I'm a new mom and I am producing more breast milk than my baby needs. I know that some mothers can't make enough milk for their babies. Is there a way for me to donate my extra supply?
That's certainly a very generous offer. Four Canadian cities now have non-profit breast-milk banks that accept donations from healthy nursing moms.
A few decades ago, there were more than 20 milk banks across the country. All but the one in Vancouver closed in the 1980s after it was discovered that the AIDS virus is spread through bodily fluids, including breast milk.
Since then, the medical community has developed ways to safeguard this precious resource through screening, testing and pasteurization procedures.
Even so, "it has been a slow crawl back up again," says Debbie Stone, managing lactation consultant at the Rogers Hixon Ontario Human Milk Bank, which is based at Mount Sinai Hospital in Toronto.
The Toronto bank – a joint venture between Mount Sinai, the Hospital For Sick Children and Sunnybrook Health Sciences Centre – opened in 2013 after more than five years of study and planning.
Mothers' milk has all the nutrients that babies need to develop and grow. It also contains special immune compounds – like antibodies – that help protect from infections.
It is widely regarded as the ideal baby food. What's more, it is a potential lifesaver for children born prematurely.
"Preterm babies are especially vulnerable because they are not really prepared for life in the outside world," says Luisa King, a breastfeeding resource nurse at Sunnybrook.
In particular, their underdeveloped bowels are susceptible to a condition called necrotizing enterocolitis (NEC) in which the gut becomes inflamed and part of the intestine can develop holes, permitting the contents to leak into the abdomen. NEC is a leading cause of death for preemies in hospital neonatal intensive-care units.
Studies have shown that preemies fed human milk are much less likely to develop NEC than those given commercial formula, which contains cow's milk.
The proteins in cow's milk are not easy to digest for premature infants, explains Dr. Elizabeth Asztalos, a neonatologist at Sunnybrook. "Human milk puts less stress on the preterm babies' guts," she says.
And yet, for a variety of reasons, some mothers of premature babies are not able to produce adequate levels of milk. That means their babies need at least some milk from other lactating moms.
"We use donor milk with the hope that we can bridge the gap until the mothers can produce enough milk for their babies," Asztalos says.
Canadian milk banks are primarily focused on feeding this extremely fragile group of preemies and some other vulnerable hospitalized babies. The key goal is to make sure that the available supply goes to those most in need, Stone says.
Another critical job of the bank is to oversee the safety of the donated milk supply. For that reason, potential donors go through a comprehensive screening process. They are asked questions about their medical history and lifestyle. As well, they undergo blood tests that look for infectious diseases.
If you are accepted as a donor, you will be given instructions on the proper handling and storage of the pumped milk. (Donors provide their own breast pump machines.)
And if you live in the greater Toronto area, a courier will come to your home to pick up the milk, which is transported to the bank in a special cooler.
Once it has arrived at the bank, the milk is tested for bacteria. If it passes this safety check, it is mixed with milk from other moms and then pasteurized by heating the batch to 62.5 C for 30 minutes. It's then rapidly chilled and frozen. The pasteurized breast milk has freezer life of six months.
Stone says the Toronto bank has received far more offers of milk from potential donors than originally expected.
"We anticipated we would have 200 donors a year. Since our opening in April of 2013, we've screened 1,050 donors."
However, only 55 per cent of those approved have followed through with regular donations. The daily demands of being a new mom can sometimes overtake the original good intentions.
Stone suggests checking out the website of the milk bank in your area to see if you meet the criteria and then considering whether the donation process is right for you.
"Some of our best donors have been bereaved moms. They've either had a miscarriage or lost a baby soon after delivery," Stone says. "They feel this is the best gift they can give in memory of their child."
Paul Taylor is a patient navigation adviser at Sunnybrook Health Sciences Centre. He is a former Health Editor of The Globe and Mail. You can find him on Twitter @epaultaylor and online at Sunnybrook's Your Health Matters.