Donated Human Milk: A Lifesaving Option for Vulnerable Infants

Kenya loses an estimated 39 infants for every 1000 live births, translating to over 50,000 babies who die before their first birthday each year. More than half of these deaths occur in the neonatal period – the first month of life – most often due to complications related to prematurity and low birth weight[1].

Essential newborn care interventions to improve the survival rate of vulnerable preterm and low birth weight babies exist, including drying, warming, immediate and exclusive breastfeeding, hygiene and cord care, antibiotics and antenatal corticosteroids. Of these solutions, breastfeeding has the greatest potential to impact child survival. It provides the unique nutrition and immune support that babies need to survive and thrive. Early exclusive breastfeeding has the potential to prevent 13% of under-five deaths globally each year[2]. Yet not every newborn is able to benefit from his or her mother’s milk, either because of maternal illness, death or abandonment, leaving these infants more vulnerable, especially when they are born preterm, with low-birth weight, sick or are severely malnourished.

For vulnerable babies without access to their mother’s own milk, the World Health Organization recommends donor human milk (DHM) as the next-best feeding option[3]. Available evidence shows that compared with formula, DHM is associated with lower incidence of the severe gut disorder, necrotising enterocolitis, and other infections during the initial hospital stay after birth. Thus, ensuring access to DHM is a lifesaving and cost-effective intervention. Human milk banks (HMBs) collect, pasteurize, test, and store safe donor milk from lactating mothers and provide it to infants in need, ensuring that even if babies cannot breastfeed, they still receive human milk as soon as possible. More than 500 HMBs have been established in over 40 countries around the world including South Africa, India, France, Japan, Brazil and Canada. Though wet-nursing was commonly practiced in the old days, Kenya is yet to embrace the advances in technology to make DHM more safely and widely available.

Following the WHO recommendation, the Ministry of Health, with support from PATH and other partners, has undertaken an initiative to establish the first human milk bank in Kenya. The Mother-Baby Friendly Initiative Plus (MBFI+), as it is called, integrates DHM with other aspects of newborn care especially breastfeeding promotion, lactation support, and kangaroo mother care. Pumwani Maternity Hospital in Nairobi County will host Kenya’s first HMB, thus expanding its capacity to offer quality comprehensive neonatal care services and secure an accreditation as an MBFI+ centre of excellence.

The CICF funded initiative has already completed an initial phase in which a formative assessment was conducted to identify enabling factors and potential barriers, building stakeholder support, a learning exchange visit to South Africa, developing national guidelines for HMB, and training key players on HMB with a focus on safety and quality assurance. The second phase, which started in March 2018, entails setting up the milk bank at Pumwani. The ongoing activities include: conducting awareness and demand generation campaigns, developing standard operating procedures for the quality control and assurance, building capacity of staff involved in running the bank, recruiting, screening and training potential breast milk donors, and screening, pasteurizing and dispensing the donated milk. It is anticipated that 2018 will end on a high note, with the commissioning of Kenya’s first Human Milk Bank.