Demand for pasteurized donor breast milk is rising.
Greater than 10 % of infants born in North Carolina are untimely, in keeping with state knowledge. In 2023, that meant 12,885 untimely infants. Breast milk helps shield untimely infants’ guts and helps facilitate their development.
The elevated demand is because of rising recognition of the well being advantages, in addition to an uptick in untimely infants in North Carolina receiving the milk.
When a mom’s personal breast milk isn’t out there, the American Academy of Pediatrics and Facilities for Illness Management and Prevention say pasteurized donor milk is the very best different — higher than method. Particularly, that’s as a result of human donor milk can dramatically cut back the chance of necrotizing enterocolitis — a critical and even deadly gastrointestinal illness that destroys the liner of a new child’s intestinal partitions.
Pasteurized human donor milk also can bridge the hole till a mom’s milk provide is available in, selling longer unique breastfeeding. And it seems that the method of rapidly pasteurizing breast milk works effectively to destroy dangerous viruses, like HIV, whereas solely minimally altering the dietary parts that shield infants.
Efforts are underway in North Carolina to bolster the availability and availability of donor milk throughout the state and broaden the variety of hospitals providing the milk to medically fragile infants.
40 years of milk banking in NC
WakeMed’s Moms’ Milk Financial institution in Cary is the one human milk financial institution in North Carolina accredited by the Human Milk Banking Affiliation of North America. The milk financial institution has operated since 1985 and is only one of 32 nonprofit milk banks in the US.
Each month, the milk financial institution collects 1000’s of ounces of breast milk from voluntary donors throughout the state. After pasteurizing it, the milk financial institution dispenses the donor milk — principally to about 44 neonatal intensive care models throughout the state and the Southeast. In fiscal yr 2024, the milk financial institution distributed 306,709 ounces or roughly 2,396 gallons — a rise of 56,243 ounces or greater than 439 gallons from fiscal yr 2023.
To place that quantity in perspective, one gallon of donor human milk can nourish 31 infants for a single day — or maintain one untimely toddler for a whole month, mentioned Courtney Ramsey-Coleman, who leads an initiative on the N.C. Division of Well being and Human Providers to enhance entry to donor milk and enhance breastfeeding charges.
Kerrie Gottschall, supervisor of Moms’ Milk Financial institution, mentioned the financial institution is on monitor to distribute much more donor milk this yr.
“We’ve seen loads of elevated orders with our NICUs regionally and out of state. It looks as if proper now the NICUs are actually busy,” she mentioned. “We’re really allotting extra milk this time of yr than this time final yr, so we’re all the time making an attempt to have extra donors.”
Final yr, in partnership with DHHS, Moms’ Milk Financial institution opened 5 new depots throughout the state the place donors can drop off breast milk. The websites have collected 250 gallons of milk thus far, Ramsey-Coleman mentioned.
“The aim is to make sure that no medically fragile infants are denied entry to [donor milk] based mostly on geography, earnings or consciousness, so actually making this a recognized and open factor identical to method is,” Ramsey-Coleman mentioned. https://datawrapper.dwcdn.web/yQs1A/1/
Customary of care
Gottschall, who labored for years as a NICU nurse, mentioned pasteurized human donor milk offers untimely infants with the very best outcomes. She watched this up shut as she took care of preemies — and noticed the potential penalties of skipping to method.
A tragedy early in her profession, round 2006, nonetheless sticks along with her. Gottschall mentioned she left her shift considering the 34-week-old untimely toddler she had been caring for was getting stronger and more healthy. However the subsequent day, she discovered that the infant had developed necrotizing enterocolitis, which might flip deadly.
“He went to surgical procedure in a single day, and his intestine had fully gone lifeless,” Gottschall recalled. “There was nothing we might do however carry him again up for his dad and mom to carry him.
“For them, it was a language barrier,” she recalled. “We provided donor milk. They mentioned, ‘No, they would favor to make use of method as a result of that they had different kids that they had used method with beforehand,’ and we accepted that.”
However in hindsight she mentioned they need to have communicated higher the significance of donor milk and the way dangerous method will be for the growing intestine. Donor human milk reduces the chance of growing necrotizing enterocolitis by about 50 % in preterm or low beginning weight infants in comparison with method feeding, in keeping with a research revealed final yr.
The case sparked Gottschall’s ardour “for feeding a child the proper approach each time” — a path she’s been on for the previous 20 years, together with the previous three years as supervisor of Moms’ Milk Financial institution. Extra individuals are beginning to perceive the significance of donor milk, she mentioned, however there’s nonetheless work to do.
“It actually ought to be the usual of take care of infants who’re born untimely to get both mom’s personal milk, or if that’s not out there, then to make use of donor milk as an alternative of method,” Ramsey-Coleman mentioned.
What’s donor milk and the place does it come from?
Milk banks acquire donations from nursing moms who’re producing extra breast milk than their infants want; all of the moms are screened for eligibility based mostly on well being and life-style components. The milk banks then course of and pasteurize the milk to make sure its security and dietary content material earlier than distributing it.
Moms’ Milk Financial institution wants 300 to 350 lively donors every month unfold from the mountains to the coast to donate their additional breast milk to keep up its pool of donor milk. Some are one-time donors who clear out their surplus of frozen breast milk. Others give on a extra common foundation all through the interval they’re nonetheless breastfeeding.
“We’ve got loads of donors who’re giving again as a result of they’ve acquired the milk within the hospital,” Gottschall mentioned. “Understanding that different moms needed to present again to them and have the ability to present diet to their child was life-changing, so loads of our donors will give again.”
Notably, about 10 % of donors are bereaved moms who decide to pump breast milk in honor of their little one, Gottschall mentioned.
Maryanne Perrin, a diet professor at UNC Greensboro who research donor milk, mentioned milk banking has been round for greater than 100 years, although she mentioned it’s extra lately been in a interval of “renaissance” and development.
The Human Milk Banking Affiliation of North America’s community of 32 milk banks disbursed a record-high 11 million ounces of pasteurized donor human milk in 2024 — a ten % enhance from 2023, in keeping with a February 2025 information launch.
In comparison with different crucial donations like blood and organs, milk banking is just not very well-known. That may result in some skepticism, Perrin mentioned.
Ramsey-Coleman has heard such uncertainty when selling the advantages of donor milk in communities.
“Lots of people are scared as a result of that’s fluids from one other particular person’s physique,” she mentioned. “Formulation has had the benefit for a very very long time, however we’re making an attempt to make folks extra conscious in regards to the security round donor milk.”
Perrin is lively in coverage efforts to advertise secure practices in donor milk banking. She was appointed in 2022 to be considered one of 16 members and co-chairperson of the World Well being Group’s Guideline Improvement Group for establishing and implementing secure and high quality human milk banking programs.
Perrin defined that screening for breast milk donation was modeled after blood donation, involving a medical and life-style historical past to make sure the security of the donated product. Moreover, milk banks in the US are regulated and inspected as meals producers by the U.S. Meals and Drug Administration and their native well being departments.
Even with all of the rigorous security protocols, together with pasteurization to get rid of viruses and micro organism, Gottschall mentioned Moms’ Milk Financial institution workers run checks on milk samples each day to make sure high quality.
“Each pool of milk that we make, we’re taking a dietary pattern of it and analyzing it, and we’re solely offering NICUs with the gold customary, which is 20 energy [per ounce] or larger,” Gottschall mentioned.
Understanding donor milk
Perrin mentioned there’s lengthy been a false impression, even amongst medical professionals, that every one breast milk is similar — and that donor milk is similar as a mom’s personal breast milk.
“They’re not practically as shut as folks wish to suppose,” Perrin mentioned. “They’re each human milk, and so folks suppose they’re like sisters. However they’re like second or third cousins in my thoughts.”
Her analysis diving into the composition of human donor milk is revealing simply how variable milk will be from individual to individual and based mostly on milk banking practices.
Funded by a $1.4 million federal grant from the Nationwide Institute of Youngster Well being and Human Improvement, Perrin collected 600 samples of donor milk from eight milk banks from all over the world — together with the US, Kenya and Poland — and is evaluating their compositions.
“Donor milk or human milk has vitamins, but it surely’s additionally chock full of those bioactive molecules, and that’s the place I say the key sauce is — that’s not what you’re going to seek out in toddler method,” Perrin mentioned. “Antimicrobial proteins can bind up micro organism and stop them from entering into the toddler’s blood provide. It has enzymes to assist the toddler digest the milk. It has white blood cells, and it has stem cells … It’s simply this very dynamic biofluid.”
Whereas her findings have but to be revealed, she mentioned moms’ genetic variations contribute to some variations in breast milk. Timing of the donation additionally performs a job.
“Seven of the milk banks look a technique and one appears to be like a special approach on virtually each nutrient,” Perrin defined. “The seven have been milk banks that principally recruit ladies who gave beginning at time period, they usually’re now three months postpartum.”
The final milk financial institution recruited ladies a few week after they gave beginning, principally to preterm infants.
Now that Perrin has characterised the variability in donor milk, she’s turned to laptop modeling to find out if there are methods milk banks can create a extra constant product filled with the wealthy macro and micronutrients that finest assist untimely infants be nourished and develop.
“We’ve got sufficient sturdy knowledge that claims if we use donor milk, we is not going to harm their intestine like we do after we use toddler method,” Perrin mentioned. “Now, the problem is how will we make a greater donor milk or a greater medical apply for utilizing donor milk in order that we get higher development?”
Increasing entry factors
Whereas donor milk is primarily utilized in NICUs, there are advantages to having it out there in outpatient settings, Ramsey-Coleman mentioned. North Carolina is trying to broaden these choices — with the intention of enhancing breastfeeding period charges.
In 2024, 82.8 % of infants born in North Carolina have been being breastfed at discharge from the hospital, in keeping with knowledge from the N.C. State Middle for Well being Statistics. Just below half of infants in North Carolina have been solely breastfed throughout their first three months, with the speed dropping to about 28 % of infants being solely breastfed by way of six months, in keeping with the newest CDC breastfeeding knowledge from 2021.
Presently, there is just one outpatient distribution web site in North Carolina the place donor milk is offered by prescription: 501 Pharmacy in Chapel Hill. Ramsey-Coleman mentioned DHHS is actively working to broaden outpatient entry with the aim of creating one other outpatient distribution heart by October. Whereas a location has not but been chosen, Ramsey-Coleman mentioned that they wish to pair the outpatient distribution with a lactation heart so {that a} mom can get assist constructing her personal milk provide whereas utilizing the donor milk as a short-term complement.
“Donor milk may be very valuable, and it’s a really restricted useful resource, so it’s not one thing that folks can use long run,” Ramsey-Coleman mentioned. “We actually need it simply to be an help to constructing [the mothers’] milk provide. As they’re build up that provide, they’ll complement just a little bit with the donor milk after which the aim could be to return to solely breastfeeding.”
Moreover, Ramsey-Coleman mentioned the state’s potential to open outpatient donor milk distribution facilities will probably be depending on the state’s provide of donor milk — contingent upon the quantity of voluntary donations.
NICUs will all the time be the primary precedence for receiving donor milk, Ramsey-Coleman mentioned. However with further donors, extra provide might probably be allotted for outpatient use, although in North Carolina donor milk is self-pay and never lined by Medicaid or personal insurance coverage. That could possibly be financially prohibitive for some, she added.
“We’re all the time encouraging the general public, if they’ve additional milk, to achieve out to us, as a result of we’re making an attempt to all the time keep forward of the curve of want,” Gottschall mentioned.
Fascinated by donating your breast milk?
All donors should be authorized by the WakeMed Cary Moms’ Milk Financial institution earlier than donating. Folks can entry the approval course of on-line.
Screened donors can drop off frozen breast milk at 10 areas. There are websites in Wake, Durham, Cumberland, Jackson, Pasquotank, Johnston and Mecklenburg counties.
Moms’ Milk Financial institution additionally has a courier who can acquire breast milk from properties or workplaces of donors inside a three-hour radius of the milk financial institution. For others who wish to give, the milk financial institution can ship a cooler to donors that they then must fill with not less than 200 ounces of donor milk so it can keep frozen whereas shipped.
