This new project is part of a joint project between the African Population and Health Research Center, a Kenya-based nonprofit research organization, and Seattle-based PATH*, a non-profit that works to expand capacity for donor human milk banks around the globe. According to a PATH briefing document, the Kenyan government has adopted WHO's guidance to recommend donor human milk as the next best option to breastmilk from the birthing parent, but in order to implement this, they need a supply of donor human milk. Recent enhancements to the Baby-Friendly Hospital Initiative, a key tool for breastfeeding success in Kenya, also underscore the importance of prioritizing donor human milk when a supplement is needed.
|Step 6 of the BFHI 10 steps.|
The African Population and Health Research Centre says the initiative will be part of a larger project that integrates donor milk, Kangaroo Mother Care, and breastfeeding promotion. They will be researching the effectiveness of this integrated model, which PATH says is adapted from its existing Mother Baby Friendly Initiative Plus (MBFI+) model.
"MBFI+ is an integrated human milk banking platform. It focuses on aligning HMBs within other key aspects of newborn care: combining banking, breastfeeding promotion, and Kangaroo Mother Care (an effective method for infant survival that involves providing skin-to-skin contact to low-birthweight infants)."
It will be interesting to see the outcomes of research into the integration of a milk bank with Kangaroo Mother Care and strong breastfeeding promotion. If the result is higher breastfeeding rates, there will actually be less of a need for supplementation with large volumes of donor milk, and as well, there will be a greater number of lactating people with milk to spare for newborns in need, which could make this milk bank highly sustainable. In many parts of the western world where milk banking is now well established, infants are still left alone for long periods in incubators while their mothers pump breastmilk nearby or even remotely. In places without good parental leave laws, it is not uncommon for someone who births prematurely to have to return to work before their infant is discharged from hospital. And even when there is access to donor milk and breastmilk expression is well supported, many infants are discharged not breastfeeding, but rather breastmilk feeding - a time and resource-intensive practice that usually relies on expensive electric double breast pumps.
PATH hopes this Kenyan milk bank initiative can establish the country as "as a center of excellence for human milk banking in the region, promoting and providing access to human milk for all infants to survive and thrive."
It will be good to see a donor milk banking "centre of excellence" that truly promotes breast*feeding* taking hold on the African continent, rather than the importation of western ways that risk further eroding breastfeeding rates. Recently researchers in Nigeria published a study exploring attitudes towards donor milk in Nigeria, and concluded: "the prospect of acceptability is high among mothers surveyed in south-east Nigeria." That country is the focus of an intensive effort to improve its breastfeeding rates through structural supports such as increasing maternity leave to six months, strengthening laws that prohibit predatory marketing that leads to breastfeeding failure, and developing strong community supports for families to ensure breastfeeding success.
Could Nigeria be the next country in the region to embrace donor milk banking?
*Editors Note: PATH has achieved some successes through partnerships with non-profits in the donor human milk banking world in other countries, notably South Africa, India and Vietnam. The organization also partners with corporations, and this has the potential to create sticky situations for these non-profit partnerships. In 2017, PATH was the recipient of a Family Larsson Rosenquist Foundation (FLRF), the foundation created by the makers of Medela, a global breast pump and bottle and teat manufacturer. There is of course an inherent conflict in accepting funding from a breast pump maker that stands to profit from donor milk banking. The company has also run afoul of the International Code of Marketing of Breast Milk Substitutes (the Code) since it launched its heavily marketed Calma bottle and teat. It looks like this project funding was not renewed, which is good news for non-profit donor milk banking around the world. Participants in PATH projects will want to encourage the organization to vet their corporate relationships carefully to ensure the good work they are doing isn't undermined by their funders.