Health e-Learning had the pleasure of recently exhibiting at the Human Milk Banking Association of North America (HMBANA) 2014 conference in the beautiful city of Victoria, British Colombia, Canada. Thank you to all our present and past students who passed by our booth to say hi, it was so great to meet you all. In Canada there are new Human milk banks opening including in our own city here in Montreal, so we were very excited to hear what the experts had to say about human milk banking.
The conference opened with Dr. Uwe Ewald Neonatologist from Uppsala, Sweden. Imagine a family centred neonatal intensive care unit (NICU) where infants and families remain together 24 hours a day and the parents provide much of the care for their children. Constant skin-to-skin care is a key element of this care. Integrating best practice into the NICU also includes family centred care, Kangaroo Mother Care, breastfeeding, breastmilk feeding and use of donor human milk.
Kerstin Hedberg Nyqvist, RN, PhD also from Uppsala, Sweden introduced us to Baby Friendly Hospital Initiative for neonatal intensive care (Neo-BFHI). There is a preliminary version of the document with evidence, standards and criteria for the steps and guiding principles, on the International Lactation Consultant Association (ILCA) website at http://www.ilca.org/i4a/pages/index.cfm?pageid=4214
We hope you enjoy this article by Arslanoglu et al., Donor Human Milk for Preterm Infants: Current Evidence and Research Directions.
The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants.
The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions for future research directions. Protection against necrotizing enterocolitis is the major clinical benefit deriving from the use of DHM when compared with formula. Limited data also suggest unfortified DHM to be associated with improved feeding tolerance and with reduced cardiovascular risk factors during adolescence.
Presence of a human milk bank (HMB) does not decrease breast-feeding rates at discharge, but decreases the use of formula during the first weeks of life. This commentary emphasizes that fresh own mother's milk (OMM) is the first choice in preterm infant feeding and strong efforts should be made to promote lactation. When OMM is not available, DHM is the recommended alternative. When neither OMM nor DHM is available, preterm formula should be used. DHM should be provided from an established HMB, which follows specific safety guidelines.
Storage and processing of human milk reduces some biological components, which may diminish its health benefits. From a nutritional point of view, DHM, like HM, does not meet the requirements of preterm infants, necessitating a specific fortification regimen to optimize growth.
Future research should focus on the improvement of milk processing in HMB, particularly of heat treatment; on the optimization of HM fortification; and on further evaluation of the potential clinical benefits of processed and fortified DHM.
The full article is available for free access from the Journal of Pediatric Gastroenterology and Nutrition.