Breast milk is considered to be containing colostrum most nutritious

1. Human milk bank: A deem project, a dream
project of Nepal.
Introduction
Human milk banking is the process by which breast
milk is collected, screened and pasteurized for the
use of hospitals or mothers who cannot breastfeed.
Currently, many milk banks have been opened all
over the world to minimize infant feeding problems.
Human milk is the best source of nutrition for all
newborn babies. More specifically, a mother’s breast
milk is the first choice of nutrition for those who are
preterm, have low birth weight, unwell and for those
vulnerable infants in the Neonatal Intensive Care
Unit (NICU). World Health Organization has
recommended that Low Birth Weight infants,
including those with Very Low Birth Weight, who
cannot be fed mother's own milk, should be fed
donor human milk (recommendation relevant for
settings where safe and affordable milk-banking
facilities are available or can be set up).

2. In Nepal, although Neonatal and child health has
been improved from the decades but the declining
rate of mortality and morbidity rate has not been
improved. According to National Health
Demographic survey, 2016: Neonatal mortality Rate
is 21/1000, Infant mortality Rate is 32/1000 and less
than 5 mortality rate is 39/1000. Many efforts have
been made by the government and stakeholders’ in
order to reduce the mortality rate. Breastfeeding is
very common in Nepal with 99% of children ever
breastfed. More than half (55%) of children are
breastfed within the first hour of life. Two-thirds of
children under six months are exclusively breastfed.
Breastfeeding promotion and the collection of donor
breast milk are linked. By offering correct
information about breastfeeding, women have an
increased chance of successfully breastfeeding their
infant and significantly reduce neonatal mortality
and morbidity. In addition, the availability of donor
breast milk is very significant for infants whose
mother cannot breastfeed because of medical
problems such as maternal active pulmonary

3. tuberculosis, cancer chemotherapy, HIV and other
viral infections. To fulfill this need, establishing
donor breast milk banking is crucial.
Therefore, it is our forth and effort to establish the
human milk bank in Kathmandu University
Dhulikhel Hospital, Dhulikhel, Kavre inside the
premises of the postnatal ward with the team of
pediatrician, gynecologist and obstetrician , Nursing
instructor/Incharge with Nursing team, advocates
and the administrative staffs..
History
Donating breast milk can be traced back to the
practice of wet nursing. Wet nursing was widely
practiced in Europe during the 19th century in order
to provide human milk for infants whose mothers
were unable to provide milk for their infants. An
alternative to wet nursing was found in human milk
banking. The first human milk bank was founded in
1909 in Vienna, Austria. Shortly after Vienna, the
first milk bank opened in the United States in the

4. Boston Floating Hospital and many others followed
all over the world.
In Nepal there are no studies conducted on the
acceptance and the significance of breast milk
In July 26, 2019 Nine Advocates filed public interest
litigation at the Supreme Court demanding
establishment of breast (human) milk banks in Nepal
to ensure enough supply of breast milk for babies,
who have not been able to get breast milk due to
several reasons. They Stated that breast milk
contains all kinds of nutrition that babies need for
their growth, they argued that breast milk was vital
to enhance immunity and prevent infection in
children.
Objectives
 To ensure that every baby born or admitted to
the hospital receives mother’s milk.
 To avoid bottle, animal & formula milk.
 To heighten breastfeeding awareness.
 Ancillary support to breastfeeding practices.

5.  To promote Baby Friendly Hospital care.
Why Breast milk Bank in Nepal?
 The first priority for infant feeding is to
encourage the use of infant’s mother’s breast
milk, but when this is not possible, donated
breast milk is the second best option.
 Human milk protects premature infants, low
birth weight infants from necrotizing entero
colitis and from sepsis.
 Human milk Bank provides mothers with an
alternative to infant feeding such as lactogen,
cow’s milk, and buffalo milk.
 Establishing breast milk bank is necessary as
breast milk cannot be substituted and wet nurses
are not easily available and it would not be
possible to produce breast milk in large quantity
from wet nurses
 The lactating mothers discard the excess breast
milk and if breast milk banks were established,
the interested mothers would have a chance to

6. provide surplus amount without compromising
on her own baby’s requirements
 In Nepal, there is no breasts milk bank and even
no studies are conducted.
Location
Human milk banks are primarily focused to provide
donor milk to newborns. Therefore, a location in
close proximity or even inside the postnatal ward is
desirable under administrative supervision by
medical staff. Based on that we plan to locate the
human milk bank inside the premises of postnatal
ward.
Donor Selection Criteria
• Healthy & well nourished
• No evidence of Tuberculosis or other infectious
diseases
• Normal on physical examination
• Human Immuno-deficiency Virus , Veneral
Diseases, Hepatitis B negative

7. • No History of hepatitis, blood transfusions,
smoking, alcohol and drug use.
• Not on any medications contraindicated while
breastfeeding
• Willing to donate
Recipients
 Absent or insufficient lactation
 For babies of non-lactating mothers, who adopt
neonates and if induced lactation is not possible.
 Abandoned neonates and sick neonates.
 Temporary interruption of breastfeeding.
 Infant at health risk from breast milk of the
biological mother.
 Babies whose mother died in the immediate
postpartum period.
Infrastructure
 partitioned room of 250 square feet for lodging
equipment, work area for technical, area for
counselling
 Provision of music/television:1

8.  Pasteurizer/Shaker-water bath (1): it should be
double walled and made of steel, with tray
capacity of 9-24 containers of 200-400ml
 Deep freezer (2): Digital display of temperature
inside it with an alarms setting.
 Refrigerators
 Breast milk pumps
 Containers: For collection and storing the milk,
single use hard plastic containers of
polycarbonates, Pyrex or propylene are used
worldwide
 Generator for continuous supply of electricity
 Cooler Boxes (for transportation)
 laboratory system for screening of serology
 computer and IT services
 Staffing requirement and training
 personal protective barriers (Sterile gloves,
gown, mask, cap)
 Record keeping
 communication media
 Furniture

9.  Feeding utensils
Constraints
 Issues on breast milk donation for banking and
its acceptance for feeding. Therefore, before
initiating the program, awareness should be
created about donor breast milk and its safety.
 Legal issues
 It is an act of unselfishness. It costs to provide
monetary compensation as a token of
appreciation.
 Difficulty in transportation of expressed milk
Summary
Breast milk bank is a feasible project .It ensures that
every baby receives breast milk while in hospital.
Milk is bacteriologically safe. It provides positive
influence on breastfeeding practices in the hospital
and community by underlining need for mother’s
milk alone. Its activity may vary between different
parts of the world due to variety of reasons:

10. economics and funding and sometimes they are
linked to religion and cultural factors.