E-Journal Dadhichi Deha Dan Samiti

The Human Milk Bank

In a country which spends less than 2% of GDP on healthcare, and is yet to overcome criminal medical negligence in BRD Medical College Gorakhpur, I witnessed a story of collective medical innovation, and human empathy in Lady Hardinge Medical College, New Delhi. This government of India funded college is more than hundred years old, and hosts something unique - one of its kind – Vatsalya Matri Amrit Kosh – the National Human Milk Bank of India.

Pediatrics is a branch of medical science that deals with the Child And Neonatology is a sub-science that relates to newly born and refutes the generally acceptable hypothesis that the baby is a miniature form of the adult.

For a baby’s healthy development, mother’s milk is the most important ingredient. It is a must for physical, mental, social, emotional and intellectual development of the baby. Healthy babies are usually born after a confinement which lasts 9 months and 7 days and are called full term babies. These babies are comparatively robust and fare well without serious problems.

However, babies which are born before full term (born at less than 9 months gestation) are called preterm or premature are more prone to infections, respiratory problems, jaundice and many other ailments and do not have the energy to suck the milk directly from the breast.

Mother's milk is a living media with many cells and growth factors. It is vital for intellectual development of the New born, acts as an anti-infectant, and has growth factors. Unlike the West, which relies on intravenous nutrition as the staple source of nutrition for preterm infants in the NICUs the indigenous medical philosophy believes in the right of every baby to get mother's milk. This makes it critical to find ways and means to ensure mother's milk for the preterm babies; preferably its own mother’s milk (MOM) or if required milk from another mother. This is where the novel milk bank serves the need.

The milk bank is different from a blood bank, stresses Dr. Sushma Nangia, Head of Department of Neonatology. The focus is on counseling the mothers who have given birth to pre term or even full term babies so that they can feed their own babies. Our aim is that every mother breast-feeds her baby. We counsel them for achieving this and support the mothers socially, emotionally and medically, adds Dr. Sushma. 

Earlier, elder women in the family used to perform this role of being a friend and a guide, providing social and emotional stability which is virtually absent with growing number of nuclear families. The lactation management Centre at Lady Hardinge fills this void. For mothers producing more milk than what their babies need donating the same voluntarily is an option they can exercise. It is a completely voluntary decision with no monetary or any other kind of incentive. The collected milk is pooled. The sister hospital for the new born, Sucheta Kriplani, has 14000 potential deliveries every year. The surplus milk from these 14000 potential deliveries is pooled and collected in a separate unit known as the Milk Bank.

This Milk Bank unit at Lady Hardinge has 8 lactation counselors. These counselors are regular hospital nurses trained in counseling the mothers. Sister-in-charge Sangita Arora and Chief Counselor sister Samuel listed the extra precautions taken by the staff to socially counsel the mothers. "Since the idea of a milk Bank is very new and quite novel, we were given training by the Norwegian nurses", states sister Samuel. The equipments in the milk bank are supported by the Embassy of Norway under Indo-Norwegian collaborative Newborn Care Project.

Precautionary measures in hygiene and cleanliness are non-compromisable, asserts the member of cleaning staff, Naresh. He enlists the precautions taken, which includes multiple washing cycles, careful pasteurization and boiling of the milk bottles. The pooled milk is stored in these bottles that are deep-frozen. On being asked about his job, Naresh is aware of his responsibility and expressed joy in working in this unit.

“So are the mothers apprehensive?” I asked Dr. Mamta, doctor-in-charge of Milk Bank, having more than 2 decades of medical experience. "Yes they are initially", responds Dr. Mamta. Generally, the problem faced by them is either no milk or pain in the breasts due to surplus milk. She recalls the story of Usha, a mother who had visited the hospital in August. She was a paranoid first time mother who had given birth to a pre term baby. After regular counseling and visits at the milk bank, she was able to feed well and donate surplus milk".

After spending a day at the hospital premise, I was relieved to see affordable public health care being delivered by the milk bank.