Like donating blood, donating breast milk saves lives. Especially in very premature babies. If Europe is far ahead in terms of public milk banks, here the practice is slow to spread.
There is, in England, a small chip weighing less than 600 grams was born after life in utero. She was well developed, but her large intestine was severely malformed, making her unable to absorb enough nutrients to live. Even after major surgery, she had to be fed intravenously, which damaged her liver. The process was therefore stopped.
Desperate, the doctors had stopped believing in his survival. Her parents took her home. As the mother was unable to breastfeed for health reasons, they turned to breast milk banks. Gradually the baby gained weight. For more than a year, she consumed the liquid generously donated by other mothers. Today, the fragile little being has become a healthy pre-teen.
This example, among thousands, illustrates the interest of breast milk banks, also called lactariums. Their operation is similar to that of blood banks. Breast milk is collected, analyzed, treated and redistributed there on medical prescription to babies born before term or presenting serious immunological and allergic digestive diseases. These banks particularly help very premature babies – babies born at less than 32 weeks or weighing less than 1,500 grams. They even save lives.
Europe has 166 milk banks. Twelve others should see the light of day shortly. The champion in this area is Sweden which, for nine million inhabitants, has 28.
In Switzerland, a country with a population comparable to that of Quebec (eight million inhabitants), there are six breast milk banks; the oldest was created in . They are all in public hospitals for children or offering gynecological services. In , 820 liters of donor milk were distributed to 454 infants, mostly very premature babies.
Canada has two breast milk banks. The oldest is in British Columbia and has been around since . The other was started in Calgary earlier this year by Jannette Festival, a trained nurse. She says that as soon as it opened, the Alberta bank was overwhelmed with offers and demands.
Quebec takes its time
In , the Héma-Québec blood bank submitted a feasibility study to the Ministry of Health and Social Services ( MSSS ) on the possible creation of the first breast milk bank in Quebec. According to the scenarios adopted, it would cost Quebec taxpayers approximately $580,000 annually, in addition to an initial investment of $800,000 that would be provided by the Héma-Québec Foundation.
"Each year, a breast milk bank would save neonatology health services approximately $1.25 million, in addition to saving the lives of around 20 newborns," says Valérie Legault, information at Héma-Québec. She adds that annually, the milk of more or less 265 donors would be needed and that nearly 1,190 very premature babies would benefit from the public bank. However, a year and a half has passed since the study was submitted, and the MSSS has still not pronounced on the subject, without anyone knowing why.
As part of its perinatality policy, the MSSS is committed to examining the possibility of setting up breast milk banks. According to Noémie Vanheuverzwijn, head of media relations at the MSSS , the government has analyzed the Héma-Québec study and work is continuing to choose the best possible avenue.
“A set of legal, financial, organizational and health dimensions must be considered.
At the end of this work, a decision will be taken in the interest of the health of premature babies, as soon as possible,” she said without further details.
Beautiful, good, cheap
Breastfeeding and lactation consultant at the Children's Hospital of St. Gallen, Switzerland, Kerri Frischknecht is convinced of the value of breast milk banks.
“Often, the mother's lactation starts later than the delivery when it occurs prematurely. The mother
's body would be biologically programmed to feed a full-term baby (at around 40 weeks). Not to mention that mothers of premature babies are often tired and strained, which does not promote lactation.
“Donor milk, which is more digestible than commercial powdered cow's milk, can be used to feed the baby until the mother can breastfeed it.
Although donor milk is not as beneficial for a very premature baby as mother's milk (custom-made, perfectly adapted to the baby's needs and unpasteurized), its nutritional qualities far exceed those of milk sold on the shelves. .
Admittedly, breast milk banks are labor intensive and cost money, admits Kerri Frischknecht, who also represents Switzerland at the European Milk Bank Association.
"But they help reduce infections and digestive problems," she says. With the result that many babies born prematurely come home sooner, which leads to cost savings.
Although the donors are not paid, collecting, screening, pasteurizing and freezing breast milk is an expensive process, says pediatrician Riccardo Pfister, president of the Swiss Society of Neonatology, which has endorsed the creation of breast milk banks since . But the hospitalization of a very premature baby is even more difficult, he points out: it can cost from 100,000 to 200,000 Swiss francs (about the equivalent in Canadian dollars).
The pediatrician, who is also responsible for the neonatology unit of the University Hospitals of Geneva, recalls however that the use of breast milk is not without risks; milk can carry diseases or infections. He also stresses that the donors - most often mothers of newborns - must correspond to a specific profile to ensure the quality of the milk.
“They must not smoke, drink or use drugs or medication, and must not be carriers of HIV or hepatitis.
An altruistic gesture
Instructor at La Leche League in Montreal (an international non-profit organization that supports breastfeeding), Kathleen Couillard is in favor of setting up a public breast milk bank.
“Like blood donation, milk donation is an altruistic gesture that aims to help other human beings,” she explains. A generous action, but also feminist, according to her. By highlighting the importance of breast milk for the health of newborns, Ms. Couillard believes that the gift of milk contributes to the recognition of the value of breastfeeding, and therefore to reversing the current of thought according to which the biological particularities of women are seen as an obstacle to their development.
“Breastfeeding or giving milk is not slavery, but fulfillment.
The expert in microbiology and immunology wonders about the depreciation of the biological functions of women by a certain feminist current, such as the one which draws a parallel between the donation of breast milk and the phenomenon of wet nurses.
“In , in the West, the donation of milk is done on a voluntary basis.
It is not restricted to a less privileged social class which depends on it for its subsistence. She recalls that the
milk is collected for fragile babies, whose mother cannot provide her own milk, and not for the children of women who choose not to breastfeed for personal reasons.
The establishment of milk banks also appears to be in line with recommendations from the World Health Organization and UNICEF . In , the two international agencies published a directive emphasizing that the best option for a baby who cannot be fed with his mother's milk (preferably breast, if not expressed) is pasteurized milk from another woman. The substitute milk, produced industrially, does not contain antibodies and its bovine proteins make it less digestible.
Will Quebec follow suit? The MSSS will tell us.
My milk via Facebook
In , when yet another powdered cow's milk for babies appeared on the Canadian market, Montrealer Emma Kwasnica, mother of two and aspiring midwife, decided to react. This is how the global virtual network Human Milk 4 Human Babies ( MSSS ) was born on Facebook, which aims to promote
“feeding babies and young children around the world with breast milk” . Since then, thousands of women from more than 50 countries give and receive free breast milk through this informal network run by 300 volunteers, without financial support.
The meteoric success of HM4HB prompted Health Canada and the US Food and Drug Administration to react in turn by issuing an advisory on the potential risks of sharing breast milk. Which in no way diminished the popularity of HM4HB .
In its Facebook page the network stresses that it does not support the sale of breast milk, nor advertising or related lucrative activities. Its platform is based on values such as generosity, solidarity, empathy, personal responsibility, respect, honesty and love. It also defends itself from being responsible for the choices and decisions of its members, whom it encourages to
“educate themselves on the risks, benefits and alternatives (sic)” related to breast milk. HM4HB reminds that breastmilk substitutes are not without risks and that sharing breastmilk is a tradition that has always existed in all cultures.