Breast milk: The nectar of the gods
FOR years midwives, doctors, parents and nurses have been emphasising the need for breastfeeding of all newborn babies, and with the current upsurge of diseases and death, the call is louder.
But with the increase both in diseases worldwide and amount of compromised health for many, the advent and importance of breast milk banks is of paramount importance.
Saying the creation of such banks did not only ensure that babies whose mothers died at birth had the lifeline they so desperately needed, those in the health sector added that the benefits far outweighed all else.
“When the bank is properly run and staff trained efficiently, one can rest assured that newborn babes start this life thing off on the perfect footing,” midwife Nora Nxumalo said.
Speaking to Independent Media as she returned from visiting a community in of women in Pretoria north last week, she said: “The milk not only comes with the right proportions of nutrients needed by newborns but it protects them from childhood allergies, sickness, and obesity.”
Nxumalo said breast milk was formulated to protect against diseases like diabetes and cancer, infections and generally strengthen the immune system from the onset.
But, she said, not all babies had the benefit of a mother who could breast feed them, as some either died at birth, others just did not produce milk, while others had to rush back to work immediately after birth.
Saying when she and other midwives and nurses got together to set up a non profit organisation to assist communities enhance their health in townships across Gauteng five years ago, they were to discover that a lot of babies were immediately put onto formula as mothers had to rush back to work. “The concept of maternity leave does not apply in all sectors, especially among the informally paid communities. Employers - from domestic to factory to street vendors, factories and others, expected women back at work as soon as they deliver.”
And this left caregivers - in some instances grandparents and siblings and neighbours, with the responsibility to feed babies with what they had. “And what they give them ranges from formula to soft porridge or whatever they can to keep the newborns satisfied until they can hand them back to their mothers.
“Never mind that some mothers die, while others have no interest in breastfeeding as, at inception, it can be daunting and frustrating. The situations we find in the homes we go into is what led us to concentrate less on general care-giving and branch into breast milk promotion, sourcing and provision,” she said.
Nxumalo and her fellow retired public service midwives said all they had intended to do was make sure their passion to care for people did not go to waste when the reached the end of employment.
“As we went in and out of townships and communities, knocked on run-down shacks and visited make-shift day care sectors, it was to discover many small babies who lacked care and nutrition and the attention they should be getting in a country which recognised and understood that the first few months of a baby were important, and what they ate would build their immunity and protect them both from childhood diseases and suffering as they grew older.”
Having worked in the public health sector and appreciating the shortcomings that exist, she said they then started approaching pregnant women and lactating mothers among others.
“Using our years of experience and knowledge of health and hygiene and disease control and the connections we had established, as set up a facility in Centurion to store milk and supply it,” she said.
They were in the process of registering their organisation, and, three years in, she said slow progress was being made.
As they go about their work so do established and registered breast milk banks, among them the South African Breastmilk Reserve (SARB), who’s focus is premature babies.
Established in 2003, they depend on donated breast milk to reducing infant mortality and morbidity at the start of the Human Development Chain. And, they add: “However, the health of an infant cannot be viewed in isolation. It is important to consider the broader health services that need to be made available to pregnant women and their children under five.”
With the slogan ‘Save babies' lives, one milk drop at a time’ The World Health Organisation and Unicef commemorate the donation of milk annually at the beginning of March, and they say the goal is to promote the establishment, support, and continuous operation of human milk banks at hospitals with neo-natal units.
They say: “Donated breast milk from safe and affordable milk banking facilities is best first alternative where mother's own milk is not available. The benefits of donated expressed breast milk for premature babies is intended to save the lives of the most vulnerable babies.”
The international organisations emphasise that breast milk remained a critical source of energy and nutrients, and it reduced mortality among malnourished children.
As they encourage countries to establish public sector and free breast milk banks they have said: “Infants who cannot be fed their mother’s own milk, or who need to be supplemented, especially low birth weight infants, including those with very low birth weight and other vulnerable infants, should be fed donor human milk.”
The WHO last year said there was growing interest in creating and sustaining human milk banks globally, to fulfil the need for donor human milk. “Human milk banks have now been established in over 60 countries globally, with a small but increasing number of milk banks operating in low-income and middle-income countries.”
“The WHO Department of Nutrition and Food Safety is in the process of creating guidance on donor human milk banking.”
And while some public health facilities were taking this up under the guidance of the Department of Health, First Netcare milk bank last week opened a bank at the Rahima Moosa Mother and Child Hospital, to, among others, develop breast milk pasteurisers to minimise pathogens and maximise nutrition in local African conditions and develop a sustainable and replicable, cost-recovery business model for non-profit, human milk banking.
They said: “In South Africa alone, eight in 100 babies are born prematurely and 11 000 premature babies die from preventable infections and complications every year, at considerable cost to the healthcare system and with far-reaching implications for socio-economic development.”
The partnership to provide the hospital’s NICU with donated breast milk from their milk banks began in 2019 and was now being advanced further as a turnkey project with the implementation of an on-site milk bank at the hospital.
“This will enable the management of the full process on site, from donor recruitment and testing to breast milk collection, processing and pasteurising, and storage, significantly enhancing the efficiencies of the project and its impact.”
Qudsiyah Kassim, a registered dietician who manages newborn nutrition in the hospital’s NICU, said premature and low birth weight babies have unique dietary needs due to their immature digestive systems, which affects their ability to digest anything other than breast milk.
“Babies in our NICU whose digestive system may not be fully developed and who already have complications, are at risk for additional health challenges if they are fed with formula at this stage, further compromising them. Breast milk, on the other hand, helps to prevent infections and other complications while giving them the nutrients they need.
“A significant difference can be noted between the health of compromised babies who receive breast milk and those who don’t.
“Through the five national Netcare Ncelisa milk banks and numerous collection points at our hospitals, Netcare has long distributed safe donated breast milk and has fed well over 4 000 babies since the establishment of Netcare Ncelisa human milk banks in 2017.”
The collaboration with Rahima Moosa Mother and Child Hospital was a testament to Netcare’s ongoing commitment to supporting babies and their families in the public sector, she said.
South Africa has just over 20 facilities for human milk banking, and, the government said, they were especially crucial for vulnerable babies—those who are premature, underweight at birth, severely malnourished, or orphaned and who faced a high risk of illness and death.
But, Nxumalo and her team said, there was a lack both of awareness and information trickling down to the community, on the importance of this resource.
“More so it is lacking when some of us try to get registered through the government, despite identifying the need and showing that we have the capability. Policies, red tape, mothers and families refusing to feed their babies the milk of another, are some of the problems we come up against.”
But this would not stop them, as they knew where to go and what to do, had the patience, resources and willingness to save one baby at a time by providing what Nxumalo said was the nectar of the Gods.
ntando.makhubu@inl.co.za