Influencing Feeding Practices in Very Preterm and Very Low Birth Weight Babies in an Area where there was No Human Milk Bank

Background: There is overwhelming evidence demonstrating the benefits of usage Pasteurised Donor Human Milk (PDHM ) over Formula Feeds as an alternative to Mothers Own Milk ( MOM ) for Very Preterm ( < 32 weeks GA ) and very low birth weight infants (VLBW; < 1500 g). We aim to describe feeding practices in these babies after starting 1st Human Milk Bank in the city of Bengaluru, India which has 42 NICUs.

Objective: To advocate the use of PDHM as an alternative to MOM to Very Preterm and VLBW Neonates in various NICUs in the city of Bengaluru, India.

Methods: Amaara Public Human Milk Bank was established by Breast Milk Foundation, a not for profit NGO, at Fortis La Femme Hospital in October 2017 as Bengaluru’s 1st Public Human Milk Bank. Invitations were sent out to all the NICUs and CMEs were conducted for Neonatologists, Obstetricians & Lactation Consultants in the city to help identify voluntary donors and sensitize the professionals, the concept of Human Milk Banking, to promote the usage of PDHM in NICUs. HMBANA & NICE guidelines were followed for screening, procuring, pasteurization, storage & dispersal of PDHM. Upon receiving the prescription from Neonatologists from various NICUs, PDHM was dispensed to the NICUs with printed instructions and guidelines. Usage of PDHM was studied over the next 15 months.

Results: Total of 96 donor mothers voluntarily donated 391,115 ml of DHM. 297,700 ml of Pasteurised Donor Human Milk was supplied to 38 NICUs benefiting 142 very preterm/ VLBW babies. No adverse events reported from any of the NICUs following usage of PDHM. In these 38 NICUs usage of PDHM as an alternative to MOM for Very Preterm and VLBW Neonates has become a regular practice, hence improving Neonatal Outcomes in the City.

Conclusion: In a developing country like India more such Public Human Milk Banks should be set up to promote the use of PDHM as a substitute for MOM to improve Neonatal Outcomes in Very Preterm and VLBW Neonates.