Breast milk shortage affects life's most vulnerable babies
By ISABELLA ALVES
Feb. 24, 2018
IDAHO FALLS, Idaho (AP) — After hearing a baby's shrill cries following birth, the next natural thing for most moms is breast-feeding. It helps grow the bond between mother and child, and breast milk gives babies a boost of antibodies and white blood cells for the best start in life.
But not every mother can breast feed, and when a baby is born premature that sustenance becomes the meaning of life and death. However, this life-saving elixir is in short supply because of a nationwide breast milk shortage.
Premature babies, born before 40 weeks gestation, can't handle formulated milk well. The baby's guts still aren't fully developed and giving them formula could damage their intestines.
This is why it's vital to give the babies' breast milk because it won't harm their intestines and gives them the antibodies they need for development.
The biggest demand for breast milk is coming from neonatal intensive care units. The American Academy of Pediatrics recommends babies born with a birth weight lower than 1,500 grams (3.3 pounds) are fed breast milk.
When the mother's own breast milk can't be used, due to medications, traumatic delivery or other health issues, pasteurized donor milk can be supplied. But getting this donor milk can be costly, and it isn't always covered by insurance companies.
Donor milk from nonprofit milk banks, such as the Mothers' Milk Bank located in Colorado, costs $4 an ounce. At for-profit milk banks, breast milk can cost up to $16 per ounce.
A premature baby can use anywhere from 1 ounce of milk a day to 2 to 3 ounces a milk per feeding, depending on their age and health. That can cost families thousands of dollars.
The short supply of breast milk drives up the price, making its value akin to liquid gold. Fortunately, breast milk can be frozen and stored, but there are times when hospitals borrow milk from one another to meet demand.
"There may be a national perceived shortage in that milk banks are always hungry for more milk," Mistelle Okada, board certified lactation consultant at Eastern Idaho Regional Medical Center, said. "It's now being used for more research projects and moms having problems keeping up with supply of milk at home."
Okada said part of the increase in demand is that hospitals are able to save babies at younger gestational ages. When Okada first started nursing 19 years ago, she said doctors wouldn't even try to resuscitate a baby younger than 27 weeks.
Now, hospitals are able to save babies at 22 weeks old, something that was unheard of 10 years ago.
"You could resuscitate them, you could get their hearts going but their guts would die (on formula)," Okada said. "Using breast milk in any form for our micro-preemies it's made the difference of whether we can save their lives or not."
Because of these younger babies filling up neonatal units, there are more mouths to fill with breast milk.
From the 1940s to the 1980s, formula was the nourishment of choice. It wasn't until the 1980s, when the grassroots breastfeeding group, La Leche League International, started making strides that breastfeeding started becoming popular.
The Centers for Disease Control and Prevention's 2016 Breastfeeding Report Card, showed that 81 percent of babies born in 2013 started to breast-feed after birth. That's up from 71 percent in 2000. Idaho and Utah are among the top breast-feeding states with 93 percent of Idaho babies breast-feeding at some point in their infancy and 94 percent of Utah babies breast-feeding.
Research began going into what made breast milk so beneficial for babies. There are enzymes, antibodies and hormones in breast milk that can't be replicated in formula.
"We got the oxygen down, we got the cardiac down . so what's the missing piece?" Okada said, referencing how to save preemie babies' lives. "That's when we figured out, it's the gut."
Part of the reason there is a breast milk shortage are the policies surrounding its use, Glenn Snow, co-founder of the for-profit International Milk Bank, said.
The American Academy of Pediatrics made it a standard of care to give breast milk to premature babies, which increased the demand. As a result, hospitals make policies about how to administer the breast milk, only the "smallest of the small" get it, Snow said.
Snow said in an in-house study, about 80 million ounces of breast milk a year would be needed to feed all the neonatal babies in the nation, but only about 15 million ounces were used.
To date, there aren't any large-scale breast milk providers. The International Milk Bank is trying to remedy this, its goals are to supply breast milk to neonatal units and hospitals nationwide.
Having a large scale provider of breast milk would cut down on the shortage and make sure neonatal babies are getting the nourishment they need, Snow said.
But eastern Idaho is lucky, there is a historical culture of breastfeeding that's normalized here, according to Katie Leask, international board certified lactation consultant at Eastern Idaho Public Health.
Outside of neonatal units, most mothers in Idaho are breast-feeding and are not experiencing a breast milk shortage. For healthy babies and mothers, breast milk is in high supply.
It's in neonatal units where the demand surpasses supply, and for babies in their most delicate stages of life, this is where help matters most.
Information from: Post Register, http://www.postregister.com