Human milk storage and banking involves expressing, collecting, processing, and distributing breast milk to support infants who cannot be breastfed directly. Milk is expressed manually or electrically and stored safely in the refrigerator or freezer. Donor milk undergoes pasteurization and screening before being distributed to hospitals. The milk is labeled and stored according to guidelines to ensure its safety and quality for premature and sick infants. Well-established human milk banks play an important role in supporting the nutritional needs of high-risk newborns.

1. Human milk storage & Banking
Dr Abbas
Associate Professor, Pediatrics
Career Institute of medical sciences ,
Lucknow

2. Expression & storage of breast milk
Expressing milk means squeezing milk out of
your breast so you can store it and feed it to your baby
late
Mannual Electronic

4. Storage of human milk
Why expressed breast milk?
working mothers
Sick babies
Preterm/low birth weight
Congenital defects in babies (cleft palate)

5. Safe Storage of Expressed Breast Milk
Safe expression:
• Wash your hands or , use an alcohol-based hand
sanitizer
• Mothers can express breast milk by hand or with
a manual or electric pump.
• Use clean pump.
• If using a shared pump kit, clean with
disinfectant wipe.

6. Safe storage:
• Use breast milk storage bags or clean food-grade
containers
– Avoid bottles with the recycle symbol number 7.
• Never store breast milk in disposable bottle liners or
plastic bags.

8. • Clearly label the breast milk with the date
• Do not store breast milk in the door of the
refrigerator or freezer.
• If expressed breast milk required storage for
more than 4 days, freeze it right away.
• Freeze breast milk in small amounts of 2 to 4
ounces.
Safe Storage tips:

9. • When freezing breast milk, leave about an inch of space
at the top of the container.
• Clearly label the container with the child’s name.
• Breast milk can be stored in an insulated cooler bag with
frozen ice packs for up to 24 hours.

10. • Always thaw the oldest breast milk first.
• There are several ways to thaw your breast milk:
– In the refrigerator overnight.
– Set in a container of warm or lukewarm water.
– Under lukewarm running water.
• Never thaw or heat breast milk in a microwave.
Safe Thawing of Breast Milk

11. • Use breast milk within 24 hours of thawing in the
refrigerator.
• Once breast milk is brought to room temperature it
should be used within 2 hours.
• Never refreeze breast milk once it has been thawed.

12. Human Milk Banking
• A human milk bank or breast milk bank is a
service which collects, screens, processes, and
dispenses by prescription human milk
donated by nursing mothers who are not
biologically related to the recipient infant

13. • ,.,
When a mother, for some reason, is
unable to feed her infant directly
her breastmilk should be expressed
and fed to the infant(EBM)
If mother’s own milk is unavailable or
insufficient
the next best option is to use pasteurized
donor human milk (PDHM)@Human Milk
Bank

14. HISTORY
• Donating breast milk can be traced back to the
practice of wet nursing.
• The first record breastmilk donation are found in
the Babylonian Code of Hammurabi (1800 BC).
• The practice of wet nursing declined by the 19th
century
• Theodor Escherich of the University of Vienna
conducted studies from 1902 to 1911 to find out
different sources of nutrition and their effect on
neonates.

15. • His studies demonstrated that breastfed neonate's
intestinal bacteria was significantly different
compared to neonates fed by other means.
• In 1909, Escherich opened the first human milk
bank in Vienna , Austria .
• The following year, another milk bank opened in the
Boston Floating Hospital, the first milk bank in the
US.
• The first milk bank in Asia under the name of Sneha,
founded by Dr. Armeda Fernandez, was started in
Dharavi, Mumbai on November 27, 1989.
• Currently, the number of human milk banks (HMB)
has grown to nearly 14 all over India

16. • The International Milk Banking Initiative (IMBI),
was founded at the International HMBANA
Congress in 2005.
• It lists 33 countries with milk bank programs.[6]
• Mothers' Milk Bank (MMB) says, this service
provides mothers with an alternative to infant
formula
• The World Health Organization (WHO) states
that the first alternative to a biological mother
not being able to breast feed is the use of
human milk from other sources.

17. Primary Recipient/consumer
• The primary and largest group of consumers of
human breast milk are premature & sick babies.
• The babies of mothers with postpartum illnesses,
and babies whose mothers have lactation failure,
till their milk output improves
• Infants with gastrointestinal disorders or metabolic
disorders may also consume this form of milk as
well.
• Human breast milk acts as a substitute, instead of
formula, when a mother cannot provide her own
milk.

18. Donor requirement
The donor population is formed by healthy
lactating mothers with healthy babies,
who are voluntarily willing to give their extra breast
milk for other babies without compromising the
nutritional needs of their own baby

19. Donor………………
A donor must:
• Be healthy
• Be in the process of lactation
• Undertake a chest x-ray or Tyne test
• Have a negative VDRL
• Have no evidence of hepatitis
• Be HIV negative
.

20. LOCATION OF HUMAN MILK BANKS
• The Human milk banks are primarily focused
to provide donor milk to high risk newborns.
• The human milk banks in the neonatal units is
associated with elevated rates of exclusive
breastfeeding rates in VLBW babies.
• The Postnatal wards or Well Baby clinics of
large hospitals are most suited place.

21. Equipment & staff
• Breast milk pumps
• Container
• Generator/Uninterrupted power supply
• Milk analyzer:
• Pasteurizer/Shaker-water bath
• Deep freezer
• Refrigerators
• Hot air oven/Autoclave
• STAFF

22. COLLECTION OF BREASTMILK
• ,
• .
The proper counselling, checking suitability for donation,
getting written informed consent, history taking, physical
examination and sampling for laboratory tests
the donor is sent to designated breastmilk collection area in
the milk bank or in the milk collection center
Breastmilk is collected by trained staff with hygienic
precautions, after method of breastmilk expression is chosen
by the donor.

23. Processing
• All batches of collected raw breast milk should be
refrigerated
• Fresh raw milk should not be added to the frozen milk
• While mixing fresh raw breast milk to frozen raw breast
milk previously collected from same donor, it should be
chilled before adding to frozen milk [18].
• For sick or preterm babies, it is advisable to use a new
container for each pumping.
• Before pasteurization, pooling and mixing may be carried
out from multiple donors to ease the process of processing
and storage.

24. • Pasteurization is carried out by Holder’s method.
• Microbiological screening of donor milk is done before
and as soon as possible after pasteurization.
• Pre-pasteurization microbiology can result in wastage of
milk
• A bacterial count of 105 CFU/ mL or more in raw breast
milk can be considered as an indicator of the poor quality
of milk.
• Based on this and on the theoretical concern that heavily
contaminated milk with specific bacteria (e.g. S. aureus,
E.coli)

25. Storage
• Pasteurized milk awaiting culture report should be
kept in dedicated freezer/freezer
• Storage should be done in the same container that is
used for pasteurization.
• It is advisable not to transfer processed milk in other
containers as it has risk of contamination.
• Culture negative processed milk should be kept at -
20°C in tightly sealed container with clear mention
of expiry date and other relevant data on the label.
• It can be preserved for 3 to 6 months

26. Disbursal
• PDHM should be disbursed at physician’s requisition
from NICU physician after informed consent from the
parents of the recipient.
• Preterm baby should preferably get PDHM from preterm
donor.
• Transport of PDHM should be done under cold storage
in the same pasteurized container till its use.
• Frozen PDHM should be thawed by either defrosting the
milk rapidly in a water bath at a temperature not
exceeding 370C, or under running lukewarm water .

27. Labeling and record keeping
• HNB should have an operational objective of ensuring
full traceability from individual donation to recipient,
• maintaining a record of all storage and processing
conditions.
• Written standard operating procedures should be
followed.
• Confidentiality of records should be maintained by the
milk bank.

28. • Proper labeling at all levels is mandatory; from sterile
container for collection of donation, pooling vessel and
pasteurization container to storage containers.
• Labels should be water resistant and names and
identifying details of donors, dates of pasteurization,
batch numbers and expiry date should be clearly
readable.
• Record keeping at all levels should be meticulous for
Donor Record File containing consent form, donor’s and
her child’s data, screening reports, pasteurization batch
files, and for PDHM Disbursal Record File containing
relevant data, including recipient consent form..

29. Thank you