Abstract
Objective
To evaluate the existing status of human milk banks in India with reference to infrastructure, human resources, funding mechanisms, operating procedures and quality assurance.
Methods
A pretested questionnaire was administered to 16 out of 22 human milk banks across India, operational for more than one year prior to commencing the study.
Results
11 (69%) milk banks were in government or charitable hospitals; only 2 (12.5%) were established with government funding. 8 (50%) had a dedicated technician and only 1(6%) had more than five lactation counsellors. Milk was collected predominantly from mothers of sick babies and in postnatal care wards followed by pediatric outpatient departments, camps, satellite centers, and homes. 10 (63%) reported gaps between donor milk demand and supply. 12 (75%) used shaker water bath pasteurizer and cooled the milk manually without monitoring temperature, and 4 (25%) pooled milk under the laminar airflow. 10 (63%) tracked donor to recipient and almost all did not collect data on early initiation, exclusive breastfeeding or human milk feeding.
Conclusion
Our study reports the gaps of milk banking practices in India, which need to be addressed for strengthening them. Gaps include suboptimal financial support from the government, shortage of key human resources, processes and data gaps, and demand supply gap of donor human milk.
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References
March of Dimes, PMNCH, Save the Children, WHO. Born Too Soon: The Global Action Report on Preterm Birth. Eds Howson CP, Kinney MV, Lawn JE. Geneva: World Health Organization, 2012.
International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4), 2015–16: India. Mumbai: IIPS; 2017.
Panczuk J, Unger S, O’Connor D, Lee SK. Human donor milk for the vulnerable infant: A Canadian perspective. Int Breastfeed J. 2014;9:4.
Cregan MD, De Mello TR, Kershaw D, McDougall K, Hartmann PE. Initiation of lactation in women after preterm delivery. Acta Obstet Gynecol Scand. 2002; 81:870–7.
PATH. Policy Brief: Ensuring Equitable Access to Human Milk for all Infants: A Comprehensive Approach to Essential Newborn Care. Seattle: PATH; 2017. Global Breastfeeding Collective. Available from: https://path.azureedge.net/media/documents/MNCHN_EquitableAccesstoHumanMilk_PolicyBrief.pdf. Accessed November 19, 2017.
WHO. Every Newborn: An Action Plan to End Preventable Deaths. Geneva: World Health Organization, 2014. Available from: https://apps.who.int/iris/bitstream/handle/10665/127938/9789241507448_eng.pdf;jsessionid=C3B6F4BB283F8EA1A4606F4EE228CB21?sequence=1. Accessed January 8, 2018
Committee on Nutrition, Section on Breastfeeding, Committee on Fetus and Newborn. Donor human milk for the high-risk infant: Preparation, safety, and usage options in the United States. Pediatrics. 2017;139:e20163440.
ESPGHAN Committee on Nutrition, Arslanoglu S, Corpeleijn W, Moro G, Braegger C, Campoy C, Colomb V, et al. Donor human milk for preterm infants: Current evidence and research directions. J Pediatr Gastroenterol Nutr. 2013;57:535–42.
DeMarchis A, Israel-Ballard K, Mansen KA, Engmann C. Establishing an integrated human milk banking approach to strengthen newborn care. J Perinatol. 2017;37:469–74.
Nangia S, Chugh RS, Sabharwal V. Human milk banking: An Indian experience. Neoreviews. 2018;19:e201.
Human Milk Banking Association of North America. Guidelines for the Establishment and Operation of a Donor Human Milk Bank; 2015.
Hartmann BT, Pang WW, Keil AD, Hartmann PE, Simmer K; Australian Neonatal Clinical Care Unit. Best practice guidelines for the operation of a donor human milk bank in an Australian NICU. Early Human Dev. 2007;83: 667–73.
Bharadva K, Tiwari S, Mishra S, Mukhopadhyay K, Yadav B, Agarwal RK, et al. Human Milk Banking Guidelines Indian Academy of Pediatrics. Indian Pediatr. 2014;51:469–74.
Government of India Ministry of Environment, Forest and Climate change. Available from: http://www.moef.nic.in/sites/default/files/Final_vetted_BMW%20Rules%202015.pdf. Accessed November 16, 2017.
Leung JCY, Yau SY. Perceptions of breastfeeding mothers on breast milk donation and establishment of human breast milk bank in Hong Kong: A Qualitative Study. International J Nursing. 2015;2:72–80.
Debortoli de MW, Christina PM, Fatima FMI, Palmira FB. Representations of women milk donors on donations for the human milk bank. Cadernos Saúde Coletiva. 2016;24:139–44.
Child Health Division, Ministry of Health and Family Welfare, Government of India. National Guidelines on Lactation Management Centres in Public Health Facilities. Available from: http://nhm.gov.in/images/pdf/programmes/IYCF/National_Guidelines_Lactation_Management_Centres.pdf. Accessed November 16, 2017.
Acknowledgments
Dr S Sitaraman, SMS Medical College, Jaipur; Dr Poonam Singh, SMIMER, Surat; Dr Suchandra Mukherjee, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata; Dr Kumutha, Government Hospital for women and children, Chennai; Dr Kamalrathnam, Institute of Child Health, Chennai; Dr. Sandhya S Khadse, BJ Government Medical college and Sassoon General Hospital, Pune; Dr Shailaja Mane, Dr DY Patil Medical College, Hospital and Research Centre, Pune; Dr Umesh Vaidya, Sahyadri Hospital, Pune; Dr Rajan Joshi, Deenanath Mangeshkar Hospital and Research Centre, Pune; Dr Vandana Kumavat, Rajiv Gandhi medical college, Chhatrapati Shivaji Maharaj Hospital, Thane; Dr Swati Manerkar, LTMMC and GH, Mumbai; Dr Ruchi Nanavati, KEM Hospital, Mumbai; Dr Sudha Rao, Wadia Hospital, Mumbai; Dr Rajesh Boob, Dr PDM Medical College, Amaravati; Dr Jaishree Kulkurni; Fernandez Hospital, Hyderabad; and Dr Raghuram Mallaiah; Fortis La Femme, New Delhi for their support in facilitating data collection. Our special gratitude and acknowledgment is extended to Kiersten Israel-Ballard Associate Director, Maternal, Newborn and Child Health and Nutrition Global Program, PATH and Sudip Mahapatra, Regional Monitoring and Evaluation Specialist, PATH, for reviewing the research design and report. We also extend our thanks to Paramita Kundu for her support in writing this manuscript and Manu Bhatia for providing editorial support.
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RCS: conceptualized the research design and protocol, provided inputs on the research tool, analysis and interpretation of the data, and contribute to manuscript writing and revised it; JM: administrative and technical guidance on the research, design of research, and provided critical inputs on writing of the manuscript; SS: contributed to research design, conceptualized the research tool, and inputs to manuscript writing; MMS and AK: data collection, analysis, manuscript writing; RD: analyzed the study results, supported interpretation and contributed to the manuscript writing and revision. All authors approved the final version of manuscript, and are willing to be accountable for all aspects of study.
Funding
This project was funded through a grant from the Margaret A. Cargill Philanthropies to PATH.
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Sachdeva, R.C., Mondkar, J., Shanbhag, S. et al. A Landscape Analysis of Human Milk Banks in India. Indian Pediatr 56, 663–668 (2019). https://doi.org/10.1007/s13312-019-1590-7
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DOI: https://doi.org/10.1007/s13312-019-1590-7