Why more milk banks are needed to reduce infant mortality

By Ann Mikia and Dorcas Moraa

August 1-7, 2021 was marked as the international breastfeeding under the theme Protect Breastfeeding: A Shared Responsibility. The day aims to foster knowledge on breast milk among mothers and caregivers- in case of illness or death of mothers- of babies. this campaign was informed by a study by the World Health Organisation (WHO), which established that nearly two out of three infants are not exclusively breastfed for the first six months. Similarly, three out of five are not breastfed in the first one hour after birth. This trend has been observed globally for over two decades, hence the seven-day campaign.

Breast milk is rich in antibodies for protection against infections, mineral and other nutrients for a healthy life. WHO says properly breastfed children register better results in intelligence tests, low risk of obesity and diabetes.

While this is the ideal situation, situations such as abandonment, illness, other medical conditions, or death of the mother may prevent the child from breastfeeding. With Kenya being among the countries with the highest maternal mortality rate at 362 per 100,000 live births, many babies are at risk of missing breastfeeding.

It is for this reason that the government installed the first milk bank in Kenya the Pumwani Maternity in March 2019 to ensure seamless access to a mother’s milk. This is the second milk bank in Africa after a similar facility in South Africa.

Gladys Wairimu delivered twins in Pumwani Maternity Hospital, but lost one. She developed a clot in her leg after two weeks after delivery and was rushed to Kenyatta referral hospital for treatment leaving the baby, who was in the incubator at Pumwani Maternity Hospital for about a month.

The baby was fed on the donated milk at the human milk bank. When Wairimu came back, her baby’s weight had improved from 900grammes to 1400grammes. The mother of the seven-month baby is grateful to Pumwani hospital milk facility, which has benefited hundreds of children since establishment.

Being one of the biggest maternity facility in the country, this is not the first breastfeeding of babies with other mothers’ milk. The practice commenced as a wet nursing where women who could not breastfeed their babies were helped by other breastfeeding mothers. Babies whose mothers died during delivery would be breastfed by other mothers alongside their own.

But in the current plan, only admitted mothers can donate or access the donated milk. Same to babies whose mothers have passed on.  

Mary Wanjiru’s baby weighs one kilogramme. She was at Pumwani hospital for a month while her baby was at a nursery. She donated milk to the bank as her baby consumed very little. When she brought her baby to the clinic for the 14^th week immunization she couldn’t donate milk.

“It really hurt me to discard milk yet I had witnessed many babies in need of breastmilk at the hospital,” she said.

Keziah Njau, a counsellor at the bank, sympathises with babies who lose mothers at birth, but cannot access the milk after being released to the next of kin.  

“I remember one man who came to pick the infant after losing his wife. He asked if he could be coming for milk from the bank. It was not possible. We don’t have a policy allowing this,” she said.

While Pumwani Maternity Hospital milk bank is the first facility in East and Central Africa, more need to be established given the high maternal mortality rates in Kenya, to ensure that infants benefit.

Similarly, countries such as the United States and Britain recruit milk donors from the community to ensure sufficient milk for all babies in need. But this has to be done backed by policy reforms allowing unlimited access.

The first human milk bank was founded in 1909 in Vienna, Austria. With time, pasteurisation was commenced to ensure safety of breast milk. Safety protocols are followed before donation. Prospective donors are counselled and screening for HIV, Hepatitis B and C, syphilis, among other infections which can be transmitted via milk. The milk is pasteurized before prescription to the babies depending on their weight.