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FORMULA 1

Meghan Doherty was born almost two years ago with brain damage so severe that she could not move her hands or legs, had to be fed through a tube and was not expected to live past six weeks.

Today, Meghan is 19 months old, smiles at pop-up picture books and is “improving every day,” said her mother, Debra Doherty, a Milwaukee-area 1st-grade teacher who credits Meghan’s survival to breast milk donated by women she has never met–strangers living hundreds, if not thousands, of miles away.

Doherty, who has four other children, produces her own breast milk for Meghan, but her body can’t make enough to fill the daily needs of her 23-pound daughter. Because Meghan-who continues to be tube-fed-can’t tolerate formulas and dairy products, Doherty buys breast milk supplied by the Mothers’ Milk Bank in Denver, which is shipped weekly to her home in Glendale, Wis.

“It has saved Meghan’s life,” said Doherty.

Although donor breast milk banks are common in Europe and other areas of the world, only six such banks exist in the United States and none in Illinois. Many doctors — not to mention patients — have never heard of milk banks, and insurance carriers often are reluctant to foot the bill for donated milk, which can cost about $600 per week for a typical infant.

Yet, with evidence of the health benefits of breast milk mounting, doctors are increasingly turning to milk banks when mothers can’t provide milk themselves.

To meet this need, new milk banks in Iowa and in Texas are being planned, while a satellite milk program in southern California began in May.

“As more research shows the importance of human milk, especially for the preterm infant, I think there’s going to be more demand [for milk banks],” says Mary Rose Tully, coordinator of the Lactation Center and Mothers’ Milk Bank in Raleigh, N.C., and chairwoman of the Human Milk Banking Association of North America. “The medical outcomes are so much better.”

Dr. Nancy Wight, a San Diego neonatologist who recently started a milk bank satellite program in conjunction with the San Jose Mothers’ Milk Bank, said that studies have shown that donor breast milk is nearly as effective as fresh human milk in reducing infection in premature babies.

In fact, it’s so effective that Wight estimates in an upcoming article she wrote for a medical journal that using donor milk instead of formula for low-birth-weight preemies at her hospital would save money, because these babies would spend less time in the neonatal intensive care unit.

Not only do breast-fed babies — whether fed by fresh milk or donated milk — have a better chance of avoiding illnesses like urinary tract infections, Wight says in her article, but tests also show they have higher IQ scores and better visual development than formula-fed infants.

“Although fresh mothers’ milk is best, banked donor human milk can save lives, reduce morbidity and save health-care dollars, while helping to ensure optimal physical and neurologic development,” writes Wight. Donor milk banks work much like blood banks. Donors are screened, undergo blood testing and provide a medical history. The donated milk is pasteurized to kill viruses. Although this process reduces some of the effectiveness of breast milk, it still retains much of its nutrient value and unique infection-fighting properties, Tully said.

Some milk banks are able to separate their milk into specialized categories, depending on the types of donors they have. For example, the Mothers’ Milk Bank at Denver separates its milk into “preemie” and “non-preemie” milk because mothers who have given birth to premature infants produce milk that is significantly different from that produced by mothers who carried to term. The Denver bank also separates milk from mothers who are on non-dairy diets, so that recipients who are dairy-sensitive can receive dairy-free milk.

Milk banks used to be more prevalent in the U.S. In the 1970s, there were about 30 banksbut in the mid-1980s, the fear of AIDS transmission, plus the development of commercial formula for premature babies, closed most of them. However, the pasteurization and testing processes donor milk undergoes today has eliminated the possibility of transmission, said Tully.

Besides preemies and infants with special needs, other types of donor milk recipients include adults with various medical conditions, such as liver transplants, adopted babies and older children with food intolerances and gastrointestinal problems.

Courtney Asprodites, for example, nurses her adopted 11-month-old Vietnamese daughter, Chloe, with a combination of donated breast milk as well as her own milk, which she was able to produce through a process called “relactation.” Asprodites, 33, an attorney and social worker in Baton Rouge, La., had given birth to her son four years before, and because she had breast-fed him, her body was able to be prodded into producing milk again through repeated uses of a breast pump. However, she can’t make quite enough milk to meet Chloe’s needs, and relies on donated milk as a supplement.

Asprodites feeds Chloe using a feeding device with small tubes taped to her breasts, attached to a bottle of donated breast milk. When Chloe nurses, she takes in her mother’s milk first; if Asprodites’ breast empties before Chloe is finished, the feeding device automatically begins pumping the donated milk through the tubes into Chloe’s mouth.

Because Chloe does not tolerate artificial formula, which gives her constipation, gas and eczema, Asprodites said that having donated breast milk as a supplement to her own milk has “made a huge difference in Chloe’s quality of life.” In fact, Asprodites has become such a fan of breast milk banks that she has decided that if she has another biological child that she will donate her extra milk.

Most women donate their milk for altruistic reasons, said Tully. After all, donors aren’t paid, and also must put up with having a blood test and filling out medical history forms. They can’t smoke or drink alcohol while donating; nor can they use many medications. Even caffeine consumption is limited.

Nevertheless, Debra Desrosiers, an Austin, Texas, day-care center director, chose to donate her milk about a month after her son was born. She was inspired by a TV show featuring a woman whose child’s life had been saved by donated breast milk. “I had my baby in my arms at the time,” said Desrosiers. “This just moved me so much — I knew it was something I had to do.”

Desrosiers was able to bring her milk to the Mothers’ Milk Bank of Austin, only a few miles away. Other donors must ship their milk much farther.

Jennifer Ayala, a 31-year-old grocery store manager in Clemmons, N.C., first began donating her breast milk when she lived in Round Lake, Ill. and developed mastitis following the birth of her son. The remedy for her breast infection was to pump frequently, so Ayala soon found herself with two full refrigerator-freezers plus a packed stand-alone freezer — much more milk than her baby could possibly consume. Ayala then discovered the North Carolina milk bank and shipped out several coolers of stored milk. “I was like: `Whew! We can finally buy frozen food again!'”

After moving to North Carolina, Ayala had another baby, again developed mastitis and again donated her extra milk. To do so, she went to her family doctor for the necessary blood test, only to find that the doctor had never heard of the milk bank, located just 90 miles away.

Indeed, many doctors are uninformed about milk banks, said Dr. Lawrence Gartner, a retired neonatologist in San Diego who is professor emeritus at the University of Chicago and serves as chairman of an American Academy of Pediatrics committee on breast-feeding.

“Among the great majority of practicing pediatricians, it’s probably not even known to most of them that [milk banks] exist,” said Gartner.

Ana Mejia-Dietche, director of the Mothers’ Milk Bank at Austin, said that even doctors who know about milk banks don’t always understand how they work. Some of the bank’s recipient mothers, she said, “have had to convince their doctors to prescribe the milk. There is some resistance. Some doctors are not that familiar with how carefully milk banks screen donors, that our milk is pasteurized. A big issue is safety.”

Cost is another factor. Banks charge a processing fee of $2.50 to $3 per ounce for milk they provide, yet this represents only about half their costs, say milk bank directors, who rely on charitable donations to make up the difference. Still, it can be a hefty tab for a typical recipient becausean infant might be expected to consume 28 ounces per day, or 196 per week, said Tully. If an infant were to receive donor milk for six months, the bill could reach $15,000.

“Yes, it’s expensive,” said Gartner. “But it’s useful and important.”

MILK BANKS IN THE U.S.

Here is a list of milk banks operating in the U.S., all of which are members of the Human Milk Banking Association of North America (www.hmbana.org). The Raleigh and Denver milk banks are most active in shipping milk across the country, while others, such as the Austin bank, are more regional in nature.

Jean Drulis, program associate at the Fomon Infant Nutrition Unit at the University of Iowa, said a milk bank is being planned to serve infants at the University of Iowa Hospitals and Clinics, which may open as early as January, depending on funding. “Our ultimate goal is to supply all preemies in Iowa,” said Drulis, but there are no plans to ship milk nationally.

– Mothers’ Milk Bank

Valley Medical Center

San Jose, Calif.

408-998-4550

– Mothers’ Milk Bank

P/SL Medical Center

Denver, Colo.

303-869-1888

– Lactation Center and Mothers’ Milk Bank WakeMed

Raleigh, N.C.

919-350-8599

– Mothers’ Milk Bank

Christiana Care Health System

Newark, Del.

302-733-2340

– Regional Milk Bank & Breastfeeding Center University of Massachusetts Memorial Health Care

Worcester, Mass.

508-334-6005

– Mothers’ Milk Bank of Austin

Austin, Texas

512-494-0800