Donor Breast Milk Gives Preemies A Fighting Chance
More than 6,000 babies are delivered annually at Wesley Medical Center in Wichita, 1,000 of them require special care. And for a certain at-risk population in the Neonatal Intensive Care Unit even more care is needed. KMUW’s Abigail Wilson reports…
Babies in the Neonatal Intensive Care Unit (NICU) at Wesley Medical Center lie in tiny incubators attached to feeding tubes and ventilators. The smallest bundles of life--some would fit in the palm of your hand--are wrapped in pink and blue blankets wearing knitted hats. The room is quiet except for the beeping and humming of machines.
"Any one who's born before 35 weeks typically needs intensive care for a period of time, with 40 weeks being full-term," says Dr. Barry Bloom, a Neonatologist and the Medical Director of the Wesley NICU. "So five weeks early or more need to be in the ICU until they mature enough to maintain their own temperature and gain weight and learn how to eat."
About 200, or a fifth of the babies here, were born weighing less than three pounds--too small for newborn "onesies" and jackets.
"This unique population that we're looking at--the smaller babies--tend to have complications with feeding, specifically necrotizing enterocolitis which is where the bowel becomes damaged," says Bloom. "Sometimes the babies actually lose a portion of their bowel because surgery has to be done and some of that sick bowel has to be taken out."
These micro-preemies, as they’re called, are not spending the time with their mothers that healthy babies would. Other couples carefully carry swaddled bundles to their cars, strapping them into safety seats for their first trip home, while these moms carry only their overnight bags. And a breast pump.
"Many of them are not prepared because their babies are born early or the babies are ill," explains Bloom. "So the mom’s interaction with the baby which would stimulate adequate breast milk production is insufficient."
Parents have unrestricted visitation to the NICU, but the intensive care unit is not an environment where a mom can constantly hold and snuggle with her newborn baby, encouraging breastfeeding. And limited contact time interferes with a mother’s milk production because the baby is not suckling and the mother’s brain gets mixed signals. Dr. Bloom says the benefits of breastfeeding are well documented for all babies.
"They have a better muscle-mass-to-fat balance in their body. They have lower incidence of infection, both short-term and long-term and less heart disease long-term," he says.
A program recently put in place at Wesley can help these preemies grow and avoid bowel complications. It’s called the Wesley Milk Donor Program. The program gives the infants access to pasteurized human-based milk that their mothers might not be able to provide.
"We're targeting the highest risk population for that bowel disease and we're feeding them during the period of time when they are most likely to develop that condition and trying to avoid any cow-based protein products," Bloom explains.
Simply put, rather than giving babies the traditional formulas when the mother’s milk supply is lacking, the infant is fed a product made using human breast milk donated from other lactating women who have an excess supply. Bloom acknowledges that for some parents the idea of feeding babies someone else’s breast milk can seem a little strange.
"In the past, for some reason, we were desensitized to drinking cows milk but sensitized to human milk; that somehow that would be weird or odd," he says. "I think in the last 20 years a big shift has occurred with human-based-products versus cow-based-products and it's clear that the human-based products are better for babies."
Women hoping to donate breast milk are screened for things like HIV, syphilis and medications. Donors are supplied with storage bags, ice bricks and an insulated cooler to ship their milk to a company called Prolacta Bioscience. Scott Elster is the CEO of Prolacta. He says the company produces what’s called standardized human milk from the donated supply.
"At Prolacta Bioscience we produce very large-scale batches and those batches are made up of hundreds of moms donations. The way a blood bank works - where donations are given credit and the blood is sort of used where’d it’s needed is exactly how Wesley’s works."
So the breast milk a woman in Wichita donates might not be used specifically at Wesley, but the donors can designate what hospital gets credit for her milk.
"There’s a Wesley milk bank and she comes through that milk bank and her donation is always tagged to Wesley," Elster explains. "So then all the milk that’s brought in is tracked and Wesley gets credit for all of that."
So far, ten women have gone through the screening process to become qualified breast milk donors for Wesley. The hospital has committed to spending up to three-quarters of a million dollars every year going forward to continue the program. That being said, Prolacta forecasts hospitals will save more than $8,000 per infant if their product is used.
"The total cost on the Prolacta arm include the cost of Prolacta's product. The savings come from the reduction in surgery on these tiny micro-preemies," says Elster.
The cost of the donor milk to the hospital, though, is a per ounce cost based on the product Wesley orders. The list price is $14 per ounce. If this was the price for a gallon of regular cow's milk, it would cost over $1,700/gallon.
The hospital’s contract with Prolacta is volume driven, so the price is lowered as the amount of milk-product ordered increases. Eventually, with enough growth in the program more babies than the current targeted population could have access to a fortified human-milk based product.
Originally aired during Morning Edition on 11/25/14.