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CHKD Milk Bank: Interview with Ashlynn Baker

To learn more about the Children’s Hospital of the King’s Daughters Milk Bank, Hampton Roads Moms reached out to Ashlynn Baker, Manager of the Milk Bank.

To our excitement, Ashlynn agreed to answer questions we had about the King’s Daughters Milk Bank and the impact of donor milk in the local community.

Ashlynn Baker’s Bio

Ashlynn Baker, BSN, RN, IBCLC Milk Bank Manager The Children’s Hospital of The King’s Daughters
It was at the age of 13 while volunteering at The Children’s Hospital of The King’s Daughters (CHKD) that I realized that I wanted to be a nurse. In 2006, I made this dream a reality and began working as a Registered Nurse in the Neonatal Intensive Care Unit. I not only provided bedside care to the hospital’s most fragile patients, but I also worked on implementing initiatives to improve their survival. In October 2012, under my leadership, CHKD began offering pasteurized donor human milk treatments to critically ill infants when mother’s own milk was unavailable. Two years later, I managed the establishment of The King’s Daughters Milk Bank at CHKD, the first non-profit milk bank in Virginia and one of only 26 in North America. I owe a huge portion of the success of the milk bank to our altruistic donors, my co-workers and to my family.

 

History of the Milk Bank

The King’s Daughters Milk Bank at CHKD opened in June 2014 and is the 1st and only non-profit human milk bank in Virginia.  Not only did the Milk Bank make history in Virginia, but also in America as the 1st milk bank to be associated with a Children’s Hospital.

Since opening their doors in 2014, the Milk Bank has received 712,855 ounces.  Each ounce can feed four babies, so the milk bank has been able to provide 178,214 feeds due to breast milk donations.

Interview with Ashlynn

What is the breast milk that is donated used for?

Breast milk is the best nutrition for all babies and can be a life-saving treatment for those who are extremely premature or critically ill. Breast milk significantly decreases the odds of life-threatening complications and infections in premature infants during the first months of life. Since many factors can prevent mothers of preterm or critically ill infants from being able to provide a sufficient supply of their own milk, CHKD has established The King’s Daughters Milk Bank to ensure that breast milk is available to the hospital’s most fragile babies.

  • Each year, preterm birth affects nearly 500,000 babies — that’s one of every eight babies born in the United States (www.cdc.gov).
  • The risk of premature or sick babies developing devastating and potentially life threatening intestinal infections is 10 times higher if they are fed formula instead of human milk.
  • Human milk protects against allergies and contains antibodies to fight disease and growth hormones that help babies develop.
  • Donor human milk is easily digested and provides infection-fighting benefits and optimal nutrition in the absence of mother’s own milk.
How do you process the donor milk to ensure that it is safe?

Donor Screening – Milk Bank screening is almost identical to blood bank screening. Donor mothers are screened verbally and via an electronic survey for lifestyle and medical history. The applicants physician and their baby’s physician must provide approval letters stating that both the mother and baby are healthy, free from disease and well nourished. The milk bank arranges and pays for additional blood testing to confirm that the donor is negative for HIV/I/II, HTLV I/II, Hepatitis B and C and syphilis.

Of note: Our altruistic donors do not receive any compensation for the donating process or their milk; they simply donate out of the kindness of their hearts.

Processing of donor human milk – Frozen donor human milk from approved donors is thawed, pooled, strained and poured into bottles, then pasteurized (sterilized to kill any potential bacteria/viruses such as HIV and Hepatitis). Pasteurized milk is quickly cooled and then frozen. Each batch of PDHM is cultured by the CHKD microbiological team after pasteurization and there must be zero growth of bacteria in order for the milk bank to dispense the pasteurized donor human milk to infants in need. Each bottle is labeled with a barcode and batch number for tracking, as well as an expiration date.

What are some of the exclusions for donors?
  • Medication use (some medications are approved – contact milk bank for more information)
  • Herbal product use
  • Tobacco product use
  • Illegal drug use
  • Risk for HIV and hepatitis, including tattoos, body piercings, or acupuncture with non-sterile needles, or the recipient of a blood transfusion within the past year.
  • Daily alcohol use
What is the benefit of the donated breast milk opposed to formula?

PDHM contains our species specific growth hormones, antibodies and proteins. These species specific components are what makes human milk optimal nutrition for all infants. Formula cannot provide immunity or species specific nutrients  that are critical to the development and protection of all infants.

Human milk diets are linked to:

  • a 58% decrease of necrotizing enterocolitis (NEC). NEC is a severe and potentially life-threatening intestinal infection that premature infants are at high risk for.
  • a 36% decrease in sudden infant death syndrome (SIDS).
  • a 64% decrease in gastrointestinal tract infections
  • reduced rates of severe retinopathy of prematurity (ROP). ROP can cause mild-to-severe vision impairment in premature infants.
  • lower rates of infections.
  • improved feeding tolerance. Human milk is gentler on the baby’s tummy and easier to digest.
  • fewer hospital re-admissions after NICU discharge.
  • higher intelligence scores were noted at 8 years of age with patients who received human milk as infants in the NICU.
  • decreased rates of obesity, cancer, heart disease and arthritis throughout adulthood.
  • a 52% decrease of celiac disease.
  • up to a 30% reduction in type 1 diabetes mellitus.
  • a 31%  decrease in childhood irritable bowel disease (IBS).
  • a 27% decrease of asthma, eczema and other skin disorders.
  • a 20% reduction in the risk for acute lymphocytic leukemia.
  • a 15% reduction risk for acute myeloid leukemia.

[Information obtained from The American Academy of Pediatrics, “Policy Statement: Breastfeeding and the Use of Human Milk,” Volume 129, Number 3, March 2012]

How does CHKD determine who gets the donated milk?

Pasteurized Donor human milk (PDHM) is dispensed by prescription only. Currently, only the highest-priority recipients, such as premature and/or critically-ill hospitalized infants, receive this treatment.

Common reasons for prescribing donor human milk include:

  • Premature birth
  • Failure to thrive
  • Malabsorption syndromes
  • Allergies
  • Feeding/formula intolerance
  • Immunologic deficiencies
  • Post-operative nutrition
  • Infectious disease

Occasionally, the King’s Daughters Milk Bank at CHKD has extra milk and is able to provide to infants with medical needs in the community by prescription.

Currently, the King’s Daughters Milk Bank at CHKD provides PDHM treatments to over 30 NICU’s up and down the East Coast. Our donors and the team here at the CHKD Milk Bank are playing a vital role in helping health care providers throughout our nation to treat our countries most fragile and critically ill infants with lifesaving human milk.

When I tell people that I donated breast milk they think it is the coolest thing.  But they also say that they have never heard of it before.  How old is the process?  How common are milk banks?

Milk banking popularity has fluctuated over the last century along with the popularity of breastfeeding. In the early 1900’s, physicians recognized that infant diseases and deaths were directly related to artificial feedings. The need to treat ill infants with breast milk was noted, and the first human milk bank opened in 1910 in Boston.

Interest in banked donor human milk declined after World War II, and saw resurgence in the 1970s. By the early 1980s there were over 50 milk banks within North America, but unfortunately, milk banks were adversely impacted by the HIV and Hepatitis epidemic. Disease transmission risk led to a rapid decline in the number of milk banks and prompted the establishment of The Human Milk Banking Association of North America (HMBANA). HMBANA was formed in 1985 to support the remaining milk banks and to develop guidelines to ensure the safety of donor human milk banking.

By 2000, donor milk banking was again on the upswing due to the increasing scientific evidence of the effectiveness of pasteurization and freezing in the destruction of viruses and bacteria as well as the benefits of human milk. More recently, in 2010 the FDA held a meeting of national experts who endorsed donor human milk banking – and deemed informal milk sharing to be unsafe.

In 2011, the United States Surgeon General’s Call to Action to Support Breastfeeding called for the removal of all obstacles that prevent fragile babies from receiving safe banked donor human milk. In 2012 and again in 2017, the American Academy of Pediatrics (AAP) released policy statements saying: “If mother’s own milk is unavailable, despite significant lactation support, pasteurized donor human milk should be used.” That support led to rapid growth in the number of non-profit milk banks achieving HMBANA accreditation status, as well as the number of hospitals offering pasteurized donor human milk as a “gold standard” treatment for their most vulnerable patient population.

Currently, there are 26 non-profit HMBANA milk banks and another 5 banks in development. Human milk nutrition is now on the forefront of “hot topics” in obstetrics, pediatrics and neonatology research, education and advocacy.

How much milk do you need to fulfill the needs of your patients?  Do you get enough donated?

We typically dispense approx. 3000-4000 ounces of pasteurized donor human milk per week – currently the supply meets the demand but we are constantly seeking new donors as donors can only donate for a short window of time… during lactation. It’s not like blood banking where you might have a blood donor for life.

Are the donors just from the Hampton Roads area?

Approx. 55% of our donors live in the state of Virginia and 39% of those donors live in Hampton Roads. The remaining 45% are donors that are primarily reside in surrounding states on the East Coast. The great thing about milk donation is that location is not an issue. The milk bank will take care of planning and paying for the overnight shipping of an approved donors frozen breast milk from their home to the milk bank in Norfolk, VA.

What is the special legacy/bereavement program that the King’s Daughter’s Milk Bank provide?

During one of the most difficult times in a mother’s life – the loss of an infant – breast milk donation can bring comfort.

Donating milk can not only be a healing experience, but it can also serve as a legacy for their angel baby. Milk expressed after a loss is often referred to as “white tears,” and donating these precious “white tears” is a loving tribute that can contribute to physical, emotional and spiritual healing. We do get calls from bereaved mothers who may have experienced a miscarriage, given birth to a stillborn baby, or had an infant pass away after days or weeks the hospital or at home. Some mothers donate the milk they already have stored in their freezers, and some mothers will begin expressing milk and continue the process of producing milk specifically to donate as a tribute to their son or daughter. The King’s Daughters Milk Bank makes bereavement donations as easy and comfortable as possible.

“As devastating as it was to lose our son Daniel, who was stillborn at 26 weeks, I found comfort and healing in donating my breast milk to CHKD in his memory.  Every life has meaning and purpose, and I hope Daniel’s short life will help save the lives of other babies who can benefit from the preemie milk I have to give.” – A legacy donor to The King’s Daughters Milk Bank

Any advice/tips for Moms wanting to donate?

Start the screening process early and before your freezer storage is maxed as it can take approx. 1-3 weeks to complete. If you are unsure if you will be accepted as a donor because of medications or donation minimums please call us so that we can assess your situation, clarify and provide guidance.

What about those who can’t donate, how can they help?

Spread the word about the need for life saving breast milk donations to non-profit milk banks for premature babies.

Support and encourage breastfeeding mothers.

Currently, insurance companies do not cover the cost of PDHM. The hospitals providing PDHM treatments to their NICU patients cover the cost and do not charge the families as PDHM. The hospitals often have to limit the use to their sickest, smallest babies because of the lack of insurance reimbursement. You can help us to provide more life-saving human milk treatments to the most fragile babies in neonatal intensive care units.

The processing fee for daily donor human milk treatments for a two pound NICU baby is approximately $25 per day or $3 a treatment. To make a tax-deductible donation, please click here (for credit card gifts) or send a check to CHKD, 601 Children’s Lane, Attention Development Department, Norfolk, VA 23507. Please note “Milk Bank” on your gift!

Have more questions about donating?  Contact the King’s Daughters Milk Bank at 757-668-MILK(6455) or www.chkd.org/milk.

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