"The milk bank was a gift from heaven!" exclaims Ellen Jones* of San Antonio, Texas. "No one can believe that Levi is the same kid!" Jones' 6-month-old, Levi, was born with a kidney problem and spent the first three months of his life in a neonatal unit. "I have tried to nurse all my babies, but with all that stress, my milk dried up," Jones says. "The problem was finding any formula on the market to help Levi gain weight. So my nutritionist and I ganged up on my doctor, and persuaded her to let us try a milk bank. Since then, Levi is a different child. Instead of a skinny little baby moaning in pain, he's turned into a chubby kid, interacting with his sister and reaching out for things. I wish I could meet some of those mothers face-to-face, and let them know how they have changed my life. I just want to say a huge 'thank you' to them."

Why Milk Banks Exist
When Laraine Lockhart-Borman, director of the Mothers' Milk Bank of Denver, Colo., hears stories like this, it makes her realize why she has been at her job for more than 16 years. "I get these calls from our recipients telling me things like, 'What did you do? It's a miracle! Instead of crying miserably all day, my baby is gurgling happily and gaining weight.'" Jeanne Mitchell, IBCLC and program director at the Denver milk bank, has seen numerous recipients who cannot find the words to express their gratitude. "We see babies who cannot tolerate any formula, and who are losing weight day by day," says Mitchell. "Then the babies receive milk from us, and their lives change." She goes on to explain that milk banks exist for babies who will not thrive without human milk. Pre-term babies, infants with failure to thrive (FTT), intolerance to formula, various allergies or other serious medical conditions are examples of some of the babies who have been helped by the growing number of breastmilk banks.

How Milk Banks Work
Thanks to the generosity of innumerable donors, milk banks are appearing all over the country – from California to Delaware. But how exactly do they work? "It's really very simple," explains Lockhart-Borman. "Women are initially referred by a physician or lactation consultant, and they are mothers that have a generous supply of milk, often in their first six months of breastfeeding." Ana Mejia-Dietche, executive director of the Mothers' Milk Bank of Austin, Texas, says she also has seen bereaved mothers, for whom this is a helpful way of dealing with the grief, and mothers of pre-term infants, whose babies can't drink all the milk. "Right now, one of our donors is a military mom who is from Alaska, but posted in Arkansas!" she says.

Becoming a donor begins with an extensive medical screening, administered over the phone. Donor mothers must be taking no medications, be non-smokers and say "no" to a long list of other questions. Mejia-Dietche points out that the process includes questions about lifestyle in general, such as caffeine and alcohol intake, and other possible risky behaviors. "If they pass the screening by phone, they receive a written checklist, which they and their doctor must sign," adds Meija-Dietche. "Following that, donors are required to submit negative blood tests for Hepatitus B and C, HIV 1 and 2, and HTLV 1 and 2, as well as a negative syphilis test and evidence of immunity to rubella. And these blood tests are repeated every six months." Donors do not receive any compensation for their milk, but they do receive the satisfaction of helping another mother and baby.

Is My Baby Going to be Safe?
When a potential donor has been approved as a healthy breastfeeding mother, she receives detailed instructions on how to collect and store her milk. Once she has pumped her milk, she freezes it in specially prepared containers, to preserve the immunologic and nutritional components. Then when she has collected enough, she either sends or brings it to the milk bank. "And then we pasteurize it," says Lockhart-Borman. "We make sure we kill all viruses and bacteria, after which it is frozen again, until we need it. From the first phone call through the pasteurizing of the milk, there is no possibility of anything going wrong," she says. "We have all the safeguards in place. And this means that a stranger's milk can be a lifesaver for a desperate mother." Mitchell explains that all milk banks work under guidelines developed by the Human Milk Banking Association of North America (HMBANA), in conjunction with various organizations including the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC), and there have never been any reported problems with the milk.

Becoming a Recipient
In order to receive milk, mothers need a doctor's prescription and they have to be under medical supervision. "There needs to be a demonstrated medical need by the recipient. Perhaps the mother cannot provide milk, or has lost her supply, or was never able to produce," explains Lockhart-Borman. Recipients do pay a processing fee, and once everything is set up, they can pick up donor milk at a local bank, or have it shipped to them. For Jones, the milk is shipped in an ice chest, packed with dry ice. "It comes in beautiful little bottles, and I put it straight into my freezer and send the container back. I live in San Antonio and get milk from Denver, so you don't have to live near a milk bank."

Becoming a Donor
"I got involved with this because I got pregnant at the same time as a very close friend, and I was devastated when she lost her child in childbirth," says Wendi White, mother of two in Austin, Texas. "It rocked my world, but the experience made me aware of how lucky I was to have a happy, healthy child. And when I heard about the milk bank, I realized it was a way for me to give something back. It's become a spiritual practice for me, and I'm grateful that I'm able to do it." White explains that for her, giving milk means pumping three times a week, producing 4 ounces each time. "Another woman at the bank is able to pump twice a day, and produce 25 ounces!" she laughs, pointing out that women are all different, and either way is just fine. In any case, most milk banks require a commitment of at least 100 ounces, partly because all of the screening and preparation are so costly.

Where to Go for More Information
The Human Milk Banking Association of North America, Inc. (HMBANA) is a nonprofit organization established in 1985 to review and revise guidelines for donor human milk banking practices in North America.

Mothers' Milk Bank
P/SL Medical Center
Denver, CO
(303) 869-1888

Mothers' Milk Bank at Austin
900 E. 30th Street, Suite 101
Austin, TX
(512) 494-0800
http://www.mmbaustin.org

Mothers' Milk Bank
Valley Medical Center
San Jose, CA
(408) 998-4550

Lactation Center & Mothers' Milk Bank
WakeMed
Raleigh, NC
(919) 350-8599

The Mother's Milk Bank
Special Care Nursery
Christiana Hospital
Newark, DE
(302) 733-2340

Regional Milk Bank
University of Massachusetts Memorial Health Care
Worcester, MA
(508) 334-6005

Mother's Milk Bank
C & W Lactation Services
Vancouver, B.C., Canada
(604) 875-2282

Banco de Leche
Veracruz, Mexico
+ 52 55 14 45 51

*Name changed to protect privacy.