human m ilk banking successes and challenges
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Human M ilk Banking: Successes and Challenges

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Human M ilk Banking: Successes and Challenges. Successes: Policy. Government backing National and regional policies and guidelines developed Funding support Facility backing and engagement Interdisciplinary teams for optimizing human milk nutrition Advocacy and awareness raising

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Presentation Transcript
successes policy
Successes: Policy
  • Government backing
    • National and regional policies and guidelines developed
    • Funding support
  • Facility backing and engagement
    • Interdisciplinary teams for optimizing human milk nutrition
  • Advocacy and awareness raising
    • HMB and breastfeeding promotion
    • Mass media/peer-review journals
  • Recognition of successfully implemented system
  • Integration of messaging
    • Neonatal care guidelines include DBM
  • Impact on breastfeeding practices
  • Health system cost-savings
  • Adoption of system to other NICUs
successes operational
Successes: Operational
  • Impact on breastfeeding
    • Provision of DHM results in increased initiation of breastfeeding in the NICU units
    • NICUs with highest BF rates have attached HMB
    • BF rates higher than formula in discharged NICU infants
    • Increased BF duration among donors
  • Long-term continuous operations
  • Improved health outcomes
    • DHM and supplementation of MOM
  • Leveraging support from volunteer blood/tissue transport services (bikes, motorcycles)
  • Integrated/holistic approach through HMB providing lactation support and assistance
successes technological
Successes: Technological
  • Improved screening, processing, tracking
  • Refined and/or simplified systems/equipment/supplies
  • Ability to assess macronutrient and protein content
    • Validated systems
  • Online accessibility
    • Screening, marketing, ordering, prescriptions
  • Standardized quality assurance and outcome reporting
challenges policy
Challenges: Policy
  • Achieving policy level support
    • HMB and supporting breastfeeding, ie MOM, lactation support
    • HMB integrated into other health programs
  • Implementing legislation to regulate and standardize HMB
  • Uncertainty of DHM importance among health care staff
  • Establishing sufficient donor base
  • Balancing promotion of DHM and capacity to meet need
    • Supply and demand
challenges policy1
Challenges: Policy
  • Limited/no financial support from government
  • Limited/no leadership or interest from government
  • Economic crisis
  • Becoming established as regional centre of reference
  • Expansion to other areas limited by cultural/tribal concerns
  • Lack of insurance coverage
  • For profit and casual sharing impacting donor base
challenges operational
Challenges: Operational
  • Identifying and retaining qualified staffing
    • Depending volunteers not sustainable
    • Lack of funds for salaries
    • Refresher trainings needed
  • Inadequate training
    • Need to develop HMB specific training program
  • Insufficient donor milk due to insufficient donors
    • Lack of breastfeeding promotion and support
  • For profit and informal milk sharing impact donor base
  • Lack of eligible donors due to high HIV prevalence
  • Maintaining consistent demand for DHM from hospitals to enable growth
challenges operational1
Challenges: Operational
  • Implementing transport for milk collection
  • Implementing a communication plan
  • Need low cost distribution methods
  • Need protected and effective on-line screening process
  • Centralized care model changing to accommodate other level III NICUs
  • Increased demand could be seen as opportunity for strengthening preterm lactation success
  • Limited space
  • Implementing HACCP
challenges technological
Challenges: Technological
  • Achieving optimal pasteurization throughput balanced against wastage
    • Matching batch volumes with distribution volumes
    • Need for pasteurizing small volumes
  • Time for processing
    • Defrosting takes a long time
  • Introducing electronic testing and reporting systems, bar code tracking systems
  • Need for improved pasteurization systems to preserve nutritional and immunological properties – balanced with microbial safety
challenges technological1
Challenges: Technological
  • Low cost bottling units that do not retard or chip
  • Low cost standard methods for testing human milk
    • medications, contamination and nutritional analysis
  • Shipping units specifically for human milk
  • Mechanized processing equipment
    • Provides homogenized milk
    • Pouring accuracy
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