Kenya's first human milk bank has opened at Pumwani Maternity Hospital. Moina Spooner, from The Conversation Africa, spoke to the team spearheading APHRC's research efforts in the establishment of Kenya's first milk bank.
Human milk banks collect, pasteurise, test, store, and distribute donated breastmilk. NataBU/Shutterstock
How long has it taken to open? What were the biggest obstacles?
The process of establishment of human milk banking in Kenya started in 2016. It was spearheaded by the NGO PATH, in partnership with APHRC and Kenya’s Ministry of Health, among other partners. It was rolled out in two phases.
During phase one we assessed people’s perceptions and acceptability of using donated human milk. We also looked at how feasible it would be to set a bank up. The results were encouraging. About 90% of participants were positive about it, 80% would donate their breast milk, and about 60% indicated that they would allow their children to be fed with donated human milk.
A committee was also set-up to provide oversight and guidance on human milk bank work in Kenya. They were sent to South Africa to learn more about the human milk banking process. Finally, local strategies were developed.
We are now in phase two of the project: the establishment of a pilot human milk bank in Pumwani Maternity Hospital. This includes the launch of a research project which examines its feasibility, effectiveness, acceptability and aims to estimate the cost of establishing an actual human milk bank in Kenya.
There have been challenges. Being a new concept, there have been some logistical challenges, for instance some of the equipment wasn’t locally available so it took longer to get it all done and installed.
There have also been concerns by some community members and health workers over the safety and quality of the donor human milk.
However, we’ve had support from the government which has been critical in addressing the logistical challenges. Advocacy and communication activities are also being rolled out to create awareness on human milk banking and address any concerns.
What is a milk bank and how does it work?
Human milk banks are facilities that systematically collect, pasteurise, test, store, and distribute donated breast milk.
An effective system has many operational processes to ensure it provides safe, high quality donor milk. They start with screening and recruiting donors who must be healthy mothers with surplus milk beyond the needs of their own child’s. Donors must undergo health checks including tests that screen for HIV, syphilis, and hepatitis B and C. Diseases could be passed to children through breastmilk.
Donors must then express milk in hygienic conditions, after which the milk is pasteurised. This involves heating the milk in a water bath at 62.5°c for 30 minutes followed by rapid cooling.
At the bank, the milk is frozen and stored at -20c. When needed, it’s thawed to room temperature and issued to children who don’t have access to their own mothers’ milk. A prescription by a qualified health professional is needed for this.
Why are they needed?
Although breastfeeding is the most natural and best way to feed infants, many babies may lack access to their mother’s milk. This could’ve happened for many reasons – maybe the mother is sick, hasn’t got enough breast milk or is dead.
From our formative research, 44% of newborns in urban health facilities were separated from their mothers for varying periods of time. This ranged from less than an hour to more than six hours and even days after birth. Of these infants, only 14% were fed on mother’s own milk during separation. 36% of the newborns weren’t fed on anything during this period and an additional 23% were fed on formula or cow’s milk.
When breastfeeding is not an option, the World Health Organisation (WHO) recommends donated human milk as a lifesaving alternative. Particularly for babies that were born early, have low birth weight, are orphaned, malnourished or are severely ill.
The Conversation Africa The Conversation Africa is an independent source of news and views from the academic and research community. Its aim is to promote better understanding of current affairs and complex issues, and allow for a better quality of public discourse and conversation. Go to: https://theconversation.com/africa
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