The upmarket suburb of Manor Gardens in Durban may look serene, but is home to ground zero in the fight against Aids. The iThemba Lethu Milk Bank is the first in the world to provide breast milk exclusively for babies abandoned or orphaned by the virus. The initiative is designed to help boost the fragile immune systems of these vulnerable children, many of whom are born underweight and suffering from symptoms such as diarrhoea and eczema.
The Milk Bank, which receives technical support and funding from Unicef, is part of the greater iThemba Lethu (meaning “our hope” in isiZulu) project, a non-profit organisation that seeks to help children whose future is threatened by HIV/Aids. The project consists of an HIV education programme and a transition home, where abandoned and orphaned babies are cared for until they can be placed with either their own extended family or with foster or adoptive parents. Penny Reimers, the Milk Bank coordinator, explains that, for these babies to have a fighting chance, they need an extra boost: “The babies we care for come from HIV-positive mothers. Their mothers have either passed away or have abandoned them. Many of these babies are malnourished and have eczema. Breast milk is more nutritious than formula. We have found that once we start feeding them donor milk they soon become stronger and healthier.”
She recounts the case of a seven-month-old baby who had been in hospital since birth and not gained a gram. “In seven months, he had not gained any weight: he only weighed 2kg. After he arrived here and we started feeding him breast milk, he gained 200 grams in just two weeks and he continued to put on weight.”
The Milk Bank has set up a network of donors recruited through antenatal classes and mother-and-baby clinics, to provide breast milk on a regular basis. The volunteers — women who have just given birth and are breastfeeding their own babies — are asked to express extra milk and freeze it in small bottles, for weekly collection by the Milk Bank.
Volunteer donor Cindy Brand thinks the programme is a great idea: “After I had my baby almost 10 months ago, he would only feed on one side. I was expressing milk from the other breast and throwing it away. It was a waste.” So when she saw an iThemba Lethu brochure at an antenatal clinic, she contacted it, was screened, and has been donating milk ever since. “I am planning to continue to donate for another couple of months. When I stop breastfeeding my baby, I will stop donating to the project.”
The Milk Bank was founded by Professor Anna Coutsoudis of the University of KwaZulu-Natal, who has conducted extensive research on the effects of exclusive breastfeeding during the first six months of a baby’s life, which is crucial for the development of the immune system.
She argues that breast milk has natural antibodies and hormones that a baby needs, and is a living substance specific to the human body. Formula is usually mixed with cow’s milk, which has evolved to feed calves, not human infants, and is less efficient.
The donors recruited for the Milk Bank are not required to undergo an HIV test, because of the costs involved, but selected by a “lifestyle screening” questionnaire about drug use, sexual partners and general health issues. While Coutsoudis admits that this is “not ideal”, she argues it is not problematic: “All donors have been tested for HIV/Aids during pregnancy. Of course, it is possible to contract it between this test and the time the mothers start donating, but chances are very slim. And as a double safeguard we do pasteurize the milk once it has been donated and we know that this kills any potential virus,” Coutsoudis contends.
While milk banks are springing up around the world, often for commercial purposes, Coutsoudis’ vision for the future is to see more, smaller milk banks open across South Africa. She explains that this is preferable to one big bank, as smaller organisations encourage personal accountability: “The little banks know exactly who their donors are, and the donors know what happens to their milk. This way, everybody who is involved knows what is going on.”
The history of milk banking
The roots of donor milk banking go back to “wet nursing”, an ancient practice in which babies were breastfed by friends, relatives or servants. For centuries it was believed that children inherited physical, mental and emotional traits through the breast milk, so the selection of a wet nurse was very important, so much so that during the 13th century, European women made more money working as wet nurses than any other occupation open to women.
In 1909, the first official milk bank was established in Vienna, with the advent of refrigeration technology. As the practice of paediatrics grew and more premature babies survived, milk banks were opened throughout North America and Europe. With the arrival of HIV/Aids in the mid 1980s and related concerns about transmission through breast milk, the number of milk banks declined drastically. Bottle feeding became the standard alternative to breastfeeding. Since the 1990s, the number of milk banks has been on the increase again. Milk banks are being set up throughout both the developing and the developed world. And as a greater number of studies are showing the benefits of human milk to infants, the belief is that they will continue to multiply. — Source: The Human Milk Banking Association of North America