Wednesday, 13 August 2014

Milk of human kindness (News Article on http://www.telegraphindia.com)

Milk of human kindness

Human milk banks are poised to sprout nationwide. Against the backdrop of world breastfeeding week (August 1-7), Smitha Verma explains why
The two-room enclosure at the end of a long corridor is a picture of calm, a far cry from the hustle and bustle of a weekday morning in one of the busiest municipal hospitals in Mumbai. An attendant pores over a register while another stands in front of small, neatly lined, steel containers in a deep freezer. The unit, which would otherwise not warrant a second look, is the life line of the neonatology department.
This is the human milk bank at the Lokmanya Tilak Municipal Medical College and General Hospital (LTMMCGH) in Sion. Every day it saves the lives of over three dozen newborns in the hospital.
"A human milk bank is vital for premature babies who require temporary intervention in cases of delayed lactation, illness of the mother or even abandonment," says Jayashree A. Mondkar, professor and head, department of neonatology, and director of the Human Milk Bank. Equipped with two pasteurizers, a hot air oven and half a dozen electric breast pumps, the milk bank collects around six litres of milk from lactating mothers every day.
The bank, Asia's first milk bank, is 25 years old. Yet, milk banking is still in its infancy in India, with the concept of donating milk never having really taken off. This may change in the near future, though, with the health ministry finalising guidelines in June this year for setting up more such banks.
A few are already functioning, and some more are on the anvil. Later this month, the first milk bank facility in Jaipur will be opened at the Mahatma Gandhi Hospital by the non government organisation (NGO) Inaya Foundation. In June, Jaipur's JK Lon Hospital, the state's biggest child specialty government hospital, signed a memorandum of understanding with Norway's Oslo University Hospital to open a human milk bank. Earlier this year, a similar initiative was undertaken in Udaipur. Last August, a public sector human milk bank was inaugurated in Calcutta and another bank opened in Pune in September.
Mother's milk, experts stress, can save a newborn's life. And India accounts for 20 per cent of infant deaths globally. Over half of these deaths are of babies under 28 days old. The World Health Organization recommends breastfeeding within the first hour of birth as one of the measures to combat infant mortality. "Breast milk provides an infant with unique antibodies for fighting infections," Mondkar explains. "Formula feed will rarely be required if we have milk banks in all hospitals," she adds.
In many developing countries, milk banks are being promoted to combat infant mortality. Brazil, which has close to 200 milk banks, had an under-five mortality rate of 14 per 1,00,000 live births in 2012, as opposed to India's 56. "Ideally, every neonatal intensive care unit in a hospital should be equipped with a milk bank," says Armida Fernandez, retired professor of neonatology and founder of the milk bank at LTMMCGH.
It was while on a fellowship trip to the United Kingdom in 1987 that Fernandez spotted human milk banks in Birmingham and Oxford. "I learnt how scientifically they store the milk and promote breastfeeding. I pledged to open a similar unit in Mumbai," she says.
It wasn't an easy task. The initial funding for the project came from the Taj Group of Hotels but when the funds ran out Fernandez approached the Municipal Corporation. "A corporator asked me, how can one woman's milk be given to another's child? I asked, 'How can milk of another species (animal) be given to a human?' The corporator was speechless and I got my funds sanctioned for setting up the facility," Fernandez recalls.
But for close to two decades no other hospital thought of opening a milk bank. Then, in 2005, Mumbai's KEM Hospital opened one which was soon followed by similar facilities in cities such as Surat, Pune, Ahmedabad, Vadodara and Chennai. Today there are 14 milk banks — five of them in Mumbai alone.

"This facility is a boon for mothers who can't breastfeed," says Rajshree Dayanand Katke, medical superintendent, Cama & Albless Hospitals, Mumbai, which started a milk bank in 2007. In 2010, around 4,000 women donated milk which benefited close to 5,000 infants. "On an average we are able to collect 1.5 to 2 lakh ml milk per year," Katke says.

The milk collected (with the help of breast pumps) from donor mothers, who are pre-screened for various diseases such as HIV and hepatitis, is pooled, cultured and then pasteurized for half an hour. It is then frozen at minus 20 degree Celsius, for milk thus stored can be used for six months. "But usually our stocks last not more than 10 days. We never have any surplus," Mondkar says.
Though not a cost-intensive project, the limitations of setting up a milk bank arise from finding donors — and in convincing mothers to give another woman's milk to their infants. "Often lactating mothers are worried that milk for their own child will be less if they donate," says Sunanada Suryavanshi, a lactation management nurse at LTMMCGH. Suryavanshi counsels close to 200 lactating mothers a week about the benefits of donating milk.
One such counselling session prompted Mumbai resident Nirmala Jogu to donate milk voluntarily for close to a year while she breastfed her child. "I used to express the milk and keep it in a deep freezer. Then once a week my husband used to deliver it to LTMMCGH," says the 31-year-old event manager. "I have counselled many of my friends about this noble endeavour," Jogu says.
Many women need to be counselled even for accepting another woman's milk. "Some people are apprehensive about taking milk from a woman belonging to another community," Nitisha Sharma, general secretary of the Inaya Foundation, says. "So we have to make them understand the benefits of a breastfeed over formula milk," Sharma says.
To create awareness, the Divya Milk Bank in Udaipur has started organising camps in colleges. "The government is yet to take this up as priority. And for corporate hospitals, this is not a money-making venture," says Devendra Aggarwal, founder of Divya Milk Bank, rueing the dismal number of milk banks. The bank's staff also asks lactating women in nearby areas to donate their surplus milk.
"We believe donors can persuade other mothers to donate," adds Aggarwal, whose NGO spent Rs 20 lakh to set up the facility.
The NGO followed the guidelines of the Human Milk Banking Association of North America, because India had no rules in place when the Divya Milk Bank was set up. But now, India is on its way to forming its own guidelines for establishing and operating human milk banks.
In June, the Infant and Young Child Feeding Chapter, Indian Academy of Paediatrics and the Union ministry of health and family welfare organised a consultative meet with various stakeholders for framing guidelines. These deal with various aspects of human milk banks such as their location, infrastructure, equipment, administrative staff, donor population, collection of breast milk and storage.
Fernandez hopes that more milk banks will open with the government showing an interest in the sharing of human milk. "We should have human milk banks just like blood banks," she says.

Reference Link
http://www.telegraphindia.com/1140810/jsp/7days/18706045.jsp

Tuesday, 12 August 2014

More than 10000 babies benefited from milk centre in city

More than 10000 babies benefited from milk center in city


As part of initiatives to promote breastfeeding, four hospitals in the city are running human milk bank, which store milk from healthy mothers to be used later to feed babies who are not able to get the same.
The milk center, started by Dr Armida Fernandez, is Asia’s first Human Milk Bank.
The milk center is operating in four main hospitals, namely JJ Hospital, Cama, KEM and Sion Hospital.
These centers provide milk to 10 to 20 premature and sick babies everyday.
The milk donors are generally mothers who have surplus milk or give birth to stillborn infants.
Medical tests are first conducted to exclude donors with HIV or AIDS.
The milk is expressed with a suction machine and then transferred to storage containers.
Each pool (three to five donors) of milk is thoroughly mixed. Then, six-ounce glass bottles are filled with the milk prior to pasteurization.
The milk is pasteurized at 65°C for 30 minutes and then frozen at minus 20°C.
It can last up to six months and is a boon for sick and abandoned babies.
About 12,000 babies are born in these hospitals every year and mothers agree to donate breast milk after intensive counseling.

“The centre has helped more than 10,000 babies now since its inception. We store about 600 to 800 mililitre milk in each centre and the babies who require the milk are provided with the same until six months,” said Dr Rajshri Katke, a gynaecologist at the Cama Hospital.

Reference Link
http://www.asianage.com/mumbai/more-10000-babies-benefited-milk-centre-city-680

Friday, 1 August 2014

Media vital to promote breastfeeding (New Article in www.afternoondc.in)

Media vital to promote breastfeeding

Friday, August 01, 2014
By Abhishek Vissapragada

The World Breastfeeding Week is underway and the theme for this year is 'Breastfeeding: A Winning Goal - For Life!' which asserts the importance of increasing and sustaining the protection, promotion and support of breastfeeding

While most of us are aware of breastfeeding and how it helps the mother and the child, doctors feel that more can be done to create awareness about it.

Dr Suman Bijlani, online consulting gynaecologist at gyneguide.com felt that it would be a good idea to have awareness campaigns about breastfeeding in Mumbai. “Yes, there is a lack of awareness and, more so, about the techniques of breastfeeding as I have seen women coming to me with queries about how to breastfeed their baby. At times, even after explaining, the instructions are not well adhered to,” Dr Bijlani said.

“But by and large, today's women are more receptive to the idea of breastfeeding because they get motivation from their family to do so,” added Dr Bijlani.

Dr Rajshri Katke, Medical Superintendent of the State-run Cama and Albless Hospital, who feels that though the Indian culture encourages mothers to breastfeed their children and make them aware about the benefits of breastfeeding, the younger generation in Mumbai needs awareness campaigns about breastfeeding.

Speaking about the improved scenario, Dr Bijlani added, “Earlier there wasn't any motivation for women from their families. The media didn't give much coverage to this issue. Even the doctors didn't feel the need to educate women about breastfeeding. But today, the scenario is different. Among the educated class, people are motivating mothers to breastfeed their children.”

According to Dr Katke, people have always known about the benefits of breastfeeding, but these days awareness is more with regards to how it is beneficial for not only the baby but also the mother.

According to Dr Bijlani, the media can play a big role in making women aware about breastfeeding. “Television can make a better impact wherein celebrities can endorse and promote breastfeeding. Social media is also another medium through which awareness campaigns can be conducted,” said Dr Bijlani.

Common myths
  •     Colostrum, the first milk secreted after birth, is not good
  •     A mother may not have enough milk to feed the baby
  •      A mother loses her figure
  •     Pumping is a good way of knowing how much milk the mother has
  •     Feeding should be done according to a schedule
Basic techniques
  •     Baby should be breastfed within the first hour after normal delivery and after three or four hours of a caesarean delivery
  •     Sit in a position that will not tire the mother
  •     Latching method ie the baby should get the entire area of the breasts to suck on and not just the nipples
  •     Women should feed the baby from one side of their breasts at a time
  •     Exclusive breastfeeding is good for the first six months

 Reference Link
http://www.afternoondc.in/city-news/media-vital-to-promote-breastfeeding/article_116325