Where Do Milk Banks Fit In?

During my early years in breastfeeding, I found the idea of milk banks intriguing but less than exciting. To me, the rubber gloves, the lab equipment, and the rest of their high-tech gadgetry were positively off-putting.  All that changed when I attended a conference of the Human Milk Banking Association of North America.  There I finally understood the bigger picture and realized that milk banks play a vital role in a breastfeeding culture. 

To better grasp this role, it helps to know the World Health Organization’s ranking of infant feeding options from healthiest to least healthy.  Healthiest is, of course, direct breastfeeding.  Second is mother’s own expressed milk. Third is donor human milk.  And fourth is infant formula.  

Donor milk can make the difference between life and death, especially among preterm and ill babies.  Although many mothers work hard to try to provide their at-risk babies with their milk, research has found that more than half of mothers expressing milk for preterm babies have inadequate milk production by Week 6.1

This is a problem because very preterm babies are at risk of acquiring a serious condition called necrotizing enterocolitis, NEC for short, and feeding infant formula increases this risk.  When a baby acquires NEC, part of his digestive tract becomes inflamed and dies.   About 1 in 5 babies who acquire NEC die from it.  According to the Centers for Disease Control and Prevention, in the U.S. NEC is the cause of nearly 2% of all infant deaths.  Babies with NEC suffer horribly and the cost of treating it is astronomical.2Babies whose NEC is severe enough to require surgery are also at risk of long-term growth delays and neurodevelopmental problems, which can affect a family and a society for a lifetime.

This is where milk banks come to the rescue.  Research has found that only 1.5% of babies fed mostly human milk acquire NEC, as compared with 10-17% of babies fed exclusively formula.3So as the Swedes have already learned, the answer to this terrible scourge is to feed preterm babies only human milk during their hospital stay.  In Sweden, no hospitalized preterm baby receives infant formula before discharge.  If a mother cannot express enough milk for her baby, donor milk is given.

Milk banks provide a safety net for mothers unable to express all the milk their babies need. While direct breastfeeding is best and mother’s own expressed milk is second best, donor milk can be a lifesaver for babies whose only other option is infant formula. 

This ray of hope is why I became a member of the leadership team of the group pictured here, which hales from Illinois and Wisconsin and is working hard to establish the Mothers’ Milk Bank of the Western Great Lakes.  Our plan is to move heaven and earth to begin providing donor milk to babies in our states, where no milk bank currently exists.  An important role of this—and any—milk bank will be to educate hospitals about human milk as the standard of care.  Even with research backing, changing practice always takes time.  But it will be well worth the effort.  Our new website will be premiering soon and I’ll post a link when it’s ready.  Please wish us luck!


1 Hill, P. et al.  Comparison of milk output between mothers of preterm and term infants: The first 6 weeks after birth.  J Hum Lact 2005; 21(1):22-30.

2Bisquera, J. A., Cooper, T. R., & Berseth, C. L.  Impact of necrotizing enterocolitis on length of stay and hospital charges in very low birth weight infants. Pediatrics 2002; 109(3): 423-28.

3Sisk, P. M., et al. Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. J Perinatol 2007;27(7), 428-33.