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NCT Conference May 15 th  2010 Telford Donor breastmilk for babies
Countess of Chester Hospital 2000-2010 <ul><li>Lynda Coulter </li></ul><ul><li>Former  Senior Neonatal Nurse Practitioner ...
<ul><li>For the   </li></ul><ul><li>Protection  </li></ul><ul><li>Promotion </li></ul><ul><li>Support </li></ul><ul><li>of...
 
<ul><ul><li>Donor breast milk is defined as breast milk expressed by a mother that is then processed by a donor milk bank ...
A Hundred years of Donor Milk Banking  Vienna 2009
WHO / UNICEF Joint Resolution 1980 (Post 70’s) <ul><li>“  Where it is not possible for the biological mother to breastfeed...
Provision for North West Donor Milk Bank Service <ul><li>Historically in the UK milk banks funded and resourced on a local...
National Guidelines
Preparation
Sieving
Bottling
Pasteurising
Transportation
from Endorsement  to  Guidelines  and  recommendations <ul><li>DOH commissions NICE   </li></ul><ul><li>to write a short c...
NICE  Short  Clinical  Guideline 132 pages
NICE Guidelines
Donor breast milk banks Currently Implementing NICE guidance & Working towards  National Standards 2010 NICE clinical guid...
Milk Banks in the UK <ul><li>Birmingham </li></ul><ul><ul><li>Women's Hospital </li></ul></ul><ul><li>Cambridge </li></ul>...
<ul><ul><li>Research has shown that breast milk is the best nourishment for babies and it is highly beneficial to their he...
The Research 2000 onward <ul><li>Donor Breastmilk versus Infant Formula for the preterm infants;  </li></ul><ul><li>A syst...
Health Economic Considerations <ul><li>Earlier enteral feeding </li></ul><ul><li>Reduced incidence of NEC </li></ul><ul><l...
Why donor breastmilk <ul><li>Artificial milks necessarily lack the protective elements contained in human milk to help to ...
GLOBAL PERSPECTIVE:  USA “ Breast Milk Banks fill need” “ I think it must be similar to what people who receive donated bl...
Women donate to breast milk banks to help others' babies
Future Plans <ul><li>Provision of Human Milk for premature babies </li></ul><ul><li>(In the North west & further if needed...
Donor Breast Milk Conference 2010 Donor breast milk in the care of the neonate The rationale for human milk feeding in the...
Donor breastmilk <ul><li>Promotion of services </li></ul><ul><li>Recruitment of new donors </li></ul><ul><li>Increasing aw...
Chester Milk Bank Activity <ul><li>688 donors since May 2000 </li></ul><ul><li>62  donors in 2003 </li></ul><ul><li>68  do...
 
 
 
 
 
 
 
Donor breast milk <ul><li>It would be desirable to expand the human milk donation service to the same level of coverage as...
Donor milk helped me
My growth on donor milk
Donating Milk
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Human Milk Banking in the care of the Premature Infant

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NCT's Big Weekend 2010
Human Milk Banking in the care of the Premature Infant
Presented by Lynda Coulter, Human Milk Bank Manager, Countess of Chester Hospital

Published in: Health & Medicine
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  • NOTES FOR PRESENTERS: Key point to raise: No payment for the donated milk is given. Additional information: The following are also defined in the ‘key to terms’: Donor milk depot: any place where donor milk can be stored before transfer to the milk bank. The depot can be run by the milk bank (for example, when donors are from wide geographic areas) or by volunteers. Drip milk: milk that is passively collected from one breast while the baby feeds at the other. Please ask your audience to refer to the ‘key to terms ’ on page 4 of the quick reference guide for a full list of definitions.
  • NOTES FOR PRESENTERS: ABOUT THIS PRESENTATION: This presentation has been written to help you raise awareness of the NICE clinical guideline on Donor breast milk banks : the operation of donor breast milk bank services . This guideline has been written for donor breast milk bank staff, healthcare professionals who care for babies who receive donor breast milk. The guideline makes recommendations on the safe and effective operation of donor milk services. These recommendations could also be used by organisations who are considering starting a donor breast milk bank. The guideline is available in a number of formats, including a quick reference guide. NICE recommends that you use the quick reference guide during your presentation so that your audience can refer to it. See the end of the presentation for ordering details. You can add your own organisation’s logo alongside the NICE logo. We have included notes for presenters, broken down into ‘key points to raise’, which you can highlight in your presentation, and ‘additional information’ that you may want to draw on, such as a rationale or an explanation of the evidence for a recommendation. Where necessary, the recommendation will be given in full. DISCLAIMER This slide set is an implementation tool and should be used alongside the published guidance. This information does not supersede or replace the guidance itself. PROMOTING EQUALITY Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties.
  • NOTES FOR PRESENTERS: Key points to raise: The last two bullet points on this slide are drawn from a Health Technology Assessment (HTA) report published in 2009, entitled ‘Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis’. This report concluded that if mechanisms by which donor milk is provided were improved, donor milk would become cost effective compared with using formula. This was based on a significant improvement in the operation of milk banking, and suggested models include setting up a national donor milk banking system similar to that for blood (Renfrew et al. 2009). Additional information: Women are recommended to breastfeed their baby exclusively for 6 months and continue to breastfeed after 6 months as part of a balanced diet (see www.dh.gov.uk for the latest Department of Health guidance on breastfeeding). In the UK, donor milk banks have been following guidance issued by various bodies. This includes a report on the collection and storage of human milk (Committee on Medical Aspects of Food Policy 1981) and, more recently, guidelines issued in 2003 by the UK Association for Milk Banking.
  • Transcript of "Human Milk Banking in the care of the Premature Infant"

    1. 1. NCT Conference May 15 th 2010 Telford Donor breastmilk for babies
    2. 2. Countess of Chester Hospital 2000-2010 <ul><li>Lynda Coulter </li></ul><ul><li>Former Senior Neonatal Nurse Practitioner </li></ul><ul><li>Human Milk Bank Manager </li></ul>
    3. 3. <ul><li>For the </li></ul><ul><li>Protection </li></ul><ul><li>Promotion </li></ul><ul><li>Support </li></ul><ul><li>of </li></ul><ul><li>BREASTFEEDING </li></ul>
    4. 5. <ul><ul><li>Donor breast milk is defined as breast milk expressed by a mother that is then processed by a donor milk bank for use by a recipient who is not the mother’s own baby. </li></ul></ul>Definition
    5. 6. A Hundred years of Donor Milk Banking Vienna 2009
    6. 7. WHO / UNICEF Joint Resolution 1980 (Post 70’s) <ul><li>“ Where it is not possible for the biological mother to breastfeed, the first alternative, if available, should be the use of Human Milk from other sources. Human Milk Banks should be available in appropriate situations.” </li></ul>
    7. 8. Provision for North West Donor Milk Bank Service <ul><li>Historically in the UK milk banks funded and resourced on a local level </li></ul><ul><li>This is the first regional service developed from Charitable Funds </li></ul><ul><li>Making the first moves to strategically meet the demands for a national service </li></ul><ul><li>2009 NICE GUIDELINES!!!!!!!! </li></ul>
    8. 9. National Guidelines
    9. 10. Preparation
    10. 11. Sieving
    11. 12. Bottling
    12. 13. Pasteurising
    13. 14. Transportation
    14. 15. from Endorsement to Guidelines and recommendations <ul><li>DOH commissions NICE </li></ul><ul><li>to write a short clinical guideline </li></ul><ul><li>Donor breast milk banks: </li></ul><ul><li>the operation of donor milk bank services </li></ul>
    15. 16. NICE Short Clinical Guideline 132 pages
    16. 17. NICE Guidelines
    17. 18. Donor breast milk banks Currently Implementing NICE guidance & Working towards National Standards 2010 NICE clinical guideline 93
    18. 19. Milk Banks in the UK <ul><li>Birmingham </li></ul><ul><ul><li>Women's Hospital </li></ul></ul><ul><li>Cambridge </li></ul><ul><ul><li>Rosie Milk Bank </li></ul></ul><ul><li>Chatham </li></ul><ul><ul><li>All Saints Hospital </li></ul></ul><ul><li>Chertsey </li></ul><ul><ul><li>St Peter’s Hospital </li></ul></ul><ul><li>Chester </li></ul><ul><ul><li>Countess of Chester Hospital </li></ul></ul><ul><li>Orpington </li></ul><ul><ul><li>The Princess Royal Hospital </li></ul></ul><ul><li>Glasgow </li></ul><ul><ul><li>Queen Mother’s Hospital </li></ul></ul><ul><li>Halifax </li></ul><ul><ul><li>Calderdale Hospital </li></ul></ul><ul><li>Kingston </li></ul><ul><ul><li>Kingston Hospital </li></ul></ul><ul><li>London </li></ul><ul><ul><li>King’s College Hospital </li></ul></ul><ul><ul><li>St George’s Hospital </li></ul></ul><ul><ul><li>Queen Charlotte’s Hospital </li></ul></ul><ul><ul><li>St Thomas’ Hospital </li></ul></ul><ul><li>N.Ireland </li></ul><ul><ul><li>Irvinestown Health Centre </li></ul></ul><ul><li>Oxford </li></ul><ul><ul><li>John Radcliffe Hospital </li></ul></ul><ul><li>Southampton </li></ul><ul><ul><li>Princess Anne Hospital </li></ul></ul><ul><li>Wirral </li></ul><ul><ul><li>Arrowe Park Hospital </li></ul></ul>
    19. 20. <ul><ul><li>Research has shown that breast milk is the best nourishment for babies and it is highly beneficial to their health in the short, medium and long term. </li></ul></ul><ul><ul><li>Donor breast milk is neither widely nor readily available in the majority of hospital or neonatal units. </li></ul></ul><ul><ul><li>Improvement in the operation of milk banking will increase cost effectiveness </li></ul></ul><ul><ul><li>Source: Health Technology Assessment (HTA) report 2009 Breastfeeding </li></ul></ul><ul><ul><li>promotion for infants in neonatal units: a systematic review and economic analysis </li></ul></ul>Background
    20. 21. The Research 2000 onward <ul><li>Donor Breastmilk versus Infant Formula for the preterm infants; </li></ul><ul><li>A systematic review and meta analysis </li></ul><ul><li>Boyd et al, April 2006 </li></ul><ul><li>Banking for the future: Investing in Human Milk </li></ul><ul><li>A.F. Williams, C.C. Kingdon, G. Weaver </li></ul><ul><li>Arch.Dis.Child.Fetal Neonatal Ed. 2007 92:158-159 </li></ul>
    21. 22. Health Economic Considerations <ul><li>Earlier enteral feeding </li></ul><ul><li>Reduced incidence of NEC </li></ul><ul><li>Reduced systemic infections </li></ul><ul><li>Reduced formula milk expenditure </li></ul><ul><li>Chester Circa (£8,000) per annum </li></ul>The Alternative: TPN @ £150 per day (inc. antibiotics)
    22. 23. Why donor breastmilk <ul><li>Artificial milks necessarily lack the protective elements contained in human milk to help to mature the infants immune, digestive and neurological systems </li></ul><ul><li>Artificial milks also cannot replicate the hormonal components such as leptin that help to regulate appetite </li></ul>
    23. 24. GLOBAL PERSPECTIVE: USA “ Breast Milk Banks fill need” “ I think it must be similar to what people who receive donated blood must feel, This kind of gift is so personal and can be monumental for those who receive it” says Shaw Trevor Hughes USA TODAY
    24. 25. Women donate to breast milk banks to help others' babies
    25. 26. Future Plans <ul><li>Provision of Human Milk for premature babies </li></ul><ul><li>(In the North west & further if needed) </li></ul><ul><li>Support a Local, Region, & National Service </li></ul><ul><li>Ability to supply the demand for milk </li></ul><ul><li>Support Regional Centres’ interest </li></ul><ul><li>Provision of a facility for audit & research </li></ul>
    26. 27. Donor Breast Milk Conference 2010 Donor breast milk in the care of the neonate The rationale for human milk feeding in the very preterm Infant Dr Colin Morgan, Consultant Neonatologist , Liverpool Women’s Hospital, Liverpool Current immunology research: Human breast milk: a rich and novel source of regulators of microbial recognition by Toll-like receptors Dr Mario O Labéta, Senior Lecturer, Medical Biochemistry Henry Wellcome Research Unit, Cardiff University School of Medicine Lactoengineering: manipulating the protein content of human milk Dr Antoni Gaya, Consultant Immunologist Human Tissue & Milk Bank, Majorca, Spain Donor breast milk in neonatal care Professor Neena Modi, Professor of Neonatology Chelsea & Westminster Hospital, London Using donor breast milk: an opportunity to change attitudes to all neonatal feeding on a neonatal unit Dr Camilla Kingdon, Consultant Neonatologist St Thomas’s Hospital, London Debate Should we use donor breast milk in the care of the neonate? Case for: Dr Colin Morgan Response: Professor Neena Modi
    27. 28. Donor breastmilk <ul><li>Promotion of services </li></ul><ul><li>Recruitment of new donors </li></ul><ul><li>Increasing awareness of availability </li></ul><ul><li>Increasing the demand for donated milk from milk banks………… </li></ul><ul><li>WE NEED YOUR HELP……………………. </li></ul>
    28. 29. Chester Milk Bank Activity <ul><li>688 donors since May 2000 </li></ul><ul><li>62 donors in 2003 </li></ul><ul><li>68 donors in 2004 </li></ul><ul><li>74 donors in 2005 </li></ul><ul><li>94 donors in 2006 </li></ul><ul><li>101 donors in 2007 </li></ul><ul><li>139 donors in 2008 </li></ul><ul><li>170 donors in 2009 </li></ul>4070 litres pasteurised 15/20% discard rate 1800 litres distributed to other hospitals 5.9 litres (average per donor)
    29. 37. Donor breast milk <ul><li>It would be desirable to expand the human milk donation service to the same level of coverage as the blood donation service so that any mother who for whatever reason could not feed her baby at the breast would be offered the option of feeding her baby with human milk </li></ul>
    30. 38. Donor milk helped me
    31. 39. My growth on donor milk
    32. 40. Donating Milk
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