In the beginning
Bringing a new baby into the world is such a special time for families. Many know the benefits of breastmilk, and the positive start it can give new babies at the beginning of their lives.
Meet two employees with Eastern Health’s Children and Women’s Health Program. Olive Goobie, lactation coordinator, and Wanda Bursey, division manager at neonatal intensive care unit (NICU). Both have spent their careers caring for new babies and moms. They work with a team of health-care professionals at the Janeway Health and Rehabilitation Centre to provide all the support parents and babies need in those first few days, weeks, or months.
(l-r) Olive Goobie, lactation coordinator, and Wanda Bursey, division manager, at neonatal intensive care unit (NICU)
Babies born prematurely are especially in need of any and all supports to help them in the early days. These tiny babies face more hurdles than babies born at full term. They have immature systems and are prone to breathing, digestive and developmental challenges. That’s why this Eastern Health team works tirelessly to ensure they are doing everything they can to ensure these babies have the best care possible.
The NICU team was looking into ways to enhance the supports they provide to these babies when they discovered that some hospitals across Canada were supplying their preemie babies with breastmilk donated from other mothers. This inspired the group to develop a plan to offer this option at the Janeway.
Members of the Children and Women’s Health team (l-r) Gail Read, Lynn Pike, Trina Mackey
“Once we learned that this was something that we could potentially be doing at Eastern Health, we knew we wanted to investigate and figure out how to make it happen,” said Wanda. “We learned early on that it wasn’t as easy as just placing an order online and having fresh milk show up the next day.”
There was some initial information gathering to learn about what mothers of preemie babies thought about the idea of feeding their babies donated milk. The feedback from families was positive and work proceeded for the benefit of the babies.
Worth the effort
Donor milk can help protect these babies by providing optimal nutrition and active growth and developmental hormones. It also contains elements that protect the bowel from harmful bacteria and viruses. This can help protect these little tiny babies from life threatening illnesses.
Milk delivery
The Eastern Health team was able to start discussions with a milk bank in the Toronto area and that’s when the possibility started to become a reality.
There were many details that needed to be figured out in order to successfully be able to implement this program at the Janeway. “We were dealing with milk, a product that is perishable, so that in itself created a few more steps in the process to ensure we were able to make it all work,” said Olive.
The team had to work with the milk bank in Toronto to work through logistics and shipping. They also had to work internally with Eastern Health’s Policy Office to create guidelines and policies around the program, and to ensure that once the frozen milk arrives in St. John’s that it is received and quickly transported in its frozen state to the freezer.
Frozen breastmilk at the Janeway Health and Rehabilitation Centre
“We were so excited to receive our first shipment. It arrived on March 14, 2018,” said Olive. “It was something we wanted to offer for a long time and now it was a reality. That same evening we started using the milk for one of our little ones who met the criteria.”
In Newfoundland and Labrador, infants born less than 1,800 gm and earlier than 33 weeks gestation are eligible for donated breastmilk. Some infants with gastrointestinal issues may also qualify. The criteria is reassessed on a regular basis. Babies born early have a more fragile gut, and breastmilk is a gentler option for their tiny bellies.
Meet a recipient
(l-r) Aaron Power, Ashely Smith and twins, Avery and Adrianna, at the Janeway NICU
Parents Ashley Smith and Aaron Power saw their twins, Avery and Adrianna, being born prematurely. Adrianna was born big enough to avoid admission to the NICU, and Avery was born at just 1,690 gm which required her to spend time in the NICU.
Avery also met the criteria for the donor milk program and once the program was discussed with her parents, they were happy to avail of the service. “We were glad to have donor milk to get Avery’s feeds started when waiting for mom’s milk to come in,” said Ashely. “The donor milk has provided Avery with a jumpstart to life that premature babies need sometimes.”
The process
The Janeway donor milk adheres to the rigid screening criteria and principles dictated by Human Milk Bank Association of North America (HMBANA). Mothers who choose to donate their excess milk in the areas that have milk banks go through a screening process, similar to the process for donating blood. This includes lifestyle and medical history questionnaire, a physical exam, and blood testing to rule out certain diseases/illnesses and drug use. Both the mother’s doctor and her baby’s doctor sign forms agreeing that the mother and baby are in good health and that her milk supply is sufficient to be able to be donated.
If the mother is accepted as a donor, her milk is shipped to the milk bank for processing. Donors are not paid for their donation, and milk banks rely on the generosity of mothers who voluntarily give their breastmilk to help a fragile baby in need.
The milk is pasteurized using techniques similar to the treatment of cow’s milk in the dairy industry. This process has been shown to kill any known potential bacterial and viral contaminants. Tests for bacteria are done in the lab on each donor’s milk. Once pasteurized, each batch of milk is tested again to verify that the milk is safe and ready for the baby’s consumption.
Seeing the benefits
“Babies who are receiving breastmilk, donated or provided by their mothers, are getting such a great start to life,” shared Wanda. “They require fewer interventions with intravenous therapy; they progress to full feeds quicker; they have fewer infections; and are being discharged from hospital sooner.”
This program is seen as a best practice by the Canadian Pediatric Society. Human milk cannot be replicated by any other source of nutrition and when the mother’s own milk is not available for the hospitalized newborn, when available, donor milk should be the next option.
To learn more about the program or donor milk, please visit the below:
Human Milk Banking Association of North America
This story was written by Brittany Mitchelmore, communication specialist with Eastern Health’s Corporate Communications Department.
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Next step is to start our own bank. The first thing I did when moving back to from Ottawa was to look into donating milk as I was pregnant and have an abundant supply. Sad I couldn’t do it here but things are going in the right direction!