蓝莓视频

鈥淭he first choice of milk for our tiniest premature babies is, of course, their mother鈥檚 own milk鈥� explains Dr Aniko Deierl, a consultant neonatologist at Queen Charlotte鈥檚 & Chelsea Hospital. But for some families, whose babies arrive in the world much earlier than expected, this just isn鈥檛 always an option.

鈥淲hen babies are born too early, mum鈥檚 body may not be ready to produce milk yet and they need support to start expressing and collecting enough to feed their baby. In the meantime, we can offer donated breastmilk from the聽聽to help bridge the gap,鈥� explains Dr Deierl.

Born too early

Pre-term birth, when babies are born before 37 weeks of pregnancy, is the leading cause of death in children under five across the world and those born prematurely can be impacted by a range of different health and cognitive issues as babies and also later in life. Researchers at the National Institute for Health and Care Research (蓝莓视频) 蓝莓视频 (BRC) are working hard to find ways to reduce early births but, in the meantime, doctors and researchers are committed to supporting families to have the best possible outcomes.

“We can offer donated breastmilk to help bridge the gap” – Dr Aniko Deierl, consultant neonatologist

A potential complication for the most vulnerable premature babies, born before 32 weeks, is a serious stomach condition where tissue in the bowel becomes inflamed. In severe cases, this tissue can die and need to be removed with an operation. Necrotising enterocolitis (NEC) affects somewhere from 6 鈥� 8 per cent of very premature infants, which could be up to 650 babies in the UK per year. It can be life threatening, in severe cases 1 in 2 will die or live with long term neurological disability and nutritional failure.

Nature鈥檚 design聽

Formula milk that has been specially developed for premature babies is not always suitable for the earliest babies. 鈥淚t tends to be based on proteins from cow鈥檚 milk, which are difficult for very small, fragile digestive systems to handle,鈥� says Dr Deierl. Human breast milk, however, is much more easily digested and absorbed because it is biologically designed to be consumed by human babies. This means it is much gentler on tummies which haven鈥檛 yet fully developed.

Dr Deierl and her colleagues know the impact that donated breast milk can have for their smallest patients. 鈥淚n our unit, where babies born before 32 weeks are offered donated breast milk as standard, the rate of babies being admitted with NEC is roughly halved.鈥�

鈥淚n our unit, where babies born before 32 weeks are offered donated breast milk as standard, the rate of babies being admitted with NEC is roughly halved鈥� 鈥� Dr Aniko Deierl, consultant neonatologist

Dr Jay Banerjee is an 蓝莓视频 Imperial BRC supported researcher and neonatal consultant at Imperial College Healthcare NHS Trust. He leads a research team aiming to better understand why some babies develop NEC and hopefully find a way to treat them more quickly, or even prevent it. 鈥淲e don鈥檛 really understand why NEC happens, and that is where the research comes in.

鈥淢any premature babies need blood transfusions to replenish blood supply in the body due to repeated blood tests. We noticed that in some premature babies who received milk feeds while being given a blood transfusion, they were more likely to develop NEC than those who didn鈥檛.鈥�

Dr Banerjee thinks that when babies receive milk feeds at the same time as a transfusion, they are unable to absorb the oxygen from the new blood in their stomach because their very fragile, brand-new stomachs are focused on the task of digesting milk. This could be one explanation as to why tissue in the digestive system can die and result in a number of reactions and severe complications that Dr Deierl and her team see in their neonatal unit.

Dr Banerjee is trying to understand which babies are most at risk of developing NEC so they can treat them earlier or even prevent it. They are also investigating whether stopping feeds during a transfusion reduces NEC risk. 鈥淲hen you transfuse and feed a premature baby at the same time, the increased flow of blood in their stomach normally seen in response to feeds just can鈥檛 happen because the transfusion is going on.鈥�

Donor milk helps thousands of premature babies across the UK, especially in the early stages, when most mothers can struggle to establish their own milk supply, or if mothers are unable to breast feed due to physical illness.

鈥淚n such situations, donor milk is the second-best choice for feeding these vulnerable infants and our goal is to ensure that donor milk is available to every newborn that would benefit from it鈥�, says Francesca March, milk bank coordinator. The majority only need it for a few early days therefore donor breast milk acts as 鈥渁 bridge to breastfeeding鈥� during these early challenges.

鈥淒onating breastmilk is one of the most precious gifts you can offer 鈥� it can be done in the comfort of your own home and collected from your door鈥�, continues Francesca. Donor milk is considered human tissue and so becoming a milk donor is similar to becoming a blood donor. The milk bank recruits actively lactating parents who are less than one-year post-birth.

鈥淒onating breastmilk is one of the most precious gifts you can offer” 鈥� Francesca March, milk bank coordinator at Queen Charlotte鈥檚 & Chelsea Hospital聽

All potential donors are asked to complete a聽聽and if they qualify are screened for infections. Milk bank staff are there for donors every step of the way Francesca explains, 鈥渞egistered donors are given clear instructions on how to collect and store milk to avoid contamination, as well as equipment such as labels, sterile bottles to store your breast milk and a thermometer to monitor your freezer temperature daily.鈥�

鈥淒onating my extra milk seemed like the obvious choice.鈥澛�

Donor, Ronit, discovered our milk bank through a friend. 鈥淚 became a donor because I knew I was lucky to be able to breastfeed so donating my extra milk seemed like the obvious choice. It also really motivated me to keep pumping when I felt like stopping.

鈥淭he process seemed quite complex at first as I was very sleep deprived and there were 鈥� understandably 鈥� some instructions to follow. However, the milk bank is always very responsive, and it all became clear fairly quickly. It was also good to have instructions so that you know you鈥檙e always doing the right thing for the recipients of the milk.

鈥淒onating has been great in lots of ways. After a tough night with a newborn, it really gives you some perspective. It doesn鈥檛 take very long but it makes you feel like you鈥檝e done something that day.鈥�

鈥淚t is nice to do something anonymously knowing it’s going to a good cause.鈥澛�

Donor, Ashley, was so grateful for the care and attention she received from the NHS throughout both her pregnancies. She saw becoming a donor as a way of giving back. 鈥淏eing a donor allows me to say thank you in a less obvious way and in the comfort and privacy of my own home.

鈥淚t is also nice to do something anonymously knowing it’s going to a good cause and without the expectations of anything in return. There is quite a bit of time allocated to complete a donation so my advice to new donors would be to avoid putting pressure on yourself to donate in the shortest time possible. Your own baby should be the priority.鈥�

鈥淭he most special gift of all鈥澛�

Gillian Weaver MBE worked at the milk bank for 30 years and is a pioneer in the milk banking field. 鈥淭hroughout my time I was able to hear from donors and recipient families about how donor milk has made a profound difference to their lives. I was most touched by being able to support milk donation from bereaved donors whose babies had sadly died and for whom donating breastmilk to benefit other babies is the most special gift of all.鈥�

Established in 1939, the milk bank at Queen Charlotte鈥檚 & Chelsea Hospital is the world鈥檚 oldest continuously operating milk bank. 鈥淚t provides donor milk to around 500 premature and sick babies each year. There are an average of 60 donor mothers per year supporting the milk bank at any one time which highlights its significant importance today鈥�, says Fiona Stubbs, lead nurse for neonates.

Queen Charlotte鈥檚 Hospital was a funded charity when the milk bank, which pre-dates the NHS, began. In 1939, infant mortality rates were high and premature births were increasing. This led to higher rates of delayed milk production and a clear need for the new milk bank service. Edith Dare, head matron of the hospital, was the first director of the milk bank and introduced an innovative training programme for midwives and nurses using cutting-edge techniques and technologies.

鈥淒ue to the lack of refrigeration at the time, dry ice was used, and the milk was frozen immediately after it reached the ‘bureau’ (how the milk bank was referred to prior to World War II) and was pasteurised鈥�, says Dr Tanya Cassidy, cultural historical researcher and author of 鈥楤anking on Milk: An Ethnography of Donor Human Milk Relations鈥�.

Original donors were from west London boroughs and only mothers who had carried healthy infants to full term were accepted. They underwent thorough tests, much like donors today, and received a nominal payment. This gesture ended following research on payment for blood donation in the 1970s.

Surviving through history聽

The milk bank has survived many historical milestones, including World War II and the discovery that HIV could be transmitted via breast milk, as well as the exponential growth of the formula industry, which impacted breastfeeding and potential donor rates. Dr Cassidy explains, 鈥淎fter the war, there were more women in the work force and this meant that they were not as supported to feed their infants, which contributed to a reduction in breastfeeding rates. The milk bank therefore suffered with fewer potential donors.鈥�

鈥淚n the 1980s, as with the recent coronavirus pandemic, there were concerns that HIV was transmitted via breast milk and this further impacted negatively on milk donations until it was confirmed that pasteurisation kills HIV.鈥�

Future growth

The milk bank currently processes approximately 300 litres of donated breast milk each year and has recently embarked on a period of growth and transformation. 鈥淲e hope to raise the visibility and understanding of our milk bank within the community, to expand our donor pool and grow our donor breast milk supply. This will support our goal to promote equity of access to donor milk and ultimately extend our offer to all newborn babies who would benefit from its use,鈥� says Fiona. 鈥淥ur vision is to help as many babies as possible through the selfless acts of our donors.鈥�

Currently, an average day involves pasteurising breast milk donations and sending off samples to microbiology. 鈥淎t the beginning of the day and towards the end, we check if there is enough milk in the freezer on our neonatal unit. We are also busy sending out questionnaires and information leaflets, registering new donors, posting donor packs and liaising with our volunteer drivers who collect our milk donations鈥�, explains Claudia Beck, milk bank supervisor and technician.

The milk bank would not be possible without Cosmic charity, who provide invaluable support and funding for the children鈥檚 and neonatal intensive care units at St Mary鈥檚 and Queen Charlotte鈥檚 & Chelsea hospitals, including a much-needed refurbishment of the milk bank itself in 2023. The refurbishment has created extra space to collect, pasteurise and store milk which has enabled the Trust to provide a consistent and increased supply of milk to our patients and we have been able to extend the service to other NHS trusts too.

鈥淎s we celebrate the 85th anniversary of this service, we want to say a huge thank you to all our wonderful donors who have helped our premature and sick babies and families over the years. Your donations have been lifesaving,鈥� says Fiona.

Individuals who are interested in becoming milk bank donors can call our milk bank between 09.30 to 14.00 on weekdays on 020 3313 3559, email聽imperial.milkbank@nhs.net, or visit our聽.