I have heard many questions from moms over the years about what to use in a situation where they don’t have enough milk to feed their babies. I do not support formula companies. However, I don’t support homemade formulas either. Neither can come up to the specificity of human milk for human babies.
What I DO support is milk banking. This can be done for your own child or for others. Proper handling, labeling and storage of the milk makes this process more useful. Here are a few helpful hints.
- Set out to have an excellent supply. That means the first hour after birth is critical for baby getting the most volume – and studies are now beginning to show that moms whose babies nurse well in the first hour (or who start pumping and hand-expressing right away if baby can’t nurse) have more abundant supplies and are less vulnerable to negative events later on in their lactation. Make sure your support person is on the same page with you in helping you achieve that early stimulation and milk removal. Mothers who get 30 sessions of effective breastfeeding or hands-on pumping within the first 3 days of birth have twice as much milk at 10 days after birth as those who have less breast stimulation and removal of milk. This has been found in more than one study.
- Pay close attention to your baby’s effectiveness in the first four weeks. If baby is not removing milk well during this period of time, the breast will reduce milk production capacity and possibly storage capacity as well. If your baby is not removing milk well, using a breast pump after morning feedings and before bedtime can help protect your supply. If your baby is not nursing effectively, please see a skilled lactation consultant for assessment. Medical-grade rental breast pumps (such as the Symphony) are generally more effective in setting up a high supply than personal pumps, which are designed to maintain supply once lactation is established and a healthy baby is nursing.
- Store your precious milk carefully. Most women use plastic bags for storage. Use bags that are thick enough and have wide enough seams to reduce breaking and leaking during thawing. Don’t over-fill bags. Get as much air out as possible and lay bags flat for freezing. Label with at least the date of pumping. Use a sharpie on part of the bag that is not in contact with the milk (on the edges) or use a piece of tape for the label. Ink written directly on plastic will leach into the milk inside. Once bags are frozen solid, they can be stacked vertically in a plastic shoe box to keep in order in the freezer. Caution: plastic milk bags that are over-filled or have thin seams can break during freezing or when transporting in the frozen state. When stacking horizontally, put a layer of paper or plastic between rows of bags. If you are shipping milk through Fedex, contact them for information. Styrofoam lined shipping boxes with dry ice can be used to ship milk overnight. Layers of bags should be separated by cardboard or thick paper to prevent puncturing each other during transport.
- Think about how much to store and when to share. To avoid wasting milk, don’t put too much in a bag – a maximum of 5 ounces. If you are pumping a couple of ounces at a time, you can add to a previous amount until you get your desired amount, as long as it is all obtained within 48 hours and kept refrigerated until frozen. The best place to store milk is in a separate deep freezer that is not opened frequently. Regular freezers should be turned as low as possible, to the point that ice cream is frozen solid. Do not store your milk in the door of the freezer. Some moms start out storing a lot of milk because they have babies with nursing difficulties. Once those babies have overcome their difficulties, moms find they don’t need the extra stored. At that point, sharing becomes a possibility, and sometimes even a necessity when freezer space becomes low!
- What about formal versus informal milk donation? Milk banks have requirements for moms since their customers are NICU’s with very tiny, vulnerable infants whose very survival depends on milk donation. Milk sharing done between healthy moms with healthy babies can be a little more relaxed. Some medications that are OK for nursing moms may be acceptable for another nursing mom – but unacceptable for a tiny medically vulnerable baby. Eats on Feets, Human Milk for Human Babies and other mother-to-mother sharing sites can help re-distribute milk from moms who are not eligible for milk bank donation to moms whose babies are not eligible for receiving banked donor milk. Tennessee is establishing it’s very first Mother’s Milk Bank. Here’s a link to find out more about how to donate and how to help. UPDATE: 2 Local donation sites are now available – in Nashville at Meharry General Hospital and in Memphis at Regional One. More donation sites are expected to come on line. Check the Mother’s Milk Bank site for more info. http://mothersmilkbankoftn.org/