RE: Hospital Policy for Milk Sharing

[Guest guest]

We only use milk from WakeMed Milk Bank. Have helped adoptive mothers who share milk on their own and have provided as much information as I could about the risks and benefits for them to make an informed decision. Doing a quick search, couldn’t find an ILCA statement regarding milk sharing, but did find the below references. After looking at these, wouldn’t put my hospital or certification on the line by coordinating any formal exchange. An old article in the Journal of Human Lactation - Informal Sharing of Human Milk: Not-so-Hypothetical Questions, Concrete Answers, by Lois D.W. ArnoldJ Hum Lact, March 1994; vol. 10, 1: pp. 43-44 details legal risks to hospital and LCs who participate in milk sharing and risks to infants receiving shared milk. There are also some other later (2001) editorials describing the inherent risks and liability. Massachuttes BF Coalition (http://massbreastfeeding.org/index.php/2005/is-it-safe-to-share-breastmilk) has a full monograph. Summary: In sum, there are risks of sharing breastmilk. Most risks can be minimized by obtaining an accurate history from the donor mother, bearing in mind one can never obtain a history that is completely trustworthy. Unknown HIV infection represents the most serious risk, and while heating breastmilk through an effective home pasteurization process could inactivate HIV, this is not routinely done in the US. Both the American Academy of Pediatrics and La Leche League discourage sharing breastmilk. It is suggested that donor mothers be screened using the protocol developed by the Human Milk Banking Association of North America. This coalition suggests using milk donations from milk banks: www.hmbana.org/donations.htm Mohrback has an article on her website that discusses mom-to-mom sharing, but don’t know of any program in a hospital that accepts such a liability - http://www.nancymohrbacher.com/blog/2010/12/6/should-milk-sharing-among-mothers-be-encouraged.html Hope this helps, JoanFrom: [mailto: ] On Behalf Of robinhollenSent: Thursday, August 09, 2012 2:01 AMTo: Subject: Hospital Policy for Milk Sharing Aside from PP I work as an LC in a hospital and wondering if anyone has created or has input for a policy regarding Milk Sharing. We affectionately call it Donor milk (from the milk bank) and Girlfriends or Community Milk. A baby was in the NICU this year, mother had tragically died after birth and that baby continues to receive Community Milk, beautiful story. Before he left the NICU, the neo's used the Community Milk, Father consent only. That should be simple enough for the post-partum floor, but I don't want to re-invent the wheel and I want to be prepared when it's presented to the policy changers. There isn't resistance (that we are aware of yet) so much as how to support it properly. Open to ideas and thanks.Robin HollenStarfish Lactation

[Guest guest]

Where do  you work Robin ? This is a beautiful story. Ghislaine Reid, BA (Translation 1981), LLL (1990), IBCLC(2002)Montreal, Quebec, Canada De : [mailto: ] De la part de robinhollenEnvoyé : 9 août 2012 02:01À : Objet : Hospital Policy for Milk Sharing Aside from PP I work as an LC in a hospital and wondering if anyone has created or has input for a policy regarding Milk Sharing. We affectionately call it Donor milk (from the milk bank) and Girlfriends or Community Milk. A baby was in the NICU this year, mother had tragically died after birth and that baby continues to receive Community Milk, beautiful story. Before he left the NICU, the neo's used the Community Milk, Father consent only. That should be simple enough for the post-partum floor, but I don't want to re-invent the wheel and I want to be prepared when it's presented to the policy changers. There isn't resistance (that we are aware of yet) so much as how to support it properly. Open to ideas and thanks.Robin HollenStarfish Lactation

[Guest guest]

I also like the paper (very thought provoking) from Akre, Gribble and Minchin :http://www.internationalbreastfeedingjournal.com/content/6/1/8/Milk sharing: from private practice to public pursuit Ghislaine Reid, BA (Translation 1981), LLL (1990), IBCLC(2002)Montreal, Quebec, Canada De : [mailto: ] De la part de joan levyEnvoyé : 9 août 2012 08:05À : Objet : RE: Hospital Policy for Milk Sharing We only use milk from WakeMed Milk Bank. Have helped adoptive mothers who share milk on their own and have provided as much information as I could about the risks and benefits for them to make an informed decision. Doing a quick search, couldn’t find an ILCA statement regarding milk sharing, but did find the below references. After looking at these, wouldn’t put my hospital or certification on the line by coordinating any formal exchange. An old article in the Journal of Human Lactation - Informal Sharing of Human Milk: Not-so-Hypothetical Questions, Concrete Answers, by Lois D.W. ArnoldJ Hum Lact, March 1994; vol. 10, 1: pp. 43-44 details legal risks to hospital and LCs who participate in milk sharing and risks to infants receiving shared milk. There are also some other later (2001) editorials describing the inherent risks and liability. Massachuttes BF Coalition (http://massbreastfeeding.org/index.php/2005/is-it-safe-to-share-breastmilk) has a full monograph. Summary: In sum, there are risks of sharing breastmilk. Most risks can be minimized by obtaining an accurate history from the donor mother, bearing in mind one can never obtain a history that is completely trustworthy. Unknown HIV infection represents the most serious risk, and while heating breastmilk through an effective home pasteurization process could inactivate HIV, this is not routinely done in the US. Both the American Academy of Pediatrics and La Leche League discourage sharing breastmilk. It is suggested that donor mothers be screened using the protocol developed by the Human Milk Banking Association of North America. This coalition suggests using milk donations from milk banks: www.hmbana.org/donations.htm Mohrback has an article on her website that discusses mom-to-mom sharing, but don’t know of any program in a hospital that accepts such a liability - http://www.nancymohrbacher.com/blog/2010/12/6/should-milk-sharing-among-mothers-be-encouraged.html Hope this helps, JoanFrom: [mailto: ] On Behalf Of robinhollenSent: Thursday, August 09, 2012 2:01 AMTo: Subject: Hospital Policy for Milk Sharing Aside from PP I work as an LC in a hospital and wondering if anyone has created or has input for a policy regarding Milk Sharing. We affectionately call it Donor milk (from the milk bank) and Girlfriends or Community Milk. A baby was in the NICU this year, mother had tragically died after birth and that baby continues to receive Community Milk, beautiful story. Before he left the NICU, the neo's used the Community Milk, Father consent only. That should be simple enough for the post-partum floor, but I don't want to re-invent the wheel and I want to be prepared when it's presented to the policy changers. There isn't resistance (that we are aware of yet) so much as how to support it properly. Open to ideas and thanks.Robin HollenStarfish Lactation