Modern research confirms that breast milk is not just food, but a unique system that adapts to the baby's needs. Specialists recommend exclusive breastfeeding for the first six months of a baby's life. But sometimes the mother has no milk, or not enough. In such cases, donor milk becomes a priority. Special banks operate to collect and store such milk. There is one in Kyiv as well, and read about where it operates in the material by UNN.
What are the benefits of breast milk
First of all, it is antibodies and biofactors.
Breast milk contains secretory IgA, lactoferrin, lysozyme, oligosaccharides (HMOs), live immune cells and cytokines – they neutralize pathogens, block their attachment to mucous membranes and reduce inflammation
Breast milk also contains beneficial bifidobacteria, forming a healthy gut microbiome, which is key for the immune system.
"This means fewer infections: children on breast milk have a lower risk of diarrhea, otitis media, lower respiratory tract infections; in premature infants, the risk of necrotizing enterocolitis is significantly reduced. Such children respond better to vaccinations – studies note higher antibody titers after vaccination," explains Osipova.
Breastfeeding also has a long-term effect: a lower risk of hospitalizations from infections in the first year, a potential reduction in the development of asthma, allergies and obesity. At the same time, a so-called "dose-effect" is observed – more own milk and exclusive breastfeeding in the first 6 months increases the protective effect.
The best protective effect is demonstrated by the mother's own milk, as donor milk loses some biofactors during pasteurization – however, it is the first alternative in the absence of own milk.
How the Breast Milk Bank in Kyiv operates
The first breast milk banks in the world appeared at the beginning of the 20th century. One of the first opened in Vienna in 1909. The first Breast Milk Bank in Ukraine started operating on March 1, 2019, on the basis of the Perinatal Center of the city of Kyiv. Its opening was an important event for the Ukrainian healthcare system, as before that there was no specialized institution of this type in the country.
The Bank operates today – it did not stop its work despite the war and blackouts.
"The Perinatal Center of the city of Kyiv has 4 pediatric intensive care units, and providing their patients with milk is a priority for the Milk Bank. However, depending on the stock available at the time of the request, if there is a surplus, the Bank can provide milk to children outside our inpatient departments," explains Anna Osipova.
The main goal of the bank is to provide donor breast milk to: prematurely born children; infants with critically low body weight; children (healthy full-term) whose mothers are temporarily unable to breastfeed for medical reasons.
Donor milk is especially important for premature infants.
"The digestive system of prematurely born children is immature, so they tolerate artificial feeding much worse compared to breast milk. Such infants have not yet sufficiently developed intestinal enzyme systems, protective mucous barrier and immune mechanisms. Because of this, formulas can increase the risk of serious complications from the gastrointestinal tract. The most dangerous of these is necrotizing enterocolitis – a severe disease in which inflammation and damage to the intestinal wall occurs," explained Osipova.
The use of donor breast milk, in addition to reducing the development of necrotizing enterocolitis, allows improving the tolerance of enteral nutrition; achieving full feeding volume faster; reducing the frequency of infectious complications; shortening the length of stay for some children in the intensive care unit.
"Therefore, we can confidently say that the emergence of the Breast Milk Bank in Kyiv made it possible to apply a feeding method whose effectiveness had already been proven by world practice," Osipova emphasized.
Donor milk is provided to infants who have indications, free of charge. Per month, the Bank helps feed up to 80 infants.
The quality of milk at the Bank is carefully monitored: each batch is subject to bacteriological culture. If non-compliance with standards is detected, the batch is disposed of.
"We also analyze each batch of milk for the amount of fats, proteins and carbohydrates, as well as calories. The composition determines which department the milk goes to," explains the head of the Milk Bank.
Milk reaches small patients only after laboratory control and mandatory processing. All donor milk is pasteurized.
Usually, a donor collects milk at home. At a temperature of 2-4°C, milk can be stored for no more than 24 hours. Milk is transported to the Perinatal Center only in frozen form – at home it can be frozen at a temperature of -18 degrees. The transportation requirements do not end there, because milk cannot be thawed – it must be transported in special isothermal containers using cold packs. A Bank courier can help with transportation, but such transportation is available only within the capital.
At the Bank, milk undergoes mandatory pasteurization. This process also has its own peculiarities – pasteurization occurs using the Holder method – this is a long-term low-temperature pasteurization.
First, the samples are thawed in the refrigerator, then they are heated for 30 minutes at a temperature of 62.5°C, which is carefully monitored. After that, the milk is rapidly cooled to ≤4°C, and then frozen. All samples are checked, and batches with bacterial growth after pasteurization are disposed of. Pasteurized, tested and labeled samples are stored frozen at a temperature of ≤–18/–20°C.
Having milk is not enough – how donors are selected
A potential breast milk donor is a healthy woman who is breastfeeding and has excess milk. A woman who smokes, including vaping, uses drugs or alcohol cannot become a donor. There are also restrictions on caffeine consumption – usually no more than 300 mg per day.
Absolute medical contraindications:
- infectious risks: HIV, hepatitis B/C, syphilis;
- recent tattoos/piercings;
- blood transfusion/organ transplant within the last 12 months;
- taking contraindicated medications (chemotherapy, isotretinoin, radioactive iodine, etc.).
Women must undergo laboratory tests to detect infectious risks, and also speak with a specialist about their general health, the course of pregnancy and childbirth, medication and dietary supplement intake, nutrition and other factors that may have an impact.
As the director of the Bank, Anna Osipova, said, in recent years there have been more women who express a desire to become milk donors.
"Unfortunately, sometimes women refuse this due to the logistics of delivering samples. Also, many women worry about blood tests and confidentiality. Blood tests for our donors are carried out free of charge, but the procedure itself sometimes causes stress," explains Osipova.
There are cases of women refusing help with feeding and donor milk. But at the Perinatal Center, there are consultants who will help make the best decision for the baby, and if necessary and possible, establish their own breastfeeding.