BACKGROUND: The Human Milk Banking Association of North America (HMBANA) is a nonprofit association that standardizes and facilitates the establishment and operation of donor human milk banks in North America. No study has characterized the demographics, characteristics, and geographic distribution of its donors. MATERIALS AND METHODS: Donors were eligible for inclusion if they were donors at MMBNE, provided a gestational age for their infant, and donated between 1/1/2011-9/1/2019. Data collected from donor surveys and milk collection procedures were analyzed using descriptive statistics, chi-square tests, t tests of independence and Mann-Whitney U tests. RESULTS: Data were analyzed from 3767 donors. On average, donors were 32.5 years old (range 17-52) and donated more than once (mean 2.8; median 2; IQR 1-3; range 1-41). The majority of donors gave birth to term infants, lived in New England, and were not bereaved. Massachusetts had the largest proportion of donors (40.9%), however donors were located in 39 states and four countries. The median total volume donated per donor was 21904mL (741Oz). The average volume of donation per donor increased over time. Mothers who had preterm births were more likely to be bereaved (66% vs. 13%; p<0.01) and the volume of donation (mL) was associated with term versus preterm birth status respectively (p<0.01). CONCLUSION: Donors to MMBNE were generally older, repeat donors with term infants, and broadly geographically distributed. Further research is warranted to understand additional characteristics associated with milk donation and any characteristics of mothers who are and are not able to donate milk in accordance with milk bank protocols.

With approximately 24,500 preterm children born annually in Canada and an estimated shortage of 6 million ounces of breast milk, the distribution of donor milk must be time-sensitive yet safe to efficiently meet this demand. Donor human milk banks take the greatest precautions to protect their users, but some of these microorganisms manage to circumvent the employed methods. The consumption of contaminated donor milk has the potential to be fatal particularly to the vulnerable, immunocompromised premature infants. The tools used by milk banks to ensure safe distribution rely heavily on the culture plate. It has been the gold standard in screening for microbiological specimens due to its wide availability, low cost, and simplicity. However, the procedural times for bacterial culture plates are tedious and long, lasting a minimum of 48 hours. Advances in microfluidics, particularly in combination with the concept of monitoring metabolites to indicate bacterial viability, hold much promise to significantly reducing the long processing times of culture plates. Combining the concept of compartmentalized culture and a chromogenic optical dye for the detection of metabolic changes as a diagnostic sensor would simplify the identification and quantification of microbial presence. The updated Rapid Culture Detection system is a nanowell device fabricated using polydimethylsiloxane (PDMS) that uses the oxygen-sensitive redox indicator Methylene Blue to determine the presence of bacteria. Preliminary studies have shown to detect bacteria in as little as 3.33 hours using these nanowells compared to the 24 hours required for microwell liquid culture (620%). Initial studies have also been conducted with human milk, indicating a slower detection than in LB media. The novel easy-to-use and low-cost Rapid Culture Detection system is a promising alternative detection tool for protecting infants from pathogenic illnesses caused by contaminated human milk and shortening the time required to access lifesaving nutrition. / Thesis / Master of Applied Science (MASc)

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ORientador : Ottilio Guernelli / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos e Agricola / Made available in DSpace on 2018-07-17T12:59:01Z (GMT). No. of bitstreams: 1 Assis_MariaAliceAltenburgde_M.pdf: 7353056 bytes, checksum: c45a5316b7db1f893b3102706accf40e (MD5) Previous issue date: 1981 / Resumo: Com o crescente interesse em utilizar o colostro humano na dieta de recém-nascidos internados nas Unidades de Tratamento Intensivo dos hospitais e maternidades, surge a necessidade de se empregar métodos adequados para a preservação do mesmo em Bancos de Leite.Estudou-se algumas alternativas de coleta, processamento tecnológico e estocagem do colostro de parturientes internadas em duas maternidades da cidade de Campinas. Avaliou-se microbiológica e imunologicamente as diferenças encontradas, quando se levou em consideração a classe sócio-econômica da doadora, as técnicas de processamento tecnológico (congelação, pasteurização e liofilização) e a estocagem no congelador (-10ºC ? 2ºC, -l8ºC ? 2ºC e ¿40ºC ? 2ºC) durante 1, 2, 3, 4, 8 e 12 semanas. Durante a coleta do c01ostro por métodos artificiais,o volume obtido variou significativamente segundo o período de lactação, a patologia da mama após o parto, tipo de parto e número de partos das doadoras. Outras variáveis tais como a idade, doenças durante a gravidez, complicações após o parto e uso de drogas (cordicóides e antibióticos) pareceram não interferir no volume coletado.O volume, a concentração de proteínas totais e os níveis de imunoglobulinas não diferiram significativamente quando se considerou a categoria social da doadora. A maior ou menor contaminação microbiológica das amos-tras de colostro fresco foi atribuída aos métodos de esterilização da bomba ordenhadeira e o local de coleta, demonstrando a importância da coleta ser realizada sob rigorosa assepsia. O colostro das doadoras de ambas as maternidades, apresentaram níveis mais altos de IgA contrastando com as concentrações baixas de IgG e IgM. A congelação e a liofilização inibiram a proliferação dos microorganismos presentes nas amostras frescas, reduzindo variavelmente os níveis de IgA, IgM e lisozima. O colostro se manteve estocado no congelador até 12 semanas, a temperaturas abaixo de ¿10ºC sem que houvesse perdas significativas de imunoglobulinas, podendo manter a qualidade microbiológica original e até melhorá-la. A pasteurização (62,5ºC, durante 30 minutos) mostrou--se um método eficaz na diminuição da contaminação microbiana, causando algum decréscimo na concentração de IgA e reduzindo de maneira acentuada os níveis de IgM e lisozima / Abstract: With the increasing interest in the application of human colostrums for the care of newly-born infants in the "Units of Intense Treatment" of Hospitals and Maternities, there is evident the need of applying proper technology for its preservation, for the Milk-Banks. Ways of collecting, technology of preservation and storage of colostrum obtained from delivering-mothers of two hospitals in Campinas were studied. An evaluation of the microbiological and immunological characteristics was made in accordance with the social-economical status of the mother, the technology of processing (freezing,freezedrying, pasteurization) and storage under controlled, temperatures (-10ºC + 2ºC; -18ºC + 2ºC; -40ºC, +2ºC) for I up to 12 weeks. Based upon artificial methods of collecting colostrum, the obtained volume varies significantly with the period of lactation, the pathology of the mammary gland post-partum, type of deliverance and frequency of deliverance of the mother. -Variables such as age, diseases during pregnancy, complications after delivery, use of drugs such as corticoids, and antibiotics seem not to interfere with the collected volume. Volume, protein content and levels of immunoglobulins were shown not to differ significantly when the social status of the donor was considered. / Mestrado / Mestre em Ciência de Alimentos

The protein content of the only human milk fortifier available in South Africa was increased in 2017. The Original fortifier (OF) and the Reformulated fortifier (RF) provided similar energy. This study aimed to prospectively compare in-hospital growth during the intermediate stage of nutrition support of very low birth weight (VLBW) preterm infants receiving human milk fortified with these two formulations in a tertiary South African hospital. Intake of VLBW infants receiving exclusively human milk plus one of two fortifiers (OF 0.2gprotein/g powder; RF 0.4gprotein/g powder) was calculated. Change in Z-scores (Fenton, 2013) from start to end of fortification of weight, length and head circumference (HC) for age was calculated as primary outcomes. Additionally, weight gain velocity (g/kg/d) and gain in length and HC (cm/wk) were calculated. Fifty eight infants (52% female; gestational age: 30±2wk; birth weight: 1215±187g) received OF (2016 to 2017) and 59 infants (56% female; gestational age: 29±2wk; birth weight 1202±167g) received RF (2017 to 2018) for 15 days. Protein intake of RF (3.7±0.4g/kg/d) was significantly higher (p<0.001) than of OF (3.4±0.2g/kg/d). Protein-to-energy ratio of RF (2.6±0.2) was significantly higher (p<0.001) than of OF (2.3±0.1g/100kcal). No adverse effects were noted. In both groups Z-scores of weight and length dropped; Z-scores for HC showed slight improvements. There were no significant differences between the two groups in terms of Z-scores, weight gain velocity, length gain or HC gain. Analysed human milk from preterm infants’ mothers’ protein levels was higher than published values. In-hospital growth was not statistically different between groups, even though calculated protein intake and protein-to-energy ratio were significantly higher in RF group. / Thesis (PhD (Dietetics))--University of Pretoria, 2019. / Human Nutrition / PhD (Dietetics) / Unrestricted

Yes / Donated Human Milk Banking is a trending topic in healthcare management and has potential for business development opportunities at hospitals and independent organisations in developing countries. A preliminary definition of a Human Milk Bank “is a service established to recruit breast milk donors, collect donated milk, and then process, screen, store, and distribute the milk to meet infants’ specific needs for optimal health. Although there are indications about the beginning of such practices date back to the 2001’s, private sector human milk banking has gained momentum in terms of popularity and acceptability. There is evidence of the presence of human milk banks in the USA during the 1990’s, which potential was affected by the development of specialty formulas, safety issues linked with viral transmission, and lack of credible clinical research in this area. However, recent developments in clinical studies, government cooperation with medical research centres and health authorities have shown considerable improvement in the public view of Human Milk Bank’s creating a positive climate for private sector provision.

The benefits of human milk are well-known, as human milk provides optimal nutrition in facilitating the growth, health, and development of infants and children. There are circumstances when a mother’s breast milk may be unavailable due to maternal illness, insufficient milk supply, contraindications, or geographical barriers (Dempsey & Miletin, 2010). Global recommendations support the use of donor human milk in situations where a mother’s own breast milk is unavailable (World Health Organization, 2009). Due to the limited supply, the pasteurized product is allocated to high risk infants within the hospitalized setting (Human Milk Bank Association of North America, 2008). Based on the allocation priorities, many individuals are unable to access donor human milk. In response to the growing demands for donor human milk, Internet based organizations have facilitated peer to peer human milk sharing. Given the fact that sharing human milk has been practiced as a covert activity, there is a lack of prevalence data (Thorley, 2008). To date, minimal research has examined this phenomenon. The purpose of this study was to explore the description of sharing human milk utilizing an online commerce-free approach. Data was collected through semi-structured interviews with 13 research participants and analyzed using an inductive approach to qualitative content analysis. Qualitative content analysis was selected based on the recognition of the importance of obtaining a rich description when exploring this phenomenon. Outcomes generated from the research study resulted in emerging concepts and categories. The concepts from the data analysis consisted of the following: commitment to human milk; virtual nature of relationships; and making the private public. The identified categories include: 1) infant feeding practices; 2) experience with sharing human milk; 3) selection of donors or recipients; 4) relationships among donors and recipients sharing human milk; 5) shared doctrine; 6) use of the Internet to share human milk; and 7) informing health care professionals and others regarding sharing human milk. Findings generated from this study provide an increase in understanding of this phenomenon. The cultivated knowledge will assist health care professionals in working in partnership with families to ensure optimal outcomes. / Thesis (Master, Nursing) -- Queen's University, 2013-07-27 20:26:30.206

Mothers are known to have an emotional attachment to their infant; however, some mothers also experience an emotional attachment to their own milk. Exclusive breastfeeding in the first six months of life, followed by continued breastfeeding with complementary solids are recommended by the American Academy of Pediatrics and the World Health Organization. Some mothers produce enough surplus milk to donate to a human milk bank. This thesis considers the emotional attachment to milk experienced by women who donate milk to a milk bank. This research is based on participant observation in a human milk bank in Florida and interviews collected from 14 milk bank donors. These methods were informed by the frameworks of moral motherhood and emotive value to foreground and enhance understanding of mothers' experiences. The results of this study show that mothers do not emotionally attach to breastmilk itself, but rather what the breastmilk represents. This study starts a conversation and brings awareness to women's emotional experiences at the beginning of motherhood, especially as they pertain to breastfeeding and human milk.

Background Benefits of breastfeeding for infants and mothers are well recognized. South Africa has a very low breastfeeding rate. Strategies to improve and promote exclusive breastfeeding rates include implementation of human milk banks (HMB). The North West Province started its first HMB in 2012 and the success and sustainability will depend on numerous factors, including identification of possible barriers to donation or receiving donor human milk. In support of such an intervention, the attitudes of each relevant stakeholders, mothers, community members and health care providers on acceptability of donating and receiving donated breastmilk is therefore important for the success of such an intervention Objectives The objective of this dissertation was determining the attitudes on acceptability regarding the donation and receiving of human breast milk for key stakeholders, namely mothers, healthcare workers and the elderly representing grandmothers. Methods This study was conducted at a public hospital and nearby clinics in North West province, South Africa using qualitative research methodology of focus group discussions (FGDs) for data collection. Eight focus groups discussed the attitudes, 3 of mothers of 0 to 12 month old infants (n=13), 3 of elderly participants older than 60 years (n=17) and 2 of healthcare professionals, working with infants younger than 1 year (n=11). Results Important attitudes on acceptability of receiving and donating human donor milk were identified from the literature and this research project. Stakeholders had safety and cultural concerns regarding donation and receiving of donated human milk. Participants also indicated the need for education that may improve the attitudes. These findings may inform future policy planning and HMB promotion in communities. The identified attitudes reflected barriers to exclusive breast feeding, donating and receiving breast milk. These included, the need for HIV screening; cultural beliefs relating to transfer of personality traits and bonding and fears of not having enough milk for their own infants; perceived changes in quality of donated milk during pasteurisation and transportation as well as HIV transmission. Conclusion The study identified important attitudes that may be possible barriers and fears to accepting or donating human breast milk. Some of the identified attitudes could also limit exclusive breast feeding. Further research is recommended to determine how prevalent the identified attitudes are in this and similar community settings. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2015

Background Benefits of breastfeeding for infants and mothers are well recognized. South Africa has a very low breastfeeding rate. Strategies to improve and promote exclusive breastfeeding rates include implementation of human milk banks (HMB). The North West Province started its first HMB in 2012 and the success and sustainability will depend on numerous factors, including identification of possible barriers to donation or receiving donor human milk. In support of such an intervention, the attitudes of each relevant stakeholders, mothers, community members and health care providers on acceptability of donating and receiving donated breastmilk is therefore important for the success of such an intervention Objectives The objective of this dissertation was determining the attitudes on acceptability regarding the donation and receiving of human breast milk for key stakeholders, namely mothers, healthcare workers and the elderly representing grandmothers. Methods This study was conducted at a public hospital and nearby clinics in North West province, South Africa using qualitative research methodology of focus group discussions (FGDs) for data collection. Eight focus groups discussed the attitudes, 3 of mothers of 0 to 12 month old infants (n=13), 3 of elderly participants older than 60 years (n=17) and 2 of healthcare professionals, working with infants younger than 1 year (n=11). Results Important attitudes on acceptability of receiving and donating human donor milk were identified from the literature and this research project. Stakeholders had safety and cultural concerns regarding donation and receiving of donated human milk. Participants also indicated the need for education that may improve the attitudes. These findings may inform future policy planning and HMB promotion in communities. The identified attitudes reflected barriers to exclusive breast feeding, donating and receiving breast milk. These included, the need for HIV screening; cultural beliefs relating to transfer of personality traits and bonding and fears of not having enough milk for their own infants; perceived changes in quality of donated milk during pasteurisation and transportation as well as HIV transmission. Conclusion The study identified important attitudes that may be possible barriers and fears to accepting or donating human breast milk. Some of the identified attitudes could also limit exclusive breast feeding. Further research is recommended to determine how prevalent the identified attitudes are in this and similar community settings. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2015