Like small portions of ice cream, a trunk-sized freezer within Flagstaff Medical Center’s Birth and Wellness Center holds dozens of bottles filled with a resource just as appreciated as the dessert, but substantially more valuable: donated breastmilk.
Collected, sanitized and shipped frozen by a milk bank in Colorado, donor milk has been used in the hospital’s Special Care Nursery for over a decade; however, the program was expanded in 2018 to all babies in need of additional nutritional support at FMC.
“It’s now pretty much available to any baby that needs it and any parent that wants it,” said Brenda Phipps, lead lactation consultant and one of the founding members of FMC’s breastfeeding center.
Since Nov. 1, 2018, when the program began, 217 babies at the hospital outside of the Special Care Nursery have received donor milk, which is provided to families for free. Phipps said the two most common uses are feeding difficulties, like the three-day gap between when a baby is born and when milk arrives, and low blood sugar. The milk has also been used for babies who are of abnormal size for their gestational age and those who have a cleft palate.
On Tuesday, nurse and lactation consultant Ann Brown prepared donor milk for a newborn experiencing excessive weight loss. The process, which is highly documented, requires her to log into a computer within the Breastfeeding Center, scan the baby’s armband ID and labels on the milk container and thaw and warm the milk in two separate machines. In total, it takes about 20 minutes for the milk to be prepared.
Brown said it takes commitment for the hospital staff to choose to prepare donor milk for patients instead of simply grabbing formula from the supply room.
“They’re very committed to understanding why it’s important and going that extra mile,” Phipps said of hospital staff.
The expansion of the donor milk program at FMC, including training of staff, was first made possible with a grant from the hospital for evidence-based practice programs, but has since been incorporated into its regular budget.
“Since we rolled it out, it’s been really successful with our patients and families,” said Julie Sturgeon, clinical manager of the Birth and Wellness Center. “We saw the importance and the significance of bringing this to our Birth and Wellness Center, so we decided that we were going to budget it into our fiscal year moving forward as long as we can.”
About every three months, the four-person FMC lactation team orders up to 100 four-ounce bottles of donor milk from the Mothers’ Milk Bank at Rocky Mountain Children’s Health Foundation, one of 29 nonprofit milk banks in North America. The Special Care Nursery orders even more.
Each week, the Mothers’ Milk Bank processes up to 15,000 ounces of milk donations, where one ounce can feed an infant in neonatal intensive care for a full day. In 2019, it dispensed more than 740,000 ounces to babies throughout the country.
The milk is shipped to the hospital on dry ice and can last up to six months in the freezer or 48 hours after being thawed. It costs the hospital $4 an ounce, funded by the $4,000 that has now been budgeted to the program annually.
The milk bank follows the standards set by the Human Milk Banking Association of North America (HMBANA), which works alongside the Centers for Disease Control and US Food and Drug Administration. These standards require banks to carefully handle pools of milk from up to five mothers that are then pasteurized and tested for bacterial growth.
“Pasteurization eliminates harmful bacteria or other potential infecting organisms. A small amount of nutritional elements are lost in the process; however, donor milk has been determined to be the second best choice after mothers’ own,” the HMBANA website states.
Women interested in donating to the milk bank are carefully screened; among other strict guidelines, the women must not be smokers or taking any medications.
“The milk is extremely safe because we are using it for our most fragile babies,” said lactation consultant Anna Singleton.
The milk bank will cover all costs of donating, including a health screening and materials to package and send the milk to the bank for processing. The Flagstaff Birth and Women’s Center on West Aspen Avenue is also a certified donation center, the only one in northern Arizona, and can accept breastmilk from approved donors.
“I breastfed my daughter and if I had known at the time there was a program like this, I totally would have donated for it,” said Rachel Soumokil, a Northern Arizona University nursing student who completed her clinical rotations at the Birth and Wellness Center in the fall.
As International Board Certified Lactation Consultants, Phipps said the FMC lactation team’s mission is “to promote, protect and support breastfeeding”; however, formula is still widely used upon parent request, in critical situations or if culture, religion or a baby’s specific situation prohibits donor milk.
“We support whatever decisions the families make and we are here to educate and help them along the way in making those decisions,” Phipps said.
Nevertheless, research shows formula is related to health issues like respiratory problems, allergies and obesity more often than in babies who use breastmilk, the lactation team said, because formula lacks ingredients like leptin, a hormone that tells babies when they are full.
Singleton also explained breastmilk helps to seal small holes present in the intestines of infants, promoting a lifelong healthy intestinal environment.
“We thought if we had donor milk as an option for parents, then it would continue to create that really healthy environment while we work towards the mom producing her own milk,” Singleton said.
Unlike formula, which Phipps said is made mostly of cow’s milk, breastmilk is also anti-inflammatory and has psychological benefits.
“Our moms, if they are having breastfeeding problems but they really do want to breastfeed, psychologically it helps them to know that they are getting human milk and not milk from another species,” Brown said, adding that this can prevent a feeling of failure that sometimes arises in mothers who experience feeding difficulties.
The only downsides of donor milk, the team agreed, is the expense and the careful process needed to prepare it.
“Most parents react with extreme gratitude that we have donor milk available,” Singleton said. “Having a choice has really been a good thing for our patients.”
Lactation consultants are at the FMC working with patients seven days a week for a total of 75 hours.