Making pasteurized donor human milk (PDHM) accessible

Photo by Nick van den Berg on Unsplash

I’ll begin this week with a nod to a previous post, Blurring the binary, which essentially challenges us to break out of rigid, categorical thinking. In the infant feeding realm, nourishing young ones is not limited to breast or bottle; families’ experiences range vastly.

In fact, our featured guests this week– Human Milk Banking Association of North America (HMBANA) Executive Director Lindsay B. Groff, MBA  and HMBANA Associate Director Sybil Sanchez, MIA, CLC— both have stories outside of the “typical” infant feeding experience.

“My commitment to maternal child health, like that of many is this field, is very personal,” Sanchez begins. “I had my daughter in my early 40s after a four-year fertility journey. Despite, finally, a successful and easy pregnancy – my fifth after four losses – I had a very challenging birth followed by an equally challenging breastfeeding initiation and post-partum period.”

Sybil Sanchez

And Groff’s story is shared beautifully here about her daughter born with giant omphalocele.

In exceptional circumstances when direct breastfeeding isn’t an option, the importance of pasteurized donor human milk (PDHM) is indisputable.

Lindsay Groff

HMBANA, once called the “collective sisterhood of milk banks”, is working to advance the field of nonprofit milk banking through member accreditation, development of evidence-based best practices, and advocacy of breastfeeding and human lactation to ensure an ethically sourced and equitably distributed supply of donor human milk. []

A handful of states– California, Texas, Washington, Missouri, Kansas, Utah, New York, Pennsylvania, and most recently New Jersey (along with paid family leave)– have recognized the benefit of PDHM and require health insurance to cover donated milk for infants under certain circumstances.

The NJ law requires insurers to cover the costs of PDHM if

  • the infant is aged younger than 6 months, 

  • the milk comes from a milk bank that meets the quality guidelines of HMBANA or is licensed by the New Jersey Department of Health,

  • and it is prescribed to the infant by a physician.

The New Jersey law offers reasonable guidelines and parameters to assure that milk is safe and that it gets to the babies who need it most,” Groff comments.

She says the hope is that states will track the health outcomes of implementing these laws.

Sanchez is hopeful too.

“Hopefully we’ll see a tipping point in legislation providing Medicaid coverage for donor milk and that will carry over into private insurance coverage as well,” she says.  “Universal coverage of donor milk is our ultimate goal as it’s a win-win for all parties involved. It saves money and lives while supporting stronger human milk feeding rates and breastfeeding exclusivity.”

This article explains that the idea of a state-sponsored milk bank in Arkansas was abandoned after determining that it would cost about $1.5 million.

“The $1.5 million estimate to start a milk bank is quite high,” Groff offers. “It would be great to know how they calculated this number.”

Human milk, including PDHM, saves lives, improves short- and long-term neonatal outcomes, thereby, also saving healthcare dollars, she goes on.

United States Breastfeeding Committee (Photo by Sara D. Davis)

PDHM in the NICU increases breastfeeding rates and duration and improves the long-term health of mother and baby, also reducing health care costs.

HMBANA and their collection sites are doing more than filling bellies.

“Milk banks, milk bank depots (collection sites), and donor milk distribution sites are all an important presence in the communities they serve, and they support breastfeeding. In addition to providing milk to babies in need, they provide education to families, healthcare providers, and the community at large. They collaborate with breastfeeding organizations, perinatal health professionals and agencies, WIC, hospitals, and others to support parents and breastfeeding throughout the regions they serve,” Groff explains.

HMBANA is well into its W.K. Kellogg Foundation strategic planning grant with four priority areas: leadership, resource development, collective impact, and structure.  

“We have made great progress while using this plan as a guide,” Groff says.

Groff and Sanchez provide suggestions on how you can help make PDHM a reality for all babies who need it:

  • Let moms in the community know about milk banking so that, if they have more milk than their babies need, they can consider donating it to help others.
  • Let families know that, if they need donor milk, it is possible to get it through a HMBANA milk bank.
  • Consider working with a milk bank near you to open a milk depot, get the word out in your community about milk banking.
  • Make a financial contribution to HMBANA, so we can continue the hard work of making donor milk accessible to all who need it.
  • Encourage hospitals in your area to establish a donor milk program. You do not need a local milk bank for your hospital to provide donor milk. Milk banks deliver donor milk widely, using dry ice and overnight shipping.
  • Support advocacy efforts of milk banks and breastfeeding organizations in your area to make donor milk available and covered by insurance in your state or community.
  • Messaging matters, but don’t forget who you are talking to. If you tell a confused post-partum mother who is struggling to breastfeed that breast is best, she might break down crying and feel more pressure rather than more commitment; yet, if you tell is her it’s important because it’s the biological norm, she’s equally likely to just be confused. You have to talk to her about what’s important to her. Likewise, a hospital administrator will hear a donor milk advocate much better if the conversation is in terms of the hospital’s bottom line. It’s our job to show how good health always makes for better business but we have to do it in a language that speaks to the listener.
More on donor milk

Global health policies that support the use of banked donor human milk: a human rights issue by Lois DW Arnold

How to Donate Your Extra Breast Milk to a Nonprofit Milk Bank by Lindsay Groff

Liquid Gold: 6 States Allow Medicaid Access for Breast Milk by Anna Berry

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