Scots fight to improve donor breast milk banking system

By Gina Edwards

Edited by Hiram Foster

When Lynsey Jamieson gave birth to premature twins last January, she didn’t know how long the 16-week-early babies would live.

Both infants required intensive care and suffered infections, heart problems and jaundice. But with five-months time and the addition of donated breast milk from the Yorkhill Donor Milk Bank in Glasgow, the babies regained stable health.

(Image courtesy of www.realbabymilk.org)

Scottish Milk Banks

Since Jamieson, a resident of Chapelton, Scotland—20 miles south of Glasgow—could not “express,” or draw enough milk, to sustain both babies, the milk bank provided what they needed, a contribution Jamieson says saved their lives.

Yet, many premature and sick babies in Scotland do not have the same access to breast milk as Jamieson’s twins, because Scotland currently only has one milk bank—of the 17 currently in existence in the UK. The Yorkhill Milk Bank is part of the Queen Mother’s Hospital, which services about 60 percent of Scotland.

(Image courtesy of www.ukamb.org)

The National Health Service in Scotland has recently launched additional campaigns encouraging new mothers to exclusively breastfeed their babies for six months. Its campaign website, “feedgoodfactor.org.uk,” says that for pre-term babies, the antibodies in breast milk protect their vulnerable immune systems. Mothers across the country are encouraged to breast feed, but some mothers who have given birth to premature or sick babies cannot express, leaving them the option of donated milk.

In the last several months various constituents from outlying parts of Scotland such as northern Inverness—a 180-mile distance from Glasgow—have requested that the government examine the issue. Jamieson has taken up the cause. “Had [my daughter] been born at a local hospital, she wouldn’t have had that opportunity to have donor breast milk,” she said.

In November, Jamieson spoke at a seminar in Scotland’s western capital of Edinburgh to various members of the Scottish parliament in hopes that they might examine the issue. “It was still very raw and emotional for me,” she said, and adding that “lots of [parliament members] were very upset, too.”

Ken Macintosh, the MSP for East Renfrewshire—a city just east of Glasgow, who helped chair the seminar, also submitted a motion to raise awareness about the work done in the milk banks. Several other members of parliament signed in support of his motion.

Despite attempting to broaden awareness of the issue, Macintosh is skeptical about milk banking’s expansion at the moment. “The public is not in support of expanding anything right now,” he said. “It’s more a case of holding on to what we’ve got, and in the long term making the service more available.” He says that hopes that the government will still conduct research and analysis on this important issue.

Breast Milk Benefits

Debbie Barnett, the donor milk coordinator at the Yorkhill Donor Milk Bank, said that breast milk can also help prevent diseases and infections because of the antibodies in it. According to the NHS 2009 Perinatal Infant Mortality and Morbidity report, immaturity accounts for 16 percent of postneonatal deaths, while infection accounts for three percent.

Barnett also that it strengthens babies’ immune systems and prevents necrotizing enterocolitis or “NEC,” an infection putting them in an intensive care unit, which can cost £2000 ($3230 US) a day. “We know from health economics that using donor milk banks can be beneficial in that respect too,” she said.

However, not everyone agrees with the insistence of breastfeeding children for six months. A recent study published in the British Medical Journal calls for review of the guidance, originally recommended by the World Health Organization (WHO) in 2001. The study claims that WHO’s recommendation was partially based on some studies of developing countries whose nutritional status is rather dissimilar to the UK, and also cites a Swedish study that questions breastfeeding’s role in preventing allergies.

Despite these potential questions, Scotland’s government maintains its support of breastfeeding infants for their first six months. Since their inception over 70 years ago, the costs for maintaining donor milk banks in the UK have increased alongside stricter regulations requiring more advanced sterilizing and treatment processes. Barnett said that the service—which began as a freezer in a hospital wing—has developed in its complexity, as the Yorkhill Milk Bank now owns two pasteurizing machines and three industrial freezers.

Donors

While in earlier days the bank used to distribute to about 40 babies per year, last year over 80 babies received the 200 liters (almost 53 gallons) of donated breast milk, free of charge.

The number of donors has also increased, from 10 to about 50, but because of tighter safety and health regulations they must go through a more thorough pre-donation process. “We’ve always done a screening but stricter guidelines have been instituted in February of last year,” she said.

One former donor, Kerry Mackay, went through this screening, which required an interview about her health habits and a blood testing. She could donate because she was in the area when she flew her premature child into the hospital in Glasgow. When her baby was well enough to return to her home in Inverness, she donated over 150 bottles of milk that she couldn’t take with her. But because of the 180-mile distance from there to the milk bank in Glasgow, she could not donate any more from there.

Mackay said that there were babies in her local hospital that could have used her milk, but could not because it didn’t have a system in place. “If they set up one or two more, even if they were small units, it would be better,” she said.

Gillian Weaver, the spokesperson for the United Kingdom Association of Milk Banking, said that while all but one of the UK’s milk banks are funded by the National Health Service, currently milk banks are not organized on a regional or national basis. “A baby’s access to breast milk depends on whether or not they’re born in a hospital that has it or whether they can access from another bank,” she said.

In January, prompted by a Parliamentary Question by Brian Adam, MSP for Aberdeen North, Public Health Minister Shona Robison said that she would explore the possibility of setting up some sort of courier system for delivering the milk. While she recognized the “valuable work” that the donor milk banks do, she said that the government currently does not have a plan to build any more banks on cost grounds.

Milk bank activists hope for improvement on the current system, whether it is a courier system or the establishment of more milk banks in hospitals. All babies in the hospitals should have access to it, Jamieson said. Others like Barnett acknowledge that the Scottish government is aware of and analyzing the issue, but they still question the feasibility of potential expansions. “A recognition that having accessible milk would be a good thing,” Barnett said, “but how it can be achieved is in question.