Sahju Joshi, 36, was devastated when she lost her baby girl on March 21. “She was just 35 days old, we took her to the All India Institute of Medical Sciences for the best possible care, but the doctors couldn’t save her,” says Sahju, a homemaker who lives with her husband and his extended family in the middle-class neighbourhood of Janakpuri in west Delhi.
Joshi, who has no other children, slipped into a depression until her husband Om Prakash threw her a lifeline. “He showed me a newspaper advertisement that urged lactating mothers to donate milk for premature babies whose mothers were not able to feed them,” Sahju says. “I couldn’t save my baby, I didn’t want other mothers to experience my loss.”
So Sahju called the listed number and became a donor, using a pump to express milk that she stored in sterilised bottles sent over by the human milk bank.
“I don’t know who my milk went to, but helping another sick baby made me happy. It gave me something to look forward to each day,” Joshi says.
Sourcing pasteurised milk from a human milk bank sounds like a nutrition fad, but it is far from that. More than 15 million babies — or one in 10 — are born “too early”, or before 37 weeks of gestation, estimates the World Health Organisation.
With preterm birth complications being the leading cause of death among children under 5 — one million premature babies die globally every year — donated breast milk becomes a vital lifeline.
Of India’s 25 million births, 3.5 million are preterm, of which 300,000 die of associated complications. Breast milk can save 156,000 of these children from dying each year.
“Banked human milk is the next best thing after the biological mother’s milk. Since mothers of very premature babies — some born before 28 weeks — may not lactate at the start, banked milk becomes an incredibly precious nutrition source that boosts recovery,” says Dr Raghuram Mallaiah, head of neonatology at Fortis La Femme, which runs a not-for-profit milk bank called Amaara.
The milk banked at Amaara is for medical use only, to feed premature babies who weigh less than 1.5 kg (anything below 2.5 kg is termed ‘low birth weight’) or are growth-restricted. “We opened in the end of April and have collected 90 litres already, 45 litres of which has been used across our hospital and others,” says Dr Mallaiah.
One of the beneficiaries has been Sunanda Arora’s as-yet-unnamed baby girl. Her premature birth at 32 weeks had her doctor recommend Amaara immediately. “Sunanda’s last baby was also premature and was given formula milk, but since she had the option this time, she chose donor milk,” says Dr Mallaiah.
Human milk is widely used in neonatal intensive care units (NICUs) globally, to treat premature babies who may suffer from disorders of malabsorption, short-gut syndrome, intractable diarrhoea, nephrotic syndrome, congenital anomalies, formula intolerance, failure to thrive or immune deficiencies. It also protects against necrotising enterocolitis (NEC), a fatal condition in premature babies in which portions of the bowel undergo tissue death. Newborns given donor milk are three times less likely to develop NEC, studies show.
Yet India has just 18 milk banks, with indeterminate milk collection, compared with 16 in the UK and 220 in Brazil.
“Many new mums want to donate; they just don’t know how to do it and where to go. If banks overcome the logistical challenges of transporting milk safely from the donor’s homes to hospitals, all newborns could get enough milk,” Dr Mallaiah says.
Even some full-term babies don’t get adequate human milk.
“Some mothers can’t lactate at the start, and mother’s milk is the perfect mix of vitamins, proteins and fat in an easily digestible form to help your baby grow and fight infections,” says gynaecologist Kanika Khanna.
Babies breastfed exclusively for six months have been found to have fewer allergies and chest, stomach and ear infections. “India has accordingly launched the MAA (Mothers’ Absolute Affection) programme to promote starting breastfeeding within one hour of birth, doing it exclusively for first six months,” says CK Mishra, secretary at the union ministry of health and family welfare.
The good news is, any healthy mother can donate.
“For the first six months, a healthy mother produces more milk than her baby needs, so she can safely donate a few millilitres a day to help out another mother,” says Dr Jayashree Mondkar, head of neonatology at Mumbai’s Sion Hospital and director of its milk bank.
Universal Donor: A mom of preemies pitches in
Keeping up with her two young children — 10-month-old Priya and 2-year-old Rohan — keeps Emily Bild (above) on her toes all day, but she takes time out each morning to express milk and store it in the freezer.
“Both my children were premature and spent some time in the NICU, the girl for two weeks because she came seven weeks early,” says Bild.
“I was lucky as I could express more than enough milk and feed them, but some mothers aren’t, so when I saw an ad for the milk bank in the newspaper, I decided to donate,” says the Delhi-based Bild, 39, who works for a non-profit organisation.
She started in July, and has been using a pump every morning to fill up one 150 ml bottle a day. “Twice a week, the milk bank sends a runner with sterilised bottles that he exchanges for filled ones I take out from the freezer. They go back to the bank in a cold box; it’s a very efficient system,” Bild says.
She plans to donate for another two to three months. “I’ll donate as long as I’m feeding my daughter, who will be a year old in a couple of months,” she says. “My babies are healthy. I’m happy I can help others too.”
India’s oldest human milk bank
In 1989, Dr Armida Fernandez opened a human milk bank at Mumbai’s Sion government hospital that was the first of its kind in Asia.
This hospital treats some of the poorest of the poor, and Dr Armida realised that many of the women who gave birth here were so severely malnourished that they could not produce enough milk.
So she decided to take from the milk-rich to give to the poor.“Every day, we doctors come face to face with some of the tiniest and sickest babies in the city. The milk bank was our way of trying to make sure that each of these babies is fed human milk,” Dr Fernandez says.
The Sion milk bank began with about 10 women donating 28 ml a day; it now gets donations from about 38 women every day.
Among the most dedicated of these has been a new mother named Nirmala Jobu. “She donated for eight months in 2014 because she wanted to do something for sick babies,” says Dr Jayashree Mondkar, head of neonatology at Soin Hospital and director of the milk bank
Healthy lactating mothers can now donate milk to any of four milk banks in Mumbai — there are also banks at the JJ, KEM and Cama hospitals.
This milk is available free to premature babies whose mothers cannot feed them, or for mothers with transmittable diseases who cannot breastfeed. The Sion hospital milk bank alone benefits 3,000 newborns annually.
(With inputs from Shweta Verhani)