A gift of life

World's second most densely populated city has just seven human milk banks. As World Breastfeeding Week begins on August 1, city doctors reiterate the need to donate

"I had a premature delivery in the seventh month. I lactated for two days and then it stopped. We were advised to start using donor milk for my daughter. I was tense about whether I would ever be able to feed my baby. I felt sad, too, and wondered, 'if other mothers can, why can't I?' I was also scared for the baby's health. But after 10 days, my baby's weight increased and I realised that it's fine. I was counselled, too, and that helped me start lactating," says 20-year-old Govandi resident Nilofer Shaikh Munawar, who delivered at Lokmanya Tilak Municipal Medical College and Hospital, Sion (LTMGH). Like Shaikh, 30 to 50 per cent of babies at the Neonatal Intensive Care Unit (NICU) and 10 to 20 per cent full-term babies in India are in need of donor milk.

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Dr Aisha Khan

This milk comes from the human milk bank or Comprehensive Lactation Management Centre (CLMC) at the hospital, which was Asia's first centre, started in 1989 by Dr Armida Fernandez. The centre manages to collect about 100l monthly via patients at the hospital, outside donors and with the help of PATH, an organisation that works to scale human milk banking. This just about meets their in-house demand.
There are only seven such centres in the city.

Naturally, the need for lactating mothers to donate is high. "Mother's milk is best for the baby; it is complete food with all necessary nutrients. When unavailable, people resort to cow's milk. A calf weighs 10 times more than a newborn; the protein content in human milk is 0.91 to 1.1gm per 100ml, and 3.3gm in cow's milk. That's extra load on the baby's kidney, especially for the first six months," says
Dr Jayashree Mondkar, dean, professor and head, department of neonatology, and director of CLMC.

Mondkar adds that human milk has anti-infective properties, improves immunity and IQ, and makes one psychologically stable. "Many mothers feed for four to six months exclusively, and then move to solid food. But breast milk is important for at least two years, which is also not the limit. So, the need for donor milk is higher," says Dr Prashant Gangal, senior paediatrician, training co-ordinator, Breastfeeding Promotion Network of India.

Nilofer Shaikh Munawar

Last year, the government released comprehensive lactation management centre guidelines, which promote breast-feeding, milk banking and kangaroo mother care. "In focus group discussions, we discovered that mothers didn't harbour as much stigma as the influencers, that is the mother-in-law and fathers. Common concerns are that it's unsafe as the mother isn't known, and what if she's a non-vegetarian? But with counselling, we manage to change this perception," says Dr Aisha Khan, project officer, PATH. Now, Shaikh has started lactating, and is also a donor at the hospital, "Koi bhi bacche ki jaan bachegi, toh khushi toh hogi dil mein."

Donor speak

Three months ago, Marine Drive resident Prachi Samani gave birth to Meher. Samani, a PR professional, had no issues with lactation and was introduced to human milk banking by Dr RK Anand. Samani is a regular donor at LTMGH, which facilitates easy donation by home pick-ups.

It helped that her in-laws were supportive and her husband researched to make sure that the institute of their choice is genuine. "Motherhood is a blessing. Not everyone is lucky enough in terms of breast feeding, and people then rely on formula milk. I am not against it, but why can't we be more open about accepting milk from banks for the child's nourishment? I even offered my milk to a friend but she didn't accept it as she felt her family wouldn't be supportive.

Prachi Samani

Breast feeding helps with postpartum blues and losing weight. Don't doubt yourself and keep trying is what I would say to every new mother. Your child is not going to be that tiny or dependent on you forever. And for mothers who can't breast feed, please be open to seek help from milk banks. There is absolutely no shame in receiving or donating. I wish pregnancy and breastfeeding is talked about more openly. Breast feeding can be tedious but it's a beautiful journey. I am glad I can do my bit by donating and creating awareness," says the young mother.

Myths about donation

*The milk is unsafe: Hospitals check health reports of mothers before accepting their milk. After pasteurisation, a culture test determines whether the milk is safe for consumption.
*My baby will go hungry: Mothers need to pump out excess milk when engorged; the more milk you express, more the production. Pumping sends a message to the brain that the baby needs more milk, hence it doesn't stop. Counselling and lactation consultants can help you continue the process.

Call to donate

At: Lokmanya Tilak Municipal General Hospital, Sion West.
Call: 24076381

At: Cama And Albless Hospital, Fort.
Call: 22620390

At: KEM Hospital, Parel.
Call: 24107000

At: Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Kalwa.
Call: 25304139

At: Nowrosjee Wadia Hospital, Parel.
Call: 24146964

At: BYL Nair Hospital, Mumbai Central.
Call: 23027000

At: JJ Hospital, Mazagaon.
Call: 23735555

Process of pasteurisation

Graphic/Uday Mohite

1. Store your milk in a freezer till you collect enough to donate. Transported in an ice box, it's stored at -20°C at CLMC.

2. Pasteurisation involves heating the milk at 62.5°C and maintaining that for 30 minutes.

3. Next, the machine rapidly cools the milk to 25°C in 10 minutes. It's further brought down to 4°C.

4. The culture from each container or the batch is sent for micro-biological testing.

5. While awaiting the results, the milk is stored in a freezer at -20°C. This milk can be stored for up to six months. The milk declared safe can then be consumed.

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