Transcript: Low Milk Supply: Donor Milk, Milk Banks and Formula
The Boob Group
TBG037 Low Milk Supply
[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
Robin Kaplan: When a breastfeeding mother is faced with the dilemma of not producing enough milk for her baby, she has to evaluate her options for supplementation. What options are out there and what are the pros and cons for using each of the supplements? Today I’m thrilled to introduce Amber McCann, a private practice International Board Certified Lactation in Maryland and owner of Nourish Breastfeeding Support. Today we are discussing supplementing options for a mother with a low milk supply. This is the Boob Group, episode 37.
[Theme Music/Intro]
Robin Kaplan: Welcome to the Boob Group broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre. At the Boob Group we’re your online support group for all things related to breastfeeding. Did you know that we have an entire panel of experts who would love to answer your breastfeeding and parenting questions, all you have to do is call our hotline at 619-866-4775 and leave a message on our voicemail. Your question will then be answered on an upcoming episode. Today I am joined by four lovely panelists in this studio. Ladies, will you please introduce yourselves? We’ll, start with you Christine.
Christine Schubert: I am Christine Schubert, and I am in an RN and IBCLC, I have three children, ages six, four and five months.
Laura De La Torre: My name is Laura De La Torre, I am currently a stay-at-home mom to my first son Theodore, who is three months old.
Regula Schmid: I am Regula Schmid, I’m a stay-at-home mom on leave from a principal-ship and I’m at home with twins Bayani and Florian who are seven months old and Vivian who is three.
Elizabeth Pasimio: I am Elizabeth Pasimio, I am 32 and I am a part time student getting my masters in Oriental Medicine. I have one child and he is nine months today.
Robin Kaplan: Happy Birthday to him! And we have Florian and Bayani in the studio today, so if you happen to hear any little squeaks or beautiful noises, they are here just hanging out and nursing as we speak.
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Robin Kaplan: Before we get started with today’s topic, here is a question you all had for one of our experts.
Denise: Hey Boob Group, this is Denise calling from Tallmadge, Ohio. And I wanted to thank you so much for your recent episode on pumping and I know that I do and I know a lot of other moms out there have questions about these kinds of just like pumping when you go back to work and it seems like there are lots of different opinions. So, I wanted to ask about storage. While I’m at work I usually pump a few times and then I go down the hall, store my milk in the fridge for the rest of the day. But if I can’t go straight home after work, I leave that in my car sometimes unrefrigerated and I do plan to put it back in the fridge once I get home. But how long can that milk stay unrefrigerated before I’m able to get home? Thanks a lot.
JonaRose Feinberg: Hi Denise, this is JonaRose Feinberg, an IBCLC in the Seattle area. It’s great that you’re pumping at work. The guidelines for safe storage of pumped milk vary depending on the source. So, it’s easy to get confused. It’s not generally considered to be safe at room temperature for anywhere from four to eight hours depending on the source.
Milk in the fridge is considered safe for three to seven days. It’s fine to gather the milk from more than one pumping session and then store that milk in the fridge until the end of the day. At that point it would be great if you could transfer the pumps milk through small ice chest or insulated bag with an ice pack. The cooler will help maintain the milk during your trip home. Even if you have to stopped to run errands or even go out for dinner, many quality pump kits come with some sort of cooler, but you can use anything from a small well insulated punch bag to a hard set of cooler you keep in your car. Depending on how long you keep the milk will need to maintain that temperature. Just pick an ice pack in the freezer at work in the morning and bring it with them when you leave. You and your milk will stay cool. Keep up the great pumping.
[Theme Music]
Robin Kaplan: Today on the Boob Group we’re discussing supplementation options for a mother with a low milk supply. Our expert Amber McCann is a private practice International Board Certified Lactation Consultant in Maryland and owner of Nourished Breastfeeding Support. She is also the co-editor of the Lactation Matters Blog, social media coordinator for GOLD Conferences International and a regular contributor to the Boob Group and a very dear friend of mine. So Amber, thank you so much for joining us and welcome to the show.
Amber McCann: Thanks for having me.
Robin Kaplan: Sure. So Amber, what options does a mother have if she’s faced with the need to supplement when she is exclusively breastfeeding and how would you rank
these in order of quality for the baby?
Amber McCann: That is a really great question and one I hear from moms every single day. Often when we think about supplementing our babies, we think we only have one choice and that is formula in a bottle. The reality is that mothers today have quite a number of choices for supplementation. The World Health Organization has a document that they call The Global Strategy for Infant and Young Child Feeding. In it they suggest the following hierarchy of feeding options. First would obviously be milk directly from the mother’s breast. If that’s not possible for any number of reasons, then next best option is milk express from the babies own mother’s breast, either through a breast pump or through hand expression and then fed to the baby. After that, they say that milk from another mother. For example, a wet nurse, a milk that has been donated in some manner and then finally using some sort of breast milk substitute like formula. Now, obviously each of these options has its advantages and disadvantages to different family, but I think it’s a really good place to start talking about what our options are, but I always maintain that women are uniquely equipped to determine for themselves what is the best choice for their baby and their family.
Robin Kaplan: So ladies here in the panel, can you tell us what type of supplementation that you used and how you decided on that for your baby? Laura, do you mind if we start with you?
Laura De La Torre: Sure. I choose to use donor breast milk. And I found that through basically people that I knew through, people that I knew friends of friends and also through a couple of Facebook pages. It’s on feeds and also the regular just local breastfeeding support group for the area that I live in.
Robin Kaplan: Okay, thank you. How about you, Christine?
Christine Schubert: So, we started out using a little bit of milk from a good friend of mine. Also she became pregnant and supply drop dramatically and so we went straight to pasteurized human milk from a milk bank.
Robin Kaplan: Okay, how about you Elizabeth?
Elizabeth Pasimio: Actually a friend of ours wet nursed our baby a little bit and then she donated some of her milk. And then we went to formula for a while until I found that there were more moms who were donating their extra milk and he’s basically, exclusively on donor milk now.
Robin Kaplan: That’s amazing! How about you, Regula?
Regula Schmid: We went with milk bank milk at first with Vivian and then later when we ran out of that we bought a can of formula which made me cry and made Vivian cry, she spit it up a lot and later very constipated until we found some donor milk and that went much better.
Robin Kaplan: And Amber, if a mom is choosing formula, how did she decide which one to buy?
Amber McCann: Great question. My go-to answer for this is always asked your doctor. I am not a nutritionist, I am not a physician, nor am I well trained in the nuances of formula composition. But I do know this, that the brand of formula that you’re likely given in the hospital as a sample might not be the best choice for your baby. Fortunately, this practice of marketing formula directly to all mothers in the hospital is diminishing through the hard work of some great organizations like Ban the bags and the baby friendly hospital initiative. But what parents need to know is that if you’re choosing to use formula, you need to connect with your baby’s pediatrician as to what is the best option for your child even if it’s different than every other mother in the neighborhood.
Robin Kaplan: And it seems like every mother here at – Christine did you say you use donor milk? Oh, you get from a friend. So, milk sharing is obviously a very popular topic and so, since milk is a bodily fluid, is it safe to offer someone else’s milk to your baby and what are the safety precautions ones should look at?
Amber McCann: This is an issue that I’m really, really interested in. Women have been feeding their milk to other mother’s babies since the dawn of time. We look at the biblical story of Moses and Jochebed was hired by Pharaoh’s daughter to feed Moses, after finding him in the bulrushes, what the Pharaoh’s daughter didn’t know was that Jochebed was actually Moses’ mother. But also in Islamic history and culture, the concept of milk kinship dates all the way back to Mohammed himself. But the idea that instead of feeding someone else’s baby directly at your breast, that you would pump and then share that milk is a newer concept. And the popularity and prevalence of breast pump have really allowed for this practice. There is however really big difference between this idea that everybody is doing it and this is the best option for my baby.
Milk sharing isn’t without its risk, but neither is driving your vehicle or eating a walnut. It’s important for those who would like to consider giving and receiving breast milk with another family to do so with eyes wide open and listen and understand and say must ask questions, be aware and not practice it blindly. One of the best practices, a limit the risk with milk sharing is really open an honest conversation with both the donor and the recipient about lifestyle choices. And for most women who are donating their milk to another family they’re also breastfeeding their own children at the same time, so I think we find some comfort in that. When I counsel clients on milk sharing, I always encourage them to ask for copies of blood test that the donating mother had during her pregnancy. I feel like this can give you a really good idea. If there are any significant health concerns and whether the risk, though very small, of giving her milk to your baby is worth it to you. We do know that there are incredible health benefits for those babies who have shared breast milk over formula and we want to balance these benefit against the risk of using another mother’s milk. But no family can determine if it’s worth it, except for the family that’s asking these questions about their own baby.
Robin Kaplan: Okay, so you mention these benefits of using donated milk from another woman over using formula. So, what are these benefits?
Amber McCann: I think the benefits are amazing. We know that breast milk is the biologically normal fluid for infants. Health experts all over the world agree that breast milk give us amazing things for the baby including this really like rock star immunity. And it’s uniquely design to be broken down efficiently by the baby. It’s perfectly designed for infants. Having the opportunity to still give all these benefits to a baby even if you’re not able to fully breastfeed your baby your own milk yourself, it’s so, so beneficial.
I also love that milk sharing allows relationships to be formed from many donors and their recipients, I often hear stories from families who become dear friends after sharing milk. And I think that really contributes to this greater community. I don’t, however, think it’s the right option for every family, many families for a number of reasons, determine that using formula is a better choice for their family, and I support every parents right and capacity to make decisions that are right for them.
Robin Kaplan: And I think one of the main questions that I get as a lactation consultant is, what diseases can be pass through the breast milk? If I was going to accept breast milk from another woman, what should I be most concerned about?
Amber McCann: It’s true that there are a number of pathogens that can enter in human milk if a mother is infected. However, few of these diseases can actually be transmitted through the human milk itself. There’s three biggies to be concerned with. One is called HTLV, HIV which kind of strikes fear in the hearts of everyone, and one called CMV.
Now CMV is typically only a challenge for pre-mature infants and honestly, I would never advocate direct milk sharing for really critically ill babies. Neither HIV nor HTLV are transmitted easily. They would both show up on any prenatal blood works that a mother had and she should be aware of her status. Of course, we don’t live in a perfect world where everyone is fully aware of their own health and of course infection could happen after the prenatal testing. But fortunately, HTLV can be deactivated by freezing milk, and I think a lot of mother’s who received milk directly from another mother are getting it already frozen and HIV can be deactivated through flash heating. Treating any milk you receive for your baby by freezing and flash heating can really further limit the risk on to the baby. I will admit all of these diseases sound really crazy scary and well I believe the risk is really, really low for healthy infant to receive another mother’s well screened milk, I believe more that each family have to determine for themselves what they feel comfortable with.
Robin Kaplan: Okay and so, if moms were looking for donated milk and they did not have a friend who could donate it to them directly, where can they find someone to donate milk for her baby?
Amber McCann: I have been so fortunate to be involved in some of really amazing milk sharing stories. I once worked with a woman who had a four year old daughter who had a disease that really impacted her daughter’s ability to process nutrition and she was four years old and she couldn’t gain weight and they decided that they wanted to add some breast milk for her diet. So, they contacted me and I was able to reach out to some people. And we end up getting her connected with a donor mother who happened to live four houses down the street from her house.
Robin Kaplan: No, no way.
Amber McCann: So, it was amazing how this relationship blossomed and this little girl thrives on the breast milk. But in addition to that, they got a really lovely, friendship. I think those kinds of opportunities are out there, even some of your panelist said, a friend of a friend, or I knew someone, I think the best way to get donor milk is to ask. Do you know anyone in your social group who is breastfeeding a baby? Would they be willing to share, I believe with all my heart there is more than enough breast milk in the world for all the world’s babies if everyone who could share did so.
So, you could ask it to your house of worship, your play groups, your mothering groups, among your friend, friends of friends, so many women are willing to donate if they know that there is a need. In addition, there are several opportunities for connecting with the families who have milk to share on the internet. People get a little freaky about – oh my goodness, I’m met this woman on the internet, like we’re meeting in a dark alley somewhere and handing off the breast milk. Most of that, the relationship I know that is certainly not what is happening. But these websites and Facebook pages really provide a place for families to connect to those who have extra milk and those who have a need. Those pages don’t though broker the exchanges, they’re only a place to connect. My favorite of all of those in an organization called Human Milk 4 Human Babies. They maintained a Facebook page for each state in the US and also in quite a number of different of different countries.
Robin Kaplan: Okay, thank you so much. So, ladies, for those of you who did use donor milk, one - were you nervous at all about using someone else’s milk and if you didn’t find it through a friend of a friend, how did you find it? Elizabeth, do you mind if we start with you?
Elizabeth Pasimio: Sure. I was petrified in the first time I gave the baby the milk. Yeah, I was really scared and I kind of had a conversation with myself like, this could make him sick, like I could be harming him. And then I thought about, I really don’t want to vaccinate him and so he needs to get breast milk, what are my options and I just decided that I was making the decision with open eyes and I did my best to ask questions about where the milk came from and the mother’s health and then just went on faith that it was going to be okay. And now that mom gave me like 900 ounces.
Robin Kaplan: Oh, my goodness!
Elizabeth Pasimio: That was the beginning, that was the beginning and from there I just decided to trust like I don’t know – the motherhood, yeah the mother, the universal motherhood feeling like that, like what Amber said about there being enough breast milk for all the babies in the world and really wanted to give my baby the best that I could.
I have used the donation sites and also like what Laura mentioned the Breastfeeding San Diego, there are amazingly generous mamas in San Diego. It’s been very humbling, it’s been just huge, huge blessing to have the networking like where someone I don’t even know is like, ‘I have a friend, I hear that you need breast milk, I have a friend of a friend and they have a freezer full’ and I am like, ‘yes, thank you, wonderful.’ It just come out in all different areas that I’ve been getting offers.
Robin Kaplan: Absolutely. And for those of you aren’t in San Diego we have this Facebook page here in San Diego called Breastfeeding San Diego and it’s a closed group and it’s where I see every single day women sharing advice, sharing stories, asking for help and quite often mentioning that either they have extra breast milk or they don’t have as much as they need and just coming out of the woodwork like you said, they’ll just ping someone. And next thing you know, we’re connecting women all over the city. So, I’m sorry if you don’t live in San Diego but that doesn’t mean that maybe your city doesn’t have something similar which is really, really cool. Regula, let me hand the microphone over to you while you’re nursing your kiddos and do you mind talking about what your experience was with donor milk and were you nervous using it?
Regula Schmid: I was very nervous the very first time I used donor milk because I didn’t know the person that well, although I did asked her for all of her lab results during pregnancy. But like Amber was saying, somebody could get infected after those labs were taken. But then I got a lot of donor milk through a local midwife who had known the people for a long time, the women for a long time and had seen all of their labs over years, so that made me feel much more comfortable.
Robin Kaplan: That’s another really good point to bring up too. You never know if your healthcare provider, especially if you’re working with midwives, they see lots of moms and they see them postpartum as well for, you know they still maintain these connections so, that’s a great point. Laura, how about you?
Laura De La Torre: I feel like I’m the minority because I honestly had no concerns using it. We had to start using day two of his life and the person who had donated the milk, it was through also my midwives and so she knew the person very well and had known her and trusted her and I trusted my midwife and my son needed the milk so. I don’t remember having any concerns.
Robin Kaplan: That’s great. How about you Christine?
Christine Schubert: Yeah, I was concerned. So using a very good friend’s milk made me feel a lot better. We’ve known the couple for a long time and I’ve always felt like if you knew the husband only well too you should be pretty safe. So, yeah, and then with the --we switch pretty quickly from the milk bank and I felt very comfortable with that but ---
Robin Kaplan: And we’ll be talking about milk banks in actually just a few minutes, because that’s a really interesting concept of using milk that’s being pasteurized as well. So,
Amber before we take our break, would you say that there are any issues that a mother should be concerned about when accepting donated breast milk for her baby?
Amber McCann: I think you’ve heard me say this again and again. But the question of, is this the right choice for my baby and my family, I think each family have to examine their own thoughts and concerns, ask every single question that’s on their mind and hearts and only step into this kind of relationship with the donating family when you feel really confident in that decision.
Robin Kaplan: Okay, well thank you. When we come back Amber will discuss home pasteurization and the option for purchasing breast milk from a milk bank, so we’ll be right back.
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Robin Kaplan: And we’re back with Amber McCann talking about a mother’s choice for supplementation when she has a need for additional breast milk most likely because of a low milk supply. So Amber, Dianne West was on the show a few months ago talking about breastfeeding after breast reduction surgery and she mentioned that mothers could actually pasteurized donated breast milk and this was – I knew that they do this for milk banks, but I had no idea that you could do home pasteurization. So, I was curious, what do you think about this and do you think this is a good option for someone who might have those concerns about donor milk and this might make them feel more comfortable?
Amber McCann: Well, I totally think Dianne West is brilliant and so I’m thrilled that she mentioned that option, I totally agree with her that for some moms, still not all, home pasteurization of donated milk is exactly the right choice. We don’t have time in this format to get into a super technical in-depth conversation about all the different ways that milk can be pasteurized. So, we’re just going to focus on what we called flash heating. And HIV is the main concern for most people who are going to choose to flash heat their milk and it can be done really simply on the stove. There is an excellent YouTube video, it’s called Flash-Heating Breast Milk Kills HIV. And it’s by -- great man, right?
Robin Kaplan: Exactly.
Amber McCann: By the UC Berkeley School of Public Health, so we’re not talking just some random people putting this video, these are people who really have studied this. And the process involved making sure all of the utensils are clean, and then we poured the milk into a glass jar, this jar is place in a pot with water and then together, the water and milk are heated very quickly until the water the reaches the rolling boil. At that point you removed the jar’s milk and allow it to cool. It’s a really low tech method and it’s been used all over the world by HIV positive mothers and it can be a really effective method for mothers who are using milk sharing as well.
Robin Kaplan: That’s so amazing. I mean when she mentioned it I was like, that just open up or at least for me thinking about how possible it could be to include that as a possibility for moms when they know that it removes that extra stress of wondering what’s being passed.
Amber McCann: Absolutely.
Robin Kaplan: And additionally to that, what questions should a mother ask her possible milk donor before accepting her milk?
Amber McCann: You know, I mention really having open and honest conversation about lifestyle is really the best way to way to limit your risk. And I would love if every mother considering accepting a donation of breast milk after a copy of the prenatal blood work from their donor. I just feel like that’s a really good step for families. Some families also want to ask about additional lifestyle choices like smoking, alcohol, diet, caffeine, medication usage. There is a really excellent list of questions for donors on the website, www.eatsonfeetsresources.org. They also include a list of questions that donors can ask their recipient families like, how will my milk be used and how long do you anticipated needing donor milk.
Robin Kaplan: That’s really interesting too. So, make sure that’s it’s actually being used appropriately, I mean you figure if you pumped that much out you want to make sure it’s going to a good guys.
Amber McCann: We feel really possessive of our milk sometimes. We have worked really hard and it’s really valuable and a lot of moms want to make sure that they know how their milk is being used.
Robin Kaplan: Absolutely. Ladies, did you find it was difficult at all to come by the donor milk that you ended up receiving, or was it fairly easy? Laura, you’re shaking your head, it was fairly easy?
Laura De La Torre: It was fairly easy, I just put the word out through everyone I knew and also my midwives and Eats on Feets and then the San Diego Facebook page.
Robin Kaplan: Okay, how about you Elizabeth?
Elizabeth Pasimio: It became easy, but in the beginning, it was difficult and stressful and it was like a full time job like driving an hour to get 20 ounces. Yes, I would do that. I was literally driving all over the county for any amount for a period of time until I was able to get kind of a comfortable amount and not driving hour and a half for one or two feedings.
Robin Kaplan: Sure, sure. How about you, Regula?
Regula Schmid: I drove all over the county too and sometimes it was hard because donors would think, they have all these milk and it would be, like you said, it would be 20 ounces that would last a day. So, it was difficult until I came across a donor who had a freezer full, because she had pumped through her premature baby and that pretty much lasted us until I was able to exclusively breastfeed.
Robin Kaplan: How about you, Christine?
Christine Schubert: Well, because it was such a dear friend of mine, she actually would drive to my house and drop it off for the first few weeks. And before we got the milk form the milk bank, so yeah, it was very easy on us to stay home and she brought it over.
Robin Kaplan: That’s wonderful. And that brings up a really good point. I’d like to talk a little bit about milk bank and so Amber, can you – there are probably many of our listeners who have never even heard of a milk bank. So, what is a milk bank and where can it be found? Or where can they be found?
Amber McCann: I have long said if there is one thing in the breastfeeding world that I would totally put on the cheerleading uniform and grab my pump-pump more, it is milk banking. Like I totally believe in it, I think it’s one of the most powerful things we have going for us. In the United States, we’re fortunate to have a number of milk banks associated with an organization called the Human Milk Banking Association of North America. I mean seriously, these milk banks save babies lives every day. They receive donations from mothers, they processed the milk, do pasteurization and they distributed to really critically ill babies all over the country.
These banks have been in the news quite a bit lately and they’re desperately in need of donations. If you are a mother who has milk to donate, please, please, please, please consider whether donating to a milk bank is the right option for your family. They primarily serve very, very sick babies who were in a queue and who are taking tiny quantities of milk each feeding. A little goes a really long way with these babies and a donation can have a really significant impact. The babies who typically received milk from the milk banks though are very different than the babies who typically receive milk through direct milk sharing like we’ve been talking about. But both of these message of getting milk to babies is really important. Well, the vast majority of milk from milk banks goes directly to babies in the hospital, there is a small amount that can be available to healthy babies for a fee. This fee is typically a couple of dollars an ounce but that can add up really quickly when you consider the amount of milk that’s required by a baby every day.
It feels really expensive, but this fee is very reasonable when you consider the level of testing and processing that a milk bank have to do for the milk. One of my very favorite, Neil Patrick Harris spoke about this while he was on the Late Late Show Craig Ferguson a couple of years ago. He and his partner had twins and they were purchasing milk from a milk bank for their babies. Some parents also can receive milk from a milk bank with a prescription from their doctor and that milk might actually be covered by insurance. But in keeping with the mission of the milk bank, the babies who are in critical health are always going to be the highest priority for them.
Robin Kaplan: Okay, and is the milk purchased from a milk bank safer than milk from a donor?
Amber McCann: I really think safer is a bit relative, safer for a baby who has health challenges, is premature, who has a life threatening illness, absolutely. Is it safer for a full time healthy robust infant? May be and maybe not. Milk banks have a process for testing and processing milk that eliminates things that could have a really negative impact on the health of the critical little one, and this is so, so important for those babies. But I liken it to this, if you had a dear friend who recently had an organ transplant, you would do everything in your power to visit them in as healthy a manner as possible. You would scrap your arms and your hands, you’d wear a mask. But if that same friend had just gone through a healthy event like the birth of a baby, you’d probably just wash your hands. So, I think different circumstances required different levels of caution.
Robin Kaplan: Okay, and for moms who are listening, who do have an access of milk and may be don’t have a friend that they would like to offer it to, and they or they’re just -- they would love to deliver it to a milk bank for babies who are critically ill, how can they donate their milk?
Amber McCann: I think any mom who is able to produce more milk than their own babies require should at least consider whether donating to a nonprofit milk bank is the right choice for her. You can find more information about how to donate on the Human Milk Banking Association of North America’s website, it’s www.hmbana.org. They required a donor mothers to be in good health, to not regularly be on most medication or oral supplements that the moms would be willing to undergo additional blood testing, which is at the expense of the milk bank. And would be willing to donate at least a hundred ounces. If this sounds like you, I encourage you to reach out and be involved. Again, the website is www.hmbana.org. You can get more information there.
Robin Kaplan: Cool. And Amber, can you share your favorite resources for helping a mother choose which supplement makes the most for her family?
Amber McCann: As a board certified lactation consultant, my favorite resource for moms asking me this question is another board certified lactation consultant. I think we really have our finger on the pulse of what the options are for supplementation. We can help you sort through all the questions, concerns, help you make a good decision for your family In addition, weighing all your options by visiting the Human Milk 4 Human Babies, Facebook pages and the Human Milk Banking Association for North America’s website can be really valuable. And obviously speaking with a breastfeeding family pediatrician can also be really important.
Robin Kaplan: Well, thank you so much Amber for your insight into supplementing options for a mother who has a low milk supply and for our Boob Group Club members our conversation will continue at the end of the show as Amber will answer a few more questions on this topic. For more information about our Boob Group Club, please visit our website at theboobgroup.com.
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Robin Kaplan: Before we end our show today, here is Lara Audelo showing tips on how to avoid societal booby traps.
Lara Audelo: Hi Boob Group listeners, I’m Lara Audelo, a certified lactation educator, the retail marketing manager at Best for Babes and the owner of MamaPear Designs. Today we’re here to talk about how you can cheat your personal breastfeeding goals without being undermined by cultural and institutional booby traps.
Let’s discussed and think where it starts, which one your doctor is using. Mother’s often forced to see how well the babies are growing and receiving the milestone on a growth chart from the pediatrician. What you may not have ever thought about is how does this growth start develop the numbers that your baby is being measured against. About six years ago, the World Health Organization released a growth charts which changes our understanding at how babies, breastfed and formula fed grow. Until recently, the growth charts used by pediatricians were based on the sample of formula fed, Caucasian babies born between 1929 and 1975 in Ohio who often starts solid food before four months. These charts were used around the world to chart baby’s growth.
In 2000 the CDC released the chart using a mixed example of breastfed and formula fed and things, which demonstrated that that breast fed and formula fed infant have a different growth pattern. Breastfed babies grows faster than formulas fed babies in the first three months and then between three to 12 months, they reel out in comparison to their formulas fed counterpart. The new WHO charts use a sample of nearly 9000 babies who are exclusively or near exclusively breastfed for the first six months. The WHO is clear that these charts are not intended to apply to just breastfed babies. They can serve as an important early warning to doctors about why is the baby is experiencing excess of weight gain. A particular concern but these babies are at risk of being overweight and obesity.
In 2010, these charts have been recommended by the CDC and the American Academy of Pediatrics. Which will begin using it later this year. Do you know if your pediatrician use this new growth charts? Don’t be afraid to ask, sometime they can take a while for these changes and recommendations to take effect. But the more mothers that ask, the faster that change will occur. A special thank you to Tanya Leiberman, IBCLC providing the booby trap series is the Best for Babes. Visit bestforbabes.org for more feed information about how to meet your personal breastfeeding goals. And my goodness, www.mamapeardesigns.com for breastfeeding supportive wearable. And be sure to listen to the Boob Group for fantastic conversations about breastfeeding and breastfeeding support.
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Robin Kaplan: Thank you so much to our experts, panelists and all of our listeners. If you have any questions about today’s show or the topic we discussed call our Boob Group hotline at 619-866-4775 and we’ll answer your question on an upcoming episode. If you have a breastfeeding topic you’d like to suggest, we’d love to hear it. Simply visit our website at the boobgroup.com and send us an email through the contact link. Coming up next week we have Veronica Tingzon on the show, discussing how a baby’s Oral Anatomy can affect breastfeeding. Thanks for listening to the Boob Group, because mothers know breast.
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This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are believed to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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Episode Transcript
The Boob Group
TBG037 Low Milk Supply
[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
Robin Kaplan: When a breastfeeding mother is faced with the dilemma of not producing enough milk for her baby, she has to evaluate her options for supplementation. What options are out there and what are the pros and cons for using each of the supplements? Today I’m thrilled to introduce Amber McCann, a private practice International Board Certified Lactation in Maryland and owner of Nourish Breastfeeding Support. Today we are discussing supplementing options for a mother with a low milk supply. This is the Boob Group, episode 37.
[Theme Music/Intro]
Robin Kaplan: Welcome to the Boob Group broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre. At the Boob Group we’re your online support group for all things related to breastfeeding. Did you know that we have an entire panel of experts who would love to answer your breastfeeding and parenting questions, all you have to do is call our hotline at 619-866-4775 and leave a message on our voicemail. Your question will then be answered on an upcoming episode. Today I am joined by four lovely panelists in this studio. Ladies, will you please introduce yourselves? We’ll, start with you Christine.
Christine Schubert: I am Christine Schubert, and I am in an RN and IBCLC, I have three children, ages six, four and five months.
Laura De La Torre: My name is Laura De La Torre, I am currently a stay-at-home mom to my first son Theodore, who is three months old.
Regula Schmid: I am Regula Schmid, I’m a stay-at-home mom on leave from a principal-ship and I’m at home with twins Bayani and Florian who are seven months old and Vivian who is three.
Elizabeth Pasimio: I am Elizabeth Pasimio, I am 32 and I am a part time student getting my masters in Oriental Medicine. I have one child and he is nine months today.
Robin Kaplan: Happy Birthday to him! And we have Florian and Bayani in the studio today, so if you happen to hear any little squeaks or beautiful noises, they are here just hanging out and nursing as we speak.
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Robin Kaplan: Before we get started with today’s topic, here is a question you all had for one of our experts.
Denise: Hey Boob Group, this is Denise calling from Tallmadge, Ohio. And I wanted to thank you so much for your recent episode on pumping and I know that I do and I know a lot of other moms out there have questions about these kinds of just like pumping when you go back to work and it seems like there are lots of different opinions. So, I wanted to ask about storage. While I’m at work I usually pump a few times and then I go down the hall, store my milk in the fridge for the rest of the day. But if I can’t go straight home after work, I leave that in my car sometimes unrefrigerated and I do plan to put it back in the fridge once I get home. But how long can that milk stay unrefrigerated before I’m able to get home? Thanks a lot.
JonaRose Feinberg: Hi Denise, this is JonaRose Feinberg, an IBCLC in the Seattle area. It’s great that you’re pumping at work. The guidelines for safe storage of pumped milk vary depending on the source. So, it’s easy to get confused. It’s not generally considered to be safe at room temperature for anywhere from four to eight hours depending on the source.
Milk in the fridge is considered safe for three to seven days. It’s fine to gather the milk from more than one pumping session and then store that milk in the fridge until the end of the day. At that point it would be great if you could transfer the pumps milk through small ice chest or insulated bag with an ice pack. The cooler will help maintain the milk during your trip home. Even if you have to stopped to run errands or even go out for dinner, many quality pump kits come with some sort of cooler, but you can use anything from a small well insulated punch bag to a hard set of cooler you keep in your car. Depending on how long you keep the milk will need to maintain that temperature. Just pick an ice pack in the freezer at work in the morning and bring it with them when you leave. You and your milk will stay cool. Keep up the great pumping.
[Theme Music]
Robin Kaplan: Today on the Boob Group we’re discussing supplementation options for a mother with a low milk supply. Our expert Amber McCann is a private practice International Board Certified Lactation Consultant in Maryland and owner of Nourished Breastfeeding Support. She is also the co-editor of the Lactation Matters Blog, social media coordinator for GOLD Conferences International and a regular contributor to the Boob Group and a very dear friend of mine. So Amber, thank you so much for joining us and welcome to the show.
Amber McCann: Thanks for having me.
Robin Kaplan: Sure. So Amber, what options does a mother have if she’s faced with the need to supplement when she is exclusively breastfeeding and how would you rank
these in order of quality for the baby?
Amber McCann: That is a really great question and one I hear from moms every single day. Often when we think about supplementing our babies, we think we only have one choice and that is formula in a bottle. The reality is that mothers today have quite a number of choices for supplementation. The World Health Organization has a document that they call The Global Strategy for Infant and Young Child Feeding. In it they suggest the following hierarchy of feeding options. First would obviously be milk directly from the mother’s breast. If that’s not possible for any number of reasons, then next best option is milk express from the babies own mother’s breast, either through a breast pump or through hand expression and then fed to the baby. After that, they say that milk from another mother. For example, a wet nurse, a milk that has been donated in some manner and then finally using some sort of breast milk substitute like formula. Now, obviously each of these options has its advantages and disadvantages to different family, but I think it’s a really good place to start talking about what our options are, but I always maintain that women are uniquely equipped to determine for themselves what is the best choice for their baby and their family.
Robin Kaplan: So ladies here in the panel, can you tell us what type of supplementation that you used and how you decided on that for your baby? Laura, do you mind if we start with you?
Laura De La Torre: Sure. I choose to use donor breast milk. And I found that through basically people that I knew through, people that I knew friends of friends and also through a couple of Facebook pages. It’s on feeds and also the regular just local breastfeeding support group for the area that I live in.
Robin Kaplan: Okay, thank you. How about you, Christine?
Christine Schubert: So, we started out using a little bit of milk from a good friend of mine. Also she became pregnant and supply drop dramatically and so we went straight to pasteurized human milk from a milk bank.
Robin Kaplan: Okay, how about you Elizabeth?
Elizabeth Pasimio: Actually a friend of ours wet nursed our baby a little bit and then she donated some of her milk. And then we went to formula for a while until I found that there were more moms who were donating their extra milk and he’s basically, exclusively on donor milk now.
Robin Kaplan: That’s amazing! How about you, Regula?
Regula Schmid: We went with milk bank milk at first with Vivian and then later when we ran out of that we bought a can of formula which made me cry and made Vivian cry, she spit it up a lot and later very constipated until we found some donor milk and that went much better.
Robin Kaplan: And Amber, if a mom is choosing formula, how did she decide which one to buy?
Amber McCann: Great question. My go-to answer for this is always asked your doctor. I am not a nutritionist, I am not a physician, nor am I well trained in the nuances of formula composition. But I do know this, that the brand of formula that you’re likely given in the hospital as a sample might not be the best choice for your baby. Fortunately, this practice of marketing formula directly to all mothers in the hospital is diminishing through the hard work of some great organizations like Ban the bags and the baby friendly hospital initiative. But what parents need to know is that if you’re choosing to use formula, you need to connect with your baby’s pediatrician as to what is the best option for your child even if it’s different than every other mother in the neighborhood.
Robin Kaplan: And it seems like every mother here at – Christine did you say you use donor milk? Oh, you get from a friend. So, milk sharing is obviously a very popular topic and so, since milk is a bodily fluid, is it safe to offer someone else’s milk to your baby and what are the safety precautions ones should look at?
Amber McCann: This is an issue that I’m really, really interested in. Women have been feeding their milk to other mother’s babies since the dawn of time. We look at the biblical story of Moses and Jochebed was hired by Pharaoh’s daughter to feed Moses, after finding him in the bulrushes, what the Pharaoh’s daughter didn’t know was that Jochebed was actually Moses’ mother. But also in Islamic history and culture, the concept of milk kinship dates all the way back to Mohammed himself. But the idea that instead of feeding someone else’s baby directly at your breast, that you would pump and then share that milk is a newer concept. And the popularity and prevalence of breast pump have really allowed for this practice. There is however really big difference between this idea that everybody is doing it and this is the best option for my baby.
Milk sharing isn’t without its risk, but neither is driving your vehicle or eating a walnut. It’s important for those who would like to consider giving and receiving breast milk with another family to do so with eyes wide open and listen and understand and say must ask questions, be aware and not practice it blindly. One of the best practices, a limit the risk with milk sharing is really open an honest conversation with both the donor and the recipient about lifestyle choices. And for most women who are donating their milk to another family they’re also breastfeeding their own children at the same time, so I think we find some comfort in that. When I counsel clients on milk sharing, I always encourage them to ask for copies of blood test that the donating mother had during her pregnancy. I feel like this can give you a really good idea. If there are any significant health concerns and whether the risk, though very small, of giving her milk to your baby is worth it to you. We do know that there are incredible health benefits for those babies who have shared breast milk over formula and we want to balance these benefit against the risk of using another mother’s milk. But no family can determine if it’s worth it, except for the family that’s asking these questions about their own baby.
Robin Kaplan: Okay, so you mention these benefits of using donated milk from another woman over using formula. So, what are these benefits?
Amber McCann: I think the benefits are amazing. We know that breast milk is the biologically normal fluid for infants. Health experts all over the world agree that breast milk give us amazing things for the baby including this really like rock star immunity. And it’s uniquely design to be broken down efficiently by the baby. It’s perfectly designed for infants. Having the opportunity to still give all these benefits to a baby even if you’re not able to fully breastfeed your baby your own milk yourself, it’s so, so beneficial.
I also love that milk sharing allows relationships to be formed from many donors and their recipients, I often hear stories from families who become dear friends after sharing milk. And I think that really contributes to this greater community. I don’t, however, think it’s the right option for every family, many families for a number of reasons, determine that using formula is a better choice for their family, and I support every parents right and capacity to make decisions that are right for them.
Robin Kaplan: And I think one of the main questions that I get as a lactation consultant is, what diseases can be pass through the breast milk? If I was going to accept breast milk from another woman, what should I be most concerned about?
Amber McCann: It’s true that there are a number of pathogens that can enter in human milk if a mother is infected. However, few of these diseases can actually be transmitted through the human milk itself. There’s three biggies to be concerned with. One is called HTLV, HIV which kind of strikes fear in the hearts of everyone, and one called CMV.
Now CMV is typically only a challenge for pre-mature infants and honestly, I would never advocate direct milk sharing for really critically ill babies. Neither HIV nor HTLV are transmitted easily. They would both show up on any prenatal blood works that a mother had and she should be aware of her status. Of course, we don’t live in a perfect world where everyone is fully aware of their own health and of course infection could happen after the prenatal testing. But fortunately, HTLV can be deactivated by freezing milk, and I think a lot of mother’s who received milk directly from another mother are getting it already frozen and HIV can be deactivated through flash heating. Treating any milk you receive for your baby by freezing and flash heating can really further limit the risk on to the baby. I will admit all of these diseases sound really crazy scary and well I believe the risk is really, really low for healthy infant to receive another mother’s well screened milk, I believe more that each family have to determine for themselves what they feel comfortable with.
Robin Kaplan: Okay and so, if moms were looking for donated milk and they did not have a friend who could donate it to them directly, where can they find someone to donate milk for her baby?
Amber McCann: I have been so fortunate to be involved in some of really amazing milk sharing stories. I once worked with a woman who had a four year old daughter who had a disease that really impacted her daughter’s ability to process nutrition and she was four years old and she couldn’t gain weight and they decided that they wanted to add some breast milk for her diet. So, they contacted me and I was able to reach out to some people. And we end up getting her connected with a donor mother who happened to live four houses down the street from her house.
Robin Kaplan: No, no way.
Amber McCann: So, it was amazing how this relationship blossomed and this little girl thrives on the breast milk. But in addition to that, they got a really lovely, friendship. I think those kinds of opportunities are out there, even some of your panelist said, a friend of a friend, or I knew someone, I think the best way to get donor milk is to ask. Do you know anyone in your social group who is breastfeeding a baby? Would they be willing to share, I believe with all my heart there is more than enough breast milk in the world for all the world’s babies if everyone who could share did so.
So, you could ask it to your house of worship, your play groups, your mothering groups, among your friend, friends of friends, so many women are willing to donate if they know that there is a need. In addition, there are several opportunities for connecting with the families who have milk to share on the internet. People get a little freaky about – oh my goodness, I’m met this woman on the internet, like we’re meeting in a dark alley somewhere and handing off the breast milk. Most of that, the relationship I know that is certainly not what is happening. But these websites and Facebook pages really provide a place for families to connect to those who have extra milk and those who have a need. Those pages don’t though broker the exchanges, they’re only a place to connect. My favorite of all of those in an organization called Human Milk 4 Human Babies. They maintained a Facebook page for each state in the US and also in quite a number of different of different countries.
Robin Kaplan: Okay, thank you so much. So, ladies, for those of you who did use donor milk, one - were you nervous at all about using someone else’s milk and if you didn’t find it through a friend of a friend, how did you find it? Elizabeth, do you mind if we start with you?
Elizabeth Pasimio: Sure. I was petrified in the first time I gave the baby the milk. Yeah, I was really scared and I kind of had a conversation with myself like, this could make him sick, like I could be harming him. And then I thought about, I really don’t want to vaccinate him and so he needs to get breast milk, what are my options and I just decided that I was making the decision with open eyes and I did my best to ask questions about where the milk came from and the mother’s health and then just went on faith that it was going to be okay. And now that mom gave me like 900 ounces.
Robin Kaplan: Oh, my goodness!
Elizabeth Pasimio: That was the beginning, that was the beginning and from there I just decided to trust like I don’t know – the motherhood, yeah the mother, the universal motherhood feeling like that, like what Amber said about there being enough breast milk for all the babies in the world and really wanted to give my baby the best that I could.
I have used the donation sites and also like what Laura mentioned the Breastfeeding San Diego, there are amazingly generous mamas in San Diego. It’s been very humbling, it’s been just huge, huge blessing to have the networking like where someone I don’t even know is like, ‘I have a friend, I hear that you need breast milk, I have a friend of a friend and they have a freezer full’ and I am like, ‘yes, thank you, wonderful.’ It just come out in all different areas that I’ve been getting offers.
Robin Kaplan: Absolutely. And for those of you aren’t in San Diego we have this Facebook page here in San Diego called Breastfeeding San Diego and it’s a closed group and it’s where I see every single day women sharing advice, sharing stories, asking for help and quite often mentioning that either they have extra breast milk or they don’t have as much as they need and just coming out of the woodwork like you said, they’ll just ping someone. And next thing you know, we’re connecting women all over the city. So, I’m sorry if you don’t live in San Diego but that doesn’t mean that maybe your city doesn’t have something similar which is really, really cool. Regula, let me hand the microphone over to you while you’re nursing your kiddos and do you mind talking about what your experience was with donor milk and were you nervous using it?
Regula Schmid: I was very nervous the very first time I used donor milk because I didn’t know the person that well, although I did asked her for all of her lab results during pregnancy. But like Amber was saying, somebody could get infected after those labs were taken. But then I got a lot of donor milk through a local midwife who had known the people for a long time, the women for a long time and had seen all of their labs over years, so that made me feel much more comfortable.
Robin Kaplan: That’s another really good point to bring up too. You never know if your healthcare provider, especially if you’re working with midwives, they see lots of moms and they see them postpartum as well for, you know they still maintain these connections so, that’s a great point. Laura, how about you?
Laura De La Torre: I feel like I’m the minority because I honestly had no concerns using it. We had to start using day two of his life and the person who had donated the milk, it was through also my midwives and so she knew the person very well and had known her and trusted her and I trusted my midwife and my son needed the milk so. I don’t remember having any concerns.
Robin Kaplan: That’s great. How about you Christine?
Christine Schubert: Yeah, I was concerned. So using a very good friend’s milk made me feel a lot better. We’ve known the couple for a long time and I’ve always felt like if you knew the husband only well too you should be pretty safe. So, yeah, and then with the --we switch pretty quickly from the milk bank and I felt very comfortable with that but ---
Robin Kaplan: And we’ll be talking about milk banks in actually just a few minutes, because that’s a really interesting concept of using milk that’s being pasteurized as well. So,
Amber before we take our break, would you say that there are any issues that a mother should be concerned about when accepting donated breast milk for her baby?
Amber McCann: I think you’ve heard me say this again and again. But the question of, is this the right choice for my baby and my family, I think each family have to examine their own thoughts and concerns, ask every single question that’s on their mind and hearts and only step into this kind of relationship with the donating family when you feel really confident in that decision.
Robin Kaplan: Okay, well thank you. When we come back Amber will discuss home pasteurization and the option for purchasing breast milk from a milk bank, so we’ll be right back.
[Theme Music]
Robin Kaplan: And we’re back with Amber McCann talking about a mother’s choice for supplementation when she has a need for additional breast milk most likely because of a low milk supply. So Amber, Dianne West was on the show a few months ago talking about breastfeeding after breast reduction surgery and she mentioned that mothers could actually pasteurized donated breast milk and this was – I knew that they do this for milk banks, but I had no idea that you could do home pasteurization. So, I was curious, what do you think about this and do you think this is a good option for someone who might have those concerns about donor milk and this might make them feel more comfortable?
Amber McCann: Well, I totally think Dianne West is brilliant and so I’m thrilled that she mentioned that option, I totally agree with her that for some moms, still not all, home pasteurization of donated milk is exactly the right choice. We don’t have time in this format to get into a super technical in-depth conversation about all the different ways that milk can be pasteurized. So, we’re just going to focus on what we called flash heating. And HIV is the main concern for most people who are going to choose to flash heat their milk and it can be done really simply on the stove. There is an excellent YouTube video, it’s called Flash-Heating Breast Milk Kills HIV. And it’s by -- great man, right?
Robin Kaplan: Exactly.
Amber McCann: By the UC Berkeley School of Public Health, so we’re not talking just some random people putting this video, these are people who really have studied this. And the process involved making sure all of the utensils are clean, and then we poured the milk into a glass jar, this jar is place in a pot with water and then together, the water and milk are heated very quickly until the water the reaches the rolling boil. At that point you removed the jar’s milk and allow it to cool. It’s a really low tech method and it’s been used all over the world by HIV positive mothers and it can be a really effective method for mothers who are using milk sharing as well.
Robin Kaplan: That’s so amazing. I mean when she mentioned it I was like, that just open up or at least for me thinking about how possible it could be to include that as a possibility for moms when they know that it removes that extra stress of wondering what’s being passed.
Amber McCann: Absolutely.
Robin Kaplan: And additionally to that, what questions should a mother ask her possible milk donor before accepting her milk?
Amber McCann: You know, I mention really having open and honest conversation about lifestyle is really the best way to way to limit your risk. And I would love if every mother considering accepting a donation of breast milk after a copy of the prenatal blood work from their donor. I just feel like that’s a really good step for families. Some families also want to ask about additional lifestyle choices like smoking, alcohol, diet, caffeine, medication usage. There is a really excellent list of questions for donors on the website, www.eatsonfeetsresources.org. They also include a list of questions that donors can ask their recipient families like, how will my milk be used and how long do you anticipated needing donor milk.
Robin Kaplan: That’s really interesting too. So, make sure that’s it’s actually being used appropriately, I mean you figure if you pumped that much out you want to make sure it’s going to a good guys.
Amber McCann: We feel really possessive of our milk sometimes. We have worked really hard and it’s really valuable and a lot of moms want to make sure that they know how their milk is being used.
Robin Kaplan: Absolutely. Ladies, did you find it was difficult at all to come by the donor milk that you ended up receiving, or was it fairly easy? Laura, you’re shaking your head, it was fairly easy?
Laura De La Torre: It was fairly easy, I just put the word out through everyone I knew and also my midwives and Eats on Feets and then the San Diego Facebook page.
Robin Kaplan: Okay, how about you Elizabeth?
Elizabeth Pasimio: It became easy, but in the beginning, it was difficult and stressful and it was like a full time job like driving an hour to get 20 ounces. Yes, I would do that. I was literally driving all over the county for any amount for a period of time until I was able to get kind of a comfortable amount and not driving hour and a half for one or two feedings.
Robin Kaplan: Sure, sure. How about you, Regula?
Regula Schmid: I drove all over the county too and sometimes it was hard because donors would think, they have all these milk and it would be, like you said, it would be 20 ounces that would last a day. So, it was difficult until I came across a donor who had a freezer full, because she had pumped through her premature baby and that pretty much lasted us until I was able to exclusively breastfeed.
Robin Kaplan: How about you, Christine?
Christine Schubert: Well, because it was such a dear friend of mine, she actually would drive to my house and drop it off for the first few weeks. And before we got the milk form the milk bank, so yeah, it was very easy on us to stay home and she brought it over.
Robin Kaplan: That’s wonderful. And that brings up a really good point. I’d like to talk a little bit about milk bank and so Amber, can you – there are probably many of our listeners who have never even heard of a milk bank. So, what is a milk bank and where can it be found? Or where can they be found?
Amber McCann: I have long said if there is one thing in the breastfeeding world that I would totally put on the cheerleading uniform and grab my pump-pump more, it is milk banking. Like I totally believe in it, I think it’s one of the most powerful things we have going for us. In the United States, we’re fortunate to have a number of milk banks associated with an organization called the Human Milk Banking Association of North America. I mean seriously, these milk banks save babies lives every day. They receive donations from mothers, they processed the milk, do pasteurization and they distributed to really critically ill babies all over the country.
These banks have been in the news quite a bit lately and they’re desperately in need of donations. If you are a mother who has milk to donate, please, please, please, please consider whether donating to a milk bank is the right option for your family. They primarily serve very, very sick babies who were in a queue and who are taking tiny quantities of milk each feeding. A little goes a really long way with these babies and a donation can have a really significant impact. The babies who typically received milk from the milk banks though are very different than the babies who typically receive milk through direct milk sharing like we’ve been talking about. But both of these message of getting milk to babies is really important. Well, the vast majority of milk from milk banks goes directly to babies in the hospital, there is a small amount that can be available to healthy babies for a fee. This fee is typically a couple of dollars an ounce but that can add up really quickly when you consider the amount of milk that’s required by a baby every day.
It feels really expensive, but this fee is very reasonable when you consider the level of testing and processing that a milk bank have to do for the milk. One of my very favorite, Neil Patrick Harris spoke about this while he was on the Late Late Show Craig Ferguson a couple of years ago. He and his partner had twins and they were purchasing milk from a milk bank for their babies. Some parents also can receive milk from a milk bank with a prescription from their doctor and that milk might actually be covered by insurance. But in keeping with the mission of the milk bank, the babies who are in critical health are always going to be the highest priority for them.
Robin Kaplan: Okay, and is the milk purchased from a milk bank safer than milk from a donor?
Amber McCann: I really think safer is a bit relative, safer for a baby who has health challenges, is premature, who has a life threatening illness, absolutely. Is it safer for a full time healthy robust infant? May be and maybe not. Milk banks have a process for testing and processing milk that eliminates things that could have a really negative impact on the health of the critical little one, and this is so, so important for those babies. But I liken it to this, if you had a dear friend who recently had an organ transplant, you would do everything in your power to visit them in as healthy a manner as possible. You would scrap your arms and your hands, you’d wear a mask. But if that same friend had just gone through a healthy event like the birth of a baby, you’d probably just wash your hands. So, I think different circumstances required different levels of caution.
Robin Kaplan: Okay, and for moms who are listening, who do have an access of milk and may be don’t have a friend that they would like to offer it to, and they or they’re just -- they would love to deliver it to a milk bank for babies who are critically ill, how can they donate their milk?
Amber McCann: I think any mom who is able to produce more milk than their own babies require should at least consider whether donating to a nonprofit milk bank is the right choice for her. You can find more information about how to donate on the Human Milk Banking Association of North America’s website, it’s www.hmbana.org. They required a donor mothers to be in good health, to not regularly be on most medication or oral supplements that the moms would be willing to undergo additional blood testing, which is at the expense of the milk bank. And would be willing to donate at least a hundred ounces. If this sounds like you, I encourage you to reach out and be involved. Again, the website is www.hmbana.org. You can get more information there.
Robin Kaplan: Cool. And Amber, can you share your favorite resources for helping a mother choose which supplement makes the most for her family?
Amber McCann: As a board certified lactation consultant, my favorite resource for moms asking me this question is another board certified lactation consultant. I think we really have our finger on the pulse of what the options are for supplementation. We can help you sort through all the questions, concerns, help you make a good decision for your family In addition, weighing all your options by visiting the Human Milk 4 Human Babies, Facebook pages and the Human Milk Banking Association for North America’s website can be really valuable. And obviously speaking with a breastfeeding family pediatrician can also be really important.
Robin Kaplan: Well, thank you so much Amber for your insight into supplementing options for a mother who has a low milk supply and for our Boob Group Club members our conversation will continue at the end of the show as Amber will answer a few more questions on this topic. For more information about our Boob Group Club, please visit our website at theboobgroup.com.
[Theme Music]
Robin Kaplan: Before we end our show today, here is Lara Audelo showing tips on how to avoid societal booby traps.
Lara Audelo: Hi Boob Group listeners, I’m Lara Audelo, a certified lactation educator, the retail marketing manager at Best for Babes and the owner of MamaPear Designs. Today we’re here to talk about how you can cheat your personal breastfeeding goals without being undermined by cultural and institutional booby traps.
Let’s discussed and think where it starts, which one your doctor is using. Mother’s often forced to see how well the babies are growing and receiving the milestone on a growth chart from the pediatrician. What you may not have ever thought about is how does this growth start develop the numbers that your baby is being measured against. About six years ago, the World Health Organization released a growth charts which changes our understanding at how babies, breastfed and formula fed grow. Until recently, the growth charts used by pediatricians were based on the sample of formula fed, Caucasian babies born between 1929 and 1975 in Ohio who often starts solid food before four months. These charts were used around the world to chart baby’s growth.
In 2000 the CDC released the chart using a mixed example of breastfed and formula fed and things, which demonstrated that that breast fed and formula fed infant have a different growth pattern. Breastfed babies grows faster than formulas fed babies in the first three months and then between three to 12 months, they reel out in comparison to their formulas fed counterpart. The new WHO charts use a sample of nearly 9000 babies who are exclusively or near exclusively breastfed for the first six months. The WHO is clear that these charts are not intended to apply to just breastfed babies. They can serve as an important early warning to doctors about why is the baby is experiencing excess of weight gain. A particular concern but these babies are at risk of being overweight and obesity.
In 2010, these charts have been recommended by the CDC and the American Academy of Pediatrics. Which will begin using it later this year. Do you know if your pediatrician use this new growth charts? Don’t be afraid to ask, sometime they can take a while for these changes and recommendations to take effect. But the more mothers that ask, the faster that change will occur. A special thank you to Tanya Leiberman, IBCLC providing the booby trap series is the Best for Babes. Visit bestforbabes.org for more feed information about how to meet your personal breastfeeding goals. And my goodness, www.mamapeardesigns.com for breastfeeding supportive wearable. And be sure to listen to the Boob Group for fantastic conversations about breastfeeding and breastfeeding support.
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Robin Kaplan: Thank you so much to our experts, panelists and all of our listeners. If you have any questions about today’s show or the topic we discussed call our Boob Group hotline at 619-866-4775 and we’ll answer your question on an upcoming episode. If you have a breastfeeding topic you’d like to suggest, we’d love to hear it. Simply visit our website at the boobgroup.com and send us an email through the contact link. Coming up next week we have Veronica Tingzon on the show, discussing how a baby’s Oral Anatomy can affect breastfeeding. Thanks for listening to the Boob Group, because mothers know breast.
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This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are believed to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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