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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Human m ilk banking successes and challenges

Human Milk Banking: Successes and Challenges

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