Donor milk delivery by electric vehicle

I never considered myself much of a car person; that is until I discovered a vehicle with a personality and a vital mission.

This vehicle is decorated in “vibrant…indigo and white…featuring the components of human milk…[and] a snowdrop, known as the milk flower,” as described in this piece.

What’s more, the EV was “sustainably wrapped using water-based resin ink and PVC-free media.”

I first learned about the car on Amy Brown’s Breastfeeding Uncovered page.  The EV is the product of a partnership between Swansea University and the Human Milk Foundation which set up a donor milk hub in Wales. The car runs donor milk deliveries and pickups across south and west Wales, expanding the reach of the charity Blood Bikes Wales, an organization that provides a free courier service to the NHS, as explained by Brown here.

Samantha Hoskins has been a breastfeeding peer counselor for 13 years, and since having a baby a year ago, she has donated over  15 liters of her milk to the mission. Hoskins is one of more than 100 women who have donated more than 250 liters of milk since the launch of the donor milk hub.

Photo courtesy of Hoskins

“I’ve always had a keen passion for breastfeeding; there isn’t enough done in our local health board to promote and help the new mums with breastfeeding so I always try to do what I can, help when I can…,” Hoskins says.

She continues, “I don’t think enough is known about breast milk donation. I know there are mixed views about it, so I try and promote it when I have a collection to try and normalise it. To show people that it is something that does go on, to show there is a need for it, to show that it’s something good, to increase knowledge, for realisation that it’s human milk for human babies…
not cow’s milk for human babies.”

Hoskins aims to express her milk once a day.

“I don’t stress about it,” she shares. “Whether it feeds one baby or two, it’s better than none is how I look at it.”

Hoskins goes on to explain the process of preparing milk for transportation which says is very easy: “I express into a bottle that the milk bank provides that also fits my electric pump. When I’ve finished, it goes straight into my freezer. I take a temperature check every day and document it in the paperwork they send.  When I have enough for collection – at least two litres, I email the milk bank, they inform Blood Bikes Wales, who then contact me to arrange a
collection day and time. When they turn up, the milk is taken out of the freezer, the time is noted and put into the blood boxes that fit on the motorbikes. [It’s] then taken straight to Singleton hospital where it gets pasteurised and ready for babies.”

Hoskins reminds us that the UK has some of the lowest breastfeeding rates in the world.

“I wish I had the time to help change that, one woman at a time,” she longs.

Liter by liter of liquid gold, women like Hoskins are helping to change that!

You can connect with Hoskins on social media here.

Across an ocean, advocates in the U.S. are working to expand access to donor milk. Take action to support these efforts here.

Reflections from a volunteer CLC working on naval base

Many of our Our Milky Way interviewees launch into their advocacy for
healthy infant feeding after they’ve endured personal situations with their
own babies. This is not Crystal Grask’s, CLC origin story into the world
of breastfeeding though.  Now the mother of a darling little one, Grask
serves as a Red Cross volunteer lactation counselor at Naval Base Rota
in Spain, but her road to breastfeeding started before becoming a
mother.

We’re pumped to feature this interview with Grask this week on Our
Milky Way.

On discovering her passion for maternal child health…

I had really no insight into maternal child health until I found myself
interviewing for the Communications Coordinator position with the Rocky
Mountain Children’s Health Foundation and Mothers’ Milk Bank. Once I
obtained the role, I started working directly with Laraine Lockhart-
Borman, the then director of the milk bank…her staff… Donor Relations
Coordinators, Certified Lactation Educators, Doulas and more. I found
myself immersed in a totally new world and was soaking up the
knowledge like a sponge. Everyday I learned something new about
breastfeeding, donating human milk, or lactation and the impact these
things have on the mother-baby dyads and the families we served.
As I learned…I found myself becoming more and more passionate about
helping moms, babies and families have successful happy starts in life.
Through the RMCHF and MMB I learned about the the Lactation
Counselor Training Course (LCTC), learned about the importance of
breastfeeding, saw firsthand the impact donating and receiving donor
human milk had on mother-baby dyads and families, and was able to
observe and glean insight into dozens of parents’ feeding journeys
through the Foundation’s  programming and milk bank’s weekly Baby
Cafe pregnancy and postpartum moms groups.

On completing the LCTC…

… Life happened, and I was unable to take the course during my tenure
at the [RMCHF], but the passion didn’t go away. It continued to blossom. I moved to Washington State where the course wasn’t offered,
but I remained passionate and steadfast in my desires using my
previous knowledge about breastfeeding/lactation to help providers (OBs
and Pediatricians) communicate with their patients about breastfeeding. I
knew I still wanted to work in this realm, and decided that once I was
able to obtain my CLC certification, I would like to pursue a private
practice.

In 2020, the course became virtual, which allowed me to start my
training! I started in December of 2020, and soon after, we moved to
Spain with the Navy. It was there I finished my training, in June of 2021. I
loved the virtual nature of the training and found – even when I was an
ocean away – I could tune in, interact during office hours, and complete
the course with ease. I really appreciated that!

On her own breastfeeding journey…

Flash forward five years… I found myself breastfeeding my daughter,
Julieanne, and having a rough journey. We started off feeding well,
resolving minor latch issues right off the bat. However, despite having a
small but adequate supply, she struggled to gain weight. Our pediatrician
immediately suggested formula supplementation, and I struggled with
that suggestion. My husband was a huge supporter of breastfeeding,
and also felt like there wasn’t a huge need to supplement. I was able to
reach out to prior colleagues… for observations, but neither of them
could find anything truly amiss. My daughter latches well and has always
been very healthy, but didn’t gain weight well no matter how much or
what we were feeding her. We discovered she has a very high
metabolism and strong passion for eating, so I found myself feeding
round the clock, triple feeding for a few weeks, and eventually settling
into a combo-feeding routine. While it wasn’t my picture perfect image of
how our breastfeeding journey would go, I am proud to say we’re still
largely breastfeeding and she’s gained a significant amount of weight.

Photo by Taylor Marie Photography

I hope to help moms receive the support I lacked in the immediate
postpartum. With consistent help and follow-up observations, perhaps
we wouldn’t have needed to supplement. I want to be that resource for other moms, to help them feel validated, encouraged to meet their goals,
and support them no matter what their feeding choices are.

On landing her volunteer CLC position at the naval base…

One of the first things I noticed after arriving at Naval Base Rota was the
multitude of pregnant women around. We were still living in COVID
times, and I quickly learned while there was support for moms to
breastfeed from a command standpoint, there were not many staff or
programs available to support the station’s breastfeeding dyads either in
hospital or at home postpartum. I knew I could help bridge this gap.
After exploring a few different avenues, I found I was able to sign up with
the Red Cross as a volunteer CLC at the Navy Medicine Readiness and
Training Command Rota (Naval Hospital Rota) Maternal Child Infant
ward! This role gives me the unique opportunity to help moms within
hours after delivering her baby, and help these dyads and families start
their feeding journeys feeling confident and supported.

On a typical day in this role…

I come in, check in with the nurse on duty or head nurse for a rundown
of our patients to learn about their delivery(ies), their baby, their current
health situation, and how feeding has been going thus far. I also ask if
mom/family has presented them with any concerns/questions about
feeding thus far, so I can be as prepared as possible when I first meet
with a mom.
After ensuring I have all the information/resources ready, I go meet with
the mom/baby dyad/ family. While in their room, we talk about how mom
is doing, I meet their new little one, and we go over how their feeling
about feeding thus far. I often provide latch assessments, and observe
feedings while in the room as well. Sometimes, during this, we’ll be in a
more relaxed setting, and mom will ask questions about any concerns
she has for when she goes home, which I answer or refer her to her
provider or the base’s Visiting Nurse if it’s a subject outside of my scope.

Once my initial visit is over, I will make a follow up plan with mom if
desired, then input notes and do any supplemental research for her. At
my follow up visit (usually that day or the next) I will give her any
resources we discussed and provide answers to her questions.
In the LCTC, we focused a lot on listening to mom, hearing her story and
using that, her experience and her health history to guide our
counseling. I think I use that often to meet moms where they are and
give them the care they deserve. I also find I’m teaching the asymmetric
latch often, even to second and third time moms! I also cover hand
expression and storage guidelines often. We get a lot of questions
around pumping and building a stash of milk for returning to work,
especially for active duty moms.

I have also started seeing postpartum patients in the hospital’s OBGYN clinic.

On unique challenges…
Grask at Rota Breastfeeding Week 2023 presenting topics like skin-to-skin and hand expression 

I think there is a strong desire to help breastfeeding moms here, but
there is an apparent lack of resources, especially for postpartum moms.
The community has one Visiting Nurse who is a rockstar seeing many
moms daily, but she’s unfortunately the only one able to do so at the
moment. To help bridge this gap, I’ve gained approval to have a small
business, Asbury Breastfeeding Counseling, and am offering my
services to moms in the community in addition to my work as a
volunteer. I’m also working with the Visiting Nurse and hospital MCI
leads to host monthly breastfeeding courses at the hospital, promote the
existing pregnancy and postpartum support groups, and soon will be
offering a BYOBB (Bring Your Own Baby and Breastfeed) class at the
hospital for new moms to learn the various positions they can breastfeed
their babies in and be available to answer any questions/troubleshoot
any feeding/latch issues in person.
We also hosted Rota Breastfeeding Week helping educate the
community here on what is available for new moms and showcasing the
various lactation spaces. We also had a latch on nursing event.

On goals for next year…

 

Over the next year, I hope to reach more moms and families to help
them feed successfully… I know this community’s resources are slim. I hope to establish these classes and have imparted education to staff so
when I ultimately transition out of this station, I know I am leaving moms
with supportive providers who can help her achieve her goals.

Some favorite breastfeeding stories…

While working at the Mothers’ Milk Bank, I was able to sit in on several
Baby Cafe postpartum support groups. During a few of these groups, I
met a parenting duo and their little one. No matter what they did, this
mom struggled to make enough for her little one, but desperately wanted
to make breastfeeding work. I listened and observed them for weeks,
learning from their interactions as a couple, parents and individuals and
gleaning insights from the [lactation care provider]  helping them.
Ultimately, I believe they began to feed with donor milk and formula, but
it was their journey and the persevering passion to help their baby and
family thrive that left an impression on me.
Here in Rota, I have been lucky enough to see a few of the moms I’ve
helped in early days several months postpartum. Two such dyads come
to mind. One was a new mom, baby born a couple weeks early had had
an ample supply of milk. Due to her baby’s early arrival, the baby was
transferred to a Spanish hospital where they received formula instead of
her breast milk. I saw her about five days postpartum and her milk
supply had fully come in but the baby was fussy and struggled to latch.
We worked on several techniques, including skin-to-skin care, cross-
cradle and football holds, asymmetric latch and also discussed ways to
pump/store milk. I was worried as this mom seemed to be ready to give
up quickly, but I ran into her six months postpartum and her once small
baby was now thriving on breast milk! It was a beautiful thing to see and
she is still breastfeeding.
In January, I served the family who had the first baby of the year. The
parents were first time parents, and had no idea what to expect or how
to navigate breastfeeding now their arrival had made her debut. Mom
and I worked on recognizing feeding cues, latching, promoting skin-to-
skin care, using dad for support, and discussed various ways to pump– hand express, manual, double-electric, wearables, to help her build a
supply later on. Soon after I had my own baby, I ran into this mom at a
moms group and found breastfeeding was going well for her! Her little
one was steadily gaining weight and she felt confident in her feeding
routine and encouraged by the support she had received early on. I was
elated at this update and so happy to see them thrive.
Personally, breastfeeding hasn’t been as easy as I’d like, but when I feed
it is the most wonderful, almost indescribable feeling. One of my favorite
stories I have is from my early postpartum days. I had been hanging out
skin-to-skin with her on the couch and accidentally fallen asleep. A little
while later I awoke — to a baby suckling on my breast! I had heard and
known about a baby’s natural instinct to find the breast, but I hadn’t expected her to seek it out and find it on her own when she was so new
to the world. Now she giggles whenever she sees my breast and is
especially excited for boob food time!

Enhancing national network of nonprofit donor milk banks and diversifying nation’s production of infant formula to secure infant nutrition in U.S.

The Infant Feeding Action Coalition USA, Inc. (IN.FACT.USA) has put together a piece detailing the global recall of contaminated Abbott powdered formulas.

In February 2022, the largest U.S. infant formula manufacturer recalled three brands of its powdered formula and one breastmilk fortifier and shut down its main manufacturing facility in Sturgis, Michigan following reports of Cronobacter infections in infants who had consumed formula manufactured at the Sturgis plant. It’s noteworthy that the initial recalls were voluntary–not required by the US Food and Drug Administration (FDA)— and they only came after nine babies died between September 2021 and January 2022 from infections.

Let’s focus on that, the death of these babies, Tameka L. Jackson-Dyer, BASc, IBCLC, CHW  urges in her Great Lakes Breastfeeding webinar Feed the Baby: Lactation, Contamination, and the American Formula Crisis.

One infant death is one too many. Initially, two deaths were reported; however, Freedom of Information requests and whistleblower action revealed that not only two, but another seven infants in the U.S. were reported to have died after consuming powdered infant formula manufactured at the Abbott factory.

“During the same period, 25 severe infections categorized as ‘Life Threatening Illness/Injury’ and 80 instances of ‘Non-Life Threatening Illness/Injury’ were reported among infants who were fed these formulas,” The Abbott Powdered Formula Scandal also points out.

“Until Cronobacter infections require mandatory notification, the number of cases of illness or deaths will never be known. Neither will their extent in the 37 countries which imported the potentially contaminated Abbott formula.”

In The Four Pillars of Infant Nutrition Security in the United States, author Amelia Psmythe Seger points out that  “The U.S. has not regulated the marketing practices of the commercial milk formula industry, unlike 70% of the world, which has implemented at least some part of the WHO’s International Code of Marketing of Breast-Milk Substitutes. In the absence of regulation, these marketing practices are predatory.”

Psmythe Seger goes on to urge, “Diversify the nation’s production of infant formula. Plainly it is a mistake to allow 42% of the infant formula in this country to be produced not only by one company but by one factory of that company. Infant formula companies are part of an infant food security system, but we don’t have to be so dependent on that industry.”

[For more on commercial influence, you can watch USBC’s series of Unpacking Commercial Milk Formula Marketing Webinar Recordings]

A history of breastmilk substitutes laid out by Jackson-Dyer reminds us that before the advent of commercial infant formulas,  wet nursing was the original supplemental feeding.

Considering the infant feeding landscape today, Jackson-Dyer quotes Michigan Breastfeeding Network Executive Director Shannon McKenney Shubert, MPH, CLC: “In my 12-year career in the field of human milk feeding, I have never once met a birthing parent who ‘chose not to breastfeed.’ In this country, whether to breastfeed is not a choice. In this country, whether to breastfeed is a question of ‘Within all the systems of oppression that I navigate, what is the best combination of things I can do to ensure the survival of my baby, myself and the rest of my family?’”

With this context in mind, Jackson-Dyer confronts the idea that yes, babies must be fed, but fed is not best; instead, it is required, she says in her webinar.

“It is the absolute minimum to sustain life,” she reminds us. “We can’t just feed the baby anything.”

Again in The Four Pillars of Infant Nutrition Security in the United States, Psmythe Seger shines light on nonprofit donor milk banks which provide pasteurized donor human milk for human babies, “the next best thing to mom.” 

“Enhance the national network of nonprofit donor milk banks,”  Psmythe Seger writes. “Support innovative partnerships across existing structures, taking a cue from a national model such as what exists in Brazil. Consider: Red Cross has the infrastructure to support donor screening; WIC offices or community health clinics could be donor drop-off sites; more hospitals could provide space and equipment for donor milk processing and distribution, as some have done. Models exist to create an affordable and plentiful alternative to commercial milk formula when a parent’s own milk is not available.”

Photo by: Sara D. Davis/
Source: United States Breastfeeding Committee (USBC)

This fall, the Access to Donor Milk Act (ADMA) was introduced in the House. ADMA would increase federal support for nonprofit milk banks and access to donor milk for medically-vulnerable infants.

What’s more, the legislation would allow state agencies to use WIC funding to promote the need for donor milk, provide emergency capacity funding when there is a demand for donor milk,  create a donor milk awareness program, and require the secretary of HHS through the FDA to issue a rule clarifying the regulatory status of donor milk provided by nonprofit milk banks.

Stay tuned for how you can help support this legislation. For other legislative and policies opportunities that support healthy infant feeding, visit USBC’s Take Action page here.