Friday, Jan. 29, 2010

Breast-Milk for Haiti: Why Donations Are Being Discouraged

The call had gone out across the U.S. to breast-feeding moms: Power up your pumps, ladies. Haitian babies need your milk.

And on Jan. 28, those babies got it.

Through a complicated chain of communication involving various members of Congress, the U.S. Department of Health and Human Services and breast-feeding organizations galore, the Human Milk Banking Association of North America (HMBANA) dispatched two coolers' worth of donated breast milk to Haitian preemies being cared for on the U.S.S. Comfort, the floating hospital anchored near Port-au-Prince. "The fact that there is a doctor on board this ship who understands the importance of breast milk is just amazing," says Amanda Nickerson, executive director of the International Breast Milk Project, which arranged the shipment of 140 3-oz. bottles of milk. Quick International Courier, a New York City–based firm that specializes in out-of-the-ordinary cargo, handled as a pro bono matter the delivery, which involved dry ice and rapid-fire transfers between Southwest Airlines, a charter flight and finally a military helicopter.

The HMBANA cargo supplements what is likely the world's only nautical milk bank. When one of the pediatricians on board the Comfort, Dr. Erika Beard Irvine, realized that she had only three cases of formula upon arrival, she connected with breast-feeding Navy moms who had deployed and didn't know what to do with their breast milk. Beard Irvine is storing their pumped milk in the ship's freezers and feeding it to the babies under her care, including one preemie born on board.

Since so-called booby bloggers first posted word earlier this week of the need for milk, thousands of women have been clamoring to donate milk to babies on the Haitian mainland. But the truth — for now, at least — is that they can't. "You want to feed those babies when you see those pictures out there," says Pauline Sakamoto, president of HMBANA, "but there is no freezer space and no electricity."

In the U.S., milk banks rigorously screen donors, then pasteurize, process and freeze their milk before distribution. When it's shipped to sick babies across the country, it's nestled in dry ice. Unrefrigerated, breast milk — like cow's milk — turns rancid.

That's why the World Health Organization, UNICEF and the United Nations World Food Programme issued a joint statement Jan. 21 that the necessary infrastructure isn't yet in place to utilize donated breast milk on the Haitian mainland.

Public-health officials maintain that breast is best in emergency situations, but only when Mom is right there to feed the baby — no need for temperature control or bottle parts to wash. Breast-feeding is self-contained, readily available and chock-full of antibodies that protect infants from infection and disease. After previous disasters, like the Indian Ocean tsunami in 2004, donations of formula flooded the affected areas from well-intentioned organizations worried that stress and poor nutrition would curtail mothers' ability to produce milk. In Indian villages where free powdered formula was distributed, formula-fed infants suffered diarrhea at a rate three times higher than breast-fed babies after the tsunami, according to a study conducted by Dr. B. Adhisivam and published in 2006 in Indian Pediatrics.

In Haiti, where most mothers breast-feed, an influx of formula — even ready-to-feed liquid formula, which requires sterilized bottles and nipples — could be particularly devastating. Both the World Health Organization and UNICEF discourage unsolicited donations of formula in disaster areas. Save the Children has been broadcasting messages in Creole on Haitian radio stations urging new mothers to breast-feed and warning against baby formula made with dirty water.

"Formula is a recipe for disaster in emergency situations," says Cathy Carothers, who serves as a spokeswoman for the U.S. Breastfeeding Committee, a coalition of more than 40 organizations, including the American Academy of Pediatrics, that promotes breast-feeding. "In emergencies, babies who are not breast-fed are more likely to die because of issues of lack of water or contaminated water and inability to sterilize feeding tools.

Eager to do something to alleviate the suffering of the smallest, many lactating women are wishing the Comfort had more storage space to handle donated milk. At least one Navy staffer, who had to leave her 10-week-old baby behind when she deployed, was "pumping and dumping" — nursing slang for pumping then discarding milk. Now that there's a use for her milk, she's ferrying it to the ship daily from the mainland, where she is currently working. Beard Irvine has a name for that milk: "Comfort food."

Read more in the new TIME book Earthquake Haiti: Tragedy and Hope and support TIME's Haiti relief efforts.