Baby wearing an orange, hooded jacket.

Breast milk provides excellent nutrition for babies. When none is available, human milk banks can help. Photo: PATH/Wendy Stone.

Human milk banks may help save vulnerable babies

Illustration of gears with text 'Fueled by innovation. Learn more.'Njabulo’s mother knew breast milk would be the best food for her baby, so when her son was born, she tried to breastfeed him. But she was HIV-positive, and a few weeks after Njabulo’s birth, she became too ill to continue. She died when Njabulo was just two months old.

With his mother gone, Njabulo had no access to the breast milk that could safely provide all the energy, nutrients, and fluids he would need for the first six months of his life, as well as antibodies to keep him free from illness. He was severely underweight and suffering from frequent diarrhea and a severe skin rash when he arrived at the iThemba Lethu transition home for HIV-exposed infants in the KwaZulu-Natal province of South Africa.

Njabulo’s condition was serious; he was in desperate need of safe nutrition. Luckily, the transition home had one of the few human milk banks in the country.

Donated milk for at-risk babies

Human milk banks, which rely on donated mothers’ milk, play an important part in ensuring that safe breast milk is available to babies whose mothers are unable to provide it. The banks are even more crucial for vulnerable babies like Njabulo—those who are premature, underweight at birth, severely malnourished, or orphaned. These babies are at high risk of illness and death.

In 2008, the World Health Organization called for World Health Assembly member nations to promote the safe use of donor milk delivered through human milk banks for vulnerable babies. However, scaling up this lifesaving intervention has been challenging in poor countries.

To ensure that donated milk doesn’t carry HIV or other pathogens, human milk banks like the one at iThemba Lethu pasteurize it. While health workers increasingly recognize the banks’ potential to help infants survive and thrive, too few hospitals have them. PATH is making it easier and more affordable for countries to introduce milk banking.

Making it affordable

PATH is promoting milk banking globally, strengthening health services in specific countries like South Africa and India, and designing and advancing cost-saving technologies. The high cost of commercial-grade milk pasteurizers is one of the biggest barriers to implementation, so we worked with the University of Washington and the Human Milk Banking Association of South Africa to develop an easy-to-use and inexpensive pasteurization monitoring system—guided by mobile phones.

Our mobile-phone app directs and monitors a simple heat-flash pasteurization process and transmits data to quality assurance supervisors. Using the system, infants in a number of neonatal intensive care wards in South Africa are fed donor milk—safely and affordably—and get second chances at healthy beginnings.

The best start at life

This technology solution is part of a larger strategy that aims to integrate human milk banking into a comprehensive breastfeeding awareness program, what we call the Mother and Baby Friendly Initiative Plus. This approach is modeled on the world’s most successful human milk banking program, located in Brazil, where milk banking is one element of a national strategy to promote breastfeeding. Brazil’s program has contributed to reducing infant mortality rates by more than 50 percent.

PATH’s comprehensive approach promotes and supports exclusive breastfeeding for the first six months of a child’s life, as well as other important baby-friendly practices. At the same time, it encourages mothers who can breastfeed to donate milk for children in need, thereby building up supplies.

Our goal is to ensure that all children have the best nutrition for a healthy start in life—through their own mother’s breast milk or, when that’s not possible, with safe donated breast milk.

A thriving baby

For babies like Njabulo, incorporating safe donated milk into feeding strategies can help encourage growth, development, and even survival. As Njabulo began to receive donated human milk, his health improved dramatically. His diarrhea stopped. His rash disappeared. He gained weight. By the time he was three months old, Njabulo was a thriving baby.

All babies deserve this opportunity.