Milk of human kindness

Donating to new mothers may seem generous, but

questions remain as to whether mum's magic liquid
should be shared
Published: 30/10/2018 at 07:30 AM
Newspaper section: Life
New mum Passavee Payacaboot set up a breast milk-sharing project out of good intentions. So when her not-for-profit scheme was harshly criticised by doctors and non-doctors
alike, she couldn't help feeling hard done by.

"I came up with the project because I understand there are mothers who don't have [adequate] breast milk supply. And I have an oversupply of milk," Passavee explained in an
interview with Thairath online.

Passavee and her actor husband Navin "Tar" Yavapolkul were attacked on social media earlier this month after publicising their efforts to get new mothers with excess breast milk
to donate. Her project Nom Jak Tao Rao Hai Free (Free Breast Milk) aims to give underprivileged infants nationwide access to breast milk. The venture is run from Passavee's
anti-ageing clinic Filorga. The couple have released pictures of themselves with fridges stocked with milk, some of which is Passavee's own product Luca's Milk. The couple
claims their project is Thailand's first.

"I have already donated milk to other mothers. My followers on Facebook and Instagram send me requests. But they must come to the clinic to meet the doctor and get medical
screening," explained Passavee.

Medical practitioners have criticised the project, warning that donated breast milk could carry diseases that affect recipients in their later years. Despite this, Navin vows to
continue their efforts.

"First, I would like [people] to understand the intentions of the milk-sharing project," Navin wrote on Instagram. "Having no money is not as painful as [parents'] inability to feed
their babies to keep their stomachs full so that they can grow naturally.

"Second, the project we initiated was carefully thought through. But of course, there are risks. We have implemented a safety protocol for every donation. Both the donors and
recipients are screened by our doctors at Filorga Clinic, who specialise in blood and allergy screening. But our doctors don't like to use Facebook. For now, we can say that we
are probably the only private milk bank in Thailand."

Human milk -- or breast milk -- is the primary nutrition for newborns and has numerous benefits, says international lactation consultant Meena Sobsamai.

"Breast milk contains antibodies that help babies recover from diseases faster," she said. "Research around the world indicates that infants who receive breast milk will be more
resistant to non-communicable diseases such as cardiovascular diseases, hypertension and obesity, as well as having a lower risk of developing Alzheimer's when they become
adults. Breastfeeding essentially provides greater health in the future."

But what about breast milk donated by others?

Paediatric hepatology Prof Dr Yong Poovorawan of the Department of Paediatrics under Chulalongkorn University posted a word of warning on Facebook.

"Breast milk is biologically similar to blood and organs which can transmit germs and diseases. Breast milk is the best, but must be from [the babies'] own mothers' milk. Don't do
milk-sharing," he wrote.

"Donors must get screened every time they donate milk, including blood tests to detect HIV, HCV [hepatitis C virus] and HBV [hepatitis B virus]. Previous negative results are no
guarantee of today's results. And there are some infections that can't be found with the current screening techniques," he added.

Human milk banks exist in many countries, such as the US, Australia and Singapore. They are usually run by hospitals, which apply strict screening processes, and milk donation
is treated as a medical matter as much as a charitable one.

Asst Prof Dr Worawut Choeyprasert, general paediatrician of haematology and oncology at Vejthani Hospital, said that medical screening for breast milk donations must have the
same standards as blood donations because they both concern bodily fluids. Most recipients of breast milk donation are premature infants who are sensitive to infections. To
prevent the risk of disease transmission, breast milk donation must be carried out through milk banks located in Ramathibodi and Siriraj hospitals.

"Milk contamination can come from a mother or a donor," Dr Worawut said. "The mother can cause disease transmission to the baby. We are worried about viruses such as HIV,
hepatitis B and C, CMV [cytomegalovirus], EBV [Epstein-Barr virus] and HTLV-1 [human T-lymphotropic virus 1]. HIV infection has a window period. Though a patient may have
an HIV infection, there will be a period when the tests still show negative results.

"Milk handling can also cause contamination, starting from how donors pump milk, put it in storage bags and store it in refrigerators, if the handling processes don't meet the
standard. At milk banks, milk in sterile storage bags is randomly checked for bacterial counts to ensure quality."

Milk banks should only be used by mothers who have a low milk supply or with premature babies. However, in reality, some mothers still share milk among people they know,
especially their sisters.

"Sisters must accept the risks. A sister may trust her sibling, but can she trust that her sibling's husband practises safe sex?" said Dr Worawut, founder of Facebook page Liang
Look Tam Jai Mor (Spoiled Paediatrician).

What other solutions are there for mothers who require more milk? Both Meena and Dr Worawut point out that most mothers can increase their own breast milk supply.

"If they can have babies, more than 95% of them can produce enough milk for their newborns," said Meena.

During the first two weeks after delivery, many mothers have low milk production. Throughout this period, they shouldn't use substitutes such as powdered milk or other mothers'
breast milk.

"If mothers let their little ones have formula, after the babies are full, they don't want to be breastfed by their own mothers. If there is no breastfeeding, the mothers' bodies will
make less breast milk," Dr Worawut said.

He recommends three techniques to increase breast milk production.

"First, breastfeeding should start soon after the infant is born. Next, babies must be properly latched to ensure effective sucking. Then, recurrent breastfeeding will stimulate milk
production."

Apart from physical techniques, a healthy mind is also key.

"Stress and pressure can cause low milk supply. Newborn mums should try to relax, get rest and drink a lot of water. Hug the babies often. Hugging increases the oxytocin
hormone which stimulates breast milk," Dr Worawut advised.

Some Thai new mothers believe in myths about eight allergy-causing foods they should avoid -- cow milk, soy milk, wheat, eggs, fish, hard shell nuts, peanuts and seafood.
According to Dr Worawut, this is a misconception.

"When mothers abstain from these kinds of foods, it increases the chance that infants become allergic to them because they haven't been exposed to any of the foods during
breastfeeding," he concluded.

Related search: milk, breast milk, milk banks, breast milk donation

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