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Resource centre on India's rural distress
 
 

Banking on mother’s milk -Jacob Koshy
-The Hindu

Liquid Gold’ may refer to petroleum, an ‘80s pop group or a particularly indulgent variety of cheese but for Raghuram Mallaiah, a doctor who specialises in newborn babies, it’s mother’s milk.

As a doctor who has to negotiate life-and-death situations for prematurely-born infants, Dr. Mallaiah holds that breast milk is “10 times more important” for babies born before their due date than those who reach full term. The biological quandary is that the mothers of children born early are often unable to lactate. Powdered formula milk is a common substitute but Dr. Mallaiah would rather that babies get the real thing. Hence his advocacy for milk banks. “I recently spoke to a woman who said she expressed so much milk that after feeding her baby, she’d give it away to the cats and dogs in her house,” says Dr. Mallaiah, who works at Delhi’s Fortis La Femme hospital and last week formally announced Amaara, a non-profit milk bank on the hospital premises. “This precious resource should be going where it is most needed.”

Dearth of milk banks

India registers 50,000 births every day but has only 14 milk banks while Brazil, with 10,000 births every day, is said to have the world’s most extensive network of 217 milk banks. Rather than a lack of will — several women are willing to donate milk to banks — insufficient awareness and the logistical challenges of transporting milk safely from mother’s homes safely to hospitals are the key hindrances to having more milk banks in the country, says Dr. Mallaiah.

This Sunday — Mother’s Day — he will flit between gynaecologists, obstetricians and workshops on how breast milk ought to be best preserved (first frozen, then pasteurised but not beyond 62.5°C else it could cream), what chemically differentiates mother’s milk from cow milk (at its crudest, more whey-less casein in the former), what is in breast milk that can’t be replicated in milk powder (among others, lactalbumin, immunoglobins that provide vital early-stage immunity), whether mother’s milk be reused (no), if it can be bought from milk banks (not off the shelf, but only on request from hospitals), and if women can sell breast milk to hospitals (absolutely no), etc.

In the month that Amaara has been functioning, it has collected 12 litres and used up half of it — for babies at Fortis La Femme and the hospital’s sister concern in Gurugram. “The aim is to have more donations and more milk that can be sent to poorer hospitals in the city as well as to rural areas,” says Dr. Mallaiah.

In a similar initiative, Divya Mother Milk Bank, an NGO in Rajasthan, has, since 2013, been collecting excess milk from mothers prescreened for various diseases like HIV and hepatitis through a pump, which is then pooled, pasteurised and frozen ready to use for up to four months. Over 600 women troop in once a week and donate enough to feed more than 400 babies, according to a report by the BBC.

Later this month, the government is expected to come up with a set of draft guidelines that specify basic regulations that milk banks ought to be adhering to.

Breastfeeding a must

Experts say that a milk bank network is only a part of the solution to improving India’s infant mortality rate. Though it has improved over the years, it is still at an unacceptably high 38 per 1,000 live births and much worse than China’s 9, according to the World Bank.

One of the most effective ways to do that it is to improve breastfeeding practices.

Dr J.P. Dadhich of the Breastfeeding Promotion Network of India says milk banks are really only required for 3 per cent of newborns. Far too many hospitals do not put in enough effort to help new mothers with their first lactation and aren’t doing enough to educate mothers to breastfeed children exclusively for the first six months, he claims. “Ideally it should be 90 per cent but barely 46 per cent newborns in India are breastfed… this is more important than milk banks,” Dr. Dadhich adds.
 
The Hindu, 8 May, 2016, please click here to access