4 Reasons NICUs Don’t Get Enough Donor Milk (and How to Fix It)

Updated: Dec 7, 2020

Donor milk in the NICU serves an important purpose. More neonatal intensive care clinicians than ever want to incorporate donor milk feeding into their unit. Yet they are often either unable to gain access to resources, or are limited in the donor milk nutrition they can bring in. Why is that?

There are often a few specific reasons:

Lack of organizational support

NICUs know why human milk feeding is necessary. Yet, purchasing decision makers outside the NICU may not know the data.

Donor milk cost

Unforeseen donor milk costs such as specialized transportation can increase the budget needed.

Information discrepancies

There may be opportunities to secure donor milk or human milk-based nutrition, but the plethora of conflicting information causes decision delays.

Donor milk pathogen concerns

NICUs may be wondering how to access the safest human milk-based nutrition that meets current food industry standards and eliminates all pathogens.

Those issues may have put a stop to your donor milk access in the past. But there are solutions you can implement.

1. Gain organizational support with data: Exclusive human milk feedings reduce NEC, sepsis, and mortality

The American Academy of Pediatrics (AAP) recommends an exclusive human milk diet for all infants, and especially those most at risk. An exclusive human milk diet can consist of mother’s own milk, donor milk, or a combination of the two.

Sharing data with your decision makers or value analysis committee will not only inform them, but also impart the strength of your reasoning behind delivering exclusive human milk feedings in your NICU.

Impart a compelling story using real-world examples and statistics. Pull resources from the AAP, recent research, and other informative tools to share. A good example is this infographic on the benefit of human milk in the NICU and its impact on NEC.

2. Reduce donor milk costs

Certain pasteurization methods require donor milk be frozen for storage and transportation. That entails specific handling requirements with extra steps to ensure it remains in a frozen state during transport. Unfortunately, those handling requirements add to the cost of donor milk. If you are considering a frozen donor milk resource, inquire about the methods of transport, how transport guarantees frozen temperature maintenance, and how costs may be alleviated if possible.

An opportunity to reduce costs is to use a sterilized, shelf-stable donor milk nutrition source. Benefit human milk-based nutrition is a shelf-stable option, meaning it can be stored and transported at room temperature. You can use shelf-stable sterilized donor milk nutrition to eliminate specialized transportation costs, increase efficiency for your staff (no more thawing time needed), while meeting the nutritional requirements of your infant patients.

3. Overcome information discrepancies by asking donor milk vendors for answers

The best way to make a donor milk resource decision for your NICU is to consult with donor milk vendors. You’ll want to listen to their presentation as well as ask your own prepared questions.

Collect questions and concerns from your leadership team prior to meeting with your selected donor milk resources. Your team will have good insight into top priorities for your unit. A few questions to add to your list:

  • Do you use Holder pasteurization or Retort processing?

  • Does your processing method destroy all pathogens?

  • If you use Holder pasteurization, how do you guarantee removal of B. cereus?

  • Does your donor milk require freezing?

  • If it requires freezing, how do you safely transport the milk?

  • If it requires freezing, how much freezer space do we need for storage?

  • If it does not require freezing, how much space do we need for storage?

  • What are your recommendations for storing an opened donor milk pouch or package?

  • How long can the opened pouch or package be kept before discarding?

  • Do you offer a variety of caloric options?

  • Does your milk already contain added minerals, or can we add as needed?

4. Pathogen concerns: Donor milk has achieved new levels of safety

Not all donor milk banks follow the same processing protocols. How can you be sure the product you order for your NICU is safe? Fortunately, more information is available than ever before to aid you in making the best decision for your unit.

Familiarize yourself with the two main donor milk processing methods: Holder pasteurization (HoP) and Retort sterilization. Both will eliminate bacteria, viruses, and mold. Holder pasteurization, however, will not eliminate all pathogens. As a result, specific processing steps need to be in place to ensure those pathogens do not transition to the finished product.

It is important to ask questions of your donor milk providers to clarify which processes they use, why they use them, and how they ensure the safety of their donor milk product. Request additional details if the answers are not clear to your satisfaction.

Overcoming hurdles to provide donor milk to infants most in need is worth the effort. With the right tools, it will become easier. Provide data to decision-makers, reduce costs, gain a deeper understanding, and verify donor milk safety. All those things will pave the way to improve your donor milk efforts, making it easier than ever to provide the gold standard in nutrition.

Are there other donor milk issues causing a delay in your NICU? Tell us more in the comments!

Medolac Benefit Human Milk products use an FDA-approved Retort sterilization food preparation method to eliminate all bacterial spores and viruses. Learn more about the Benefit human milk-based nutrition line for NICU infants.