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Breastfeeding - Breast Milk Sharing in Newborn Services

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Background

Breast feeding and breast milk provides nutritional, protective, and economical benefits to mothers and babies. If maternal breast milk is not available or not available in sufficient quantities, donor breast milk may be requested. The cultural personal and or physical factors affecting infant feeding are to be respected and staff are to support and assist woman in their choice of infant feeding. To promote safe breast milk sharing these three principles need to be followed:

  • Informed choice
  • Donor screening
  • Safe handling

Currently Auckland District Health Board does not have a donor milk bank facility or facilities to pasteurise breast milk.

Definitions

Donor breast milk Human breast milk donated by a person other than the biological mother.
Donor This is the person providing the breast milk.
Recipient This is the baby who will receive the donor breast milk.

Ensuring safe peer to peer milk sharing

View breast milk sharing flow chart

The following information should be available to parents

  1. Informed choice
    Provide patients with the knowledge to make a safe decision regarding sharing breast milk. This includes;
    - giving patients the information pamphlet
    - making a referral to the Lactation Consultant or Clinical Charge Nurse
    - Human milk sharing form to mother's LMC or GP
    - Advising neonatologist responsible for baby's care
  2. Donor screening
    Breast milk may contain viruses and substances that may be transmitted to infants. Health and risk screening is required from a prospective donor to confirm the milk is suitable for recipient use. See donor breast milk screening form. This form must be sighted by GP, LMC, Neonatologist or other health professional involved in the screening process. Copies of screening information made available to parents
  3. Legal documentation
    Donor consent form signed
    Recipient consent form signed
    ADHB agreement for treatment form signed (this is available with NICU forms)

Administration of donor milk

  1. The donor mother must be given guidance on the expressing and storage of breast milk
  2. Donor milk must be recorded correctly on the donor milk record sheet.
  3. Donor milk will be labeled donor milk and will have an expiry date on each pottle as well as the donors NHI.
  4. Before administration the milk will be checked by two staff and documented on the donor milk record sheet attached to the individual baby's feeding chart.
  5. As there may be more than one donor it is important we are able to if necessary track the donor by this process.
  6. All donor milk will be frozen at time of expressing and will expire three months after expression time. 

References

  1. Gribble, D,K (2012) Biomedical Ethics and Peer to Peer Milk Sharing Clinical Lactation, 3.3 pg 109-112 .
  2. National Institute for Health and Clinical Excellence (2010) Donor breast milk banks: the operation of donor breast milk services. London: National Institute for health and Clinical Excellence.
  3. World Health Organisation, UNICEF, Global Strategy for infant and young child feeding. Geneva. WHO, 2003
  4. Simmer S, Hartmann B (2009) The knowns and unknowns of milk banking. J Early Human Development, 85, pg701-704
  5. Scott S, O'Donaghue K, Carpenter M, Daley A. Directed donations of Breastmilk. Infection Control and Prevention Department, Royal Children's Hospital Melbourne
  6. Canterbury District Health Board; Donor Breast Milk Health Screen
  7. Capital Coast District Health Board; Use of Donor Breast Milk Policy

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Document Control

  • Date last published: 01 December 2015
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years