their intestines is going to start their immune system for life.”

Accessing Human Milk Banks

Currently, there are 32 nonprofit milk banks across the U.S. and Canada that hold accreditation from The Human Milk Banking Association of North America (HMBANA). At these banks, the milk is pooled together and pasteurized. Depending on the bank, it’s then distributed to individuals, hospitals or dispensaries locally or across North America.

Milk banks rely on donations from mothers like Alley, who began producing an abundance of milk after her son was released from the NICU. Much like blood donors, they’re required to go through health screenings and blood testing to ensure they’re good candidates.

Alley donates bags of her frozen milk every few weeks to CHOP Mother’s Milk Bank, one of the few HMBANA-accredited milk banks operating directly in a U.S. hospital. The hospital collects a majority of its supply from inpatient mothers and employees, pasteurizing and processing it on-site. “I knew how it felt to be in need and have that provided,” says Alley. “To be part of that for other babies and other parents felt really good.”

While CHOP, equipped with a dedicated in-house milk bank, can offer unrestricted access to pasteurized donor human milk for all inpatients, many other NICU and well-baby units have a limited supply that’s allocated to the most vulnerable infants.

“There are a lot of hospitals that unfortunately have to put restrictions on who is eligible to receive the milk, in large part because of cost,” Devine explains. For parents looking to use donor human milk outside of the hospital, access can be even more challenging. Oftentimes, insurance doesn’t cover it, leaving parents responsible for bearing the costs.

“On average, it costs about four and a half dollars per ounce when you purchase it from a milk bank … most infants take somewhere around 30 ounces a day—that’s a lot of money to be spending on just one day’s worth of feed for your baby,” Devine says. “Improving access and affordability to human milk is really key in particular to the patients that we serve, because even when they go home, coming from CHOP, they usually still have pretty complex issues going on and still can benefit from human milk.”

At Main Line Health, Lactation Consultant Donna Sinnott has helped to initiate a program to tackle this. In addition to offering free donor human milk to inpatients, the hospital system assists families who require additional supplementation after discharge by providing them with free milk during their initial days at home. The program, called The “Donor to Door: Bridge Milk for Home,” relies heavily on donations from the community, with a price tag of about $60,000 a year.

Legislative action is also being taken to address these ongoing accessibility challenges. On a federal level, the Access to Donor Milk Act of 2023, introduced by bipartisan representatives and senators, would increase federal support for education and facilitate access to donor milk for WIC-enrolled families nationwide. Meanwhile, in Pennsylvania, there’s legislation moving through the House that would mandate Medicaid coverage for medically necessary human donor milk for children under a year old.

“If insurance covered it, it actually would save the insurance companies money in the long term, because the conditions of babies that get sick from not having donor milk are [even more costly],” says Sinnott. “Creating a healthy foundation to a baby’s life is gonna help the entire health care system.”

Interested in becoming a human milk donor or have questions about CHOP Mother’s Milk Bank? Call 267-425-1662 or email CHOPMMB@email.chop.edu.