SA Breastmilk Reserve

OBJECTIVES OF WORLD BREASTFEEDING WEEK 2009 (Augustus 1-7)

• To draw attention to the vital role that breastfeeding plays in emergencies worldwide.
• To stress the need for active protection and support of breastfeeding before and during emergencies.
• To inform mothers, breastfeeding advocates, communities, health professionals, governments, aid agencies, donors, and the media on how they can actively support breastfeeding before and during an emergency.
• To mobilize action and nurture networking and collaboration between those with breastfeeding skills and those involved in emergency response.

RATIONALE

• Children are the most vulnerable in emergencies – child mortality can soar from 2 to 70 times higher than average due to diarrhea, respiratory illness and malnutrition.
• Breastfeeding is a life saving intervention and protection is greatest for the youngest infants. Even in non-emergency settings, non-breastfed babies under 2 months of age are six times more likely to die.
• Emergencies can happen anywhere in the world. Emergencies destroy what is ‘normal,’ leaving caregivers struggling to cope and infants vulnerable to disease and death.
• During emergencies, mothers need active support to continue or re-establish breastfeeding.
• Emergency preparedness is vital. Supporting breastfeeding in non-emergency settings will strengthen mothers’ capacity to cope in an emergency.

 For more info read beneath or visit: http://www.sabr.org.za/

Availability and Indications for Donor Breastmilk
SABR in-hospital banks and affiliated institutions


1.    The South African Breastmilk Reserve (SABR) operates as a non-profit organisation (NPO) and depends on financial donations.

2.    SABR operates in accordance with the South African Human Tissue Act, No 65, of 1983.

2.1      Breast milk donors make a free contribution of breastmilk and receive no remuneration, financial or in kind.

2.2     ALL MOTHERS donating breast milk undergo VERY STRICT SCREENING   PROTOCOL, and have PROOF OF NEGATIVE  ANTE-NATAL HIV  RESULTS.

2.3     ALL DONOR MILK IS PASTURISED AT 66 degrees Celsius for 30 minutes, so as to make sure that ALL VIRUSSES AND BACTERIA ARE ILLEMUNATED.

3.    Donor Breast milk (DBM) is supplied at no-charge to public hospital facilities.

4.    DBM is supplied to private hospital facilities. Parents/guardians of recipients are required to make a once off donation of R200 in support of processing and transport costs. Same-day deliveries attract delivery costs as per ‘SABR Ordering Protocol’.

5.    The donor milk supply is limited and explicit indications for the administration of donor breast milk (DBM) to prioritised infants are mandatory. All infant have the right to equal and fair access to DBM.

6.    For profit sale of SABR DBM, is strictly prohibited.

7.    Donor breast milk from SABR will be supplied, if the following conditions are met, for a period of 14 days. Thereafter, for special or high risk cases, paediatricians are required to motivate further use of DBM, verbally (telephonically) with the SABR paediatric medical adviser:

8.         Physician Order 

8.1    A prescription from a paediatrician specifying the volume of donor breast milk and the volume that the mother of the infant can produce.

8.2    Written verification from a registered lactation consultant that all measures have been taken and are in place to facilitate lactation of the infant’s own mother and the reasons for lactation failure.

8.3    . Mothers of infants using DBM must receive active support and motivation to promote lactation This will ensure the continuation of breastfeeding once the 14days of DBM supplementation have lapsed.

8.4    Under no circumstance should mothers of recipients be given the impression that DBM is an alternative to their own lactation or that DBM will be supplied until discharge of the infant.

9.      Recipients

9.1     PREMATURE Infants with a birth weight <1,8 kg and <14 days old who are at risk to develop necrotising enterocolitis (Severe Intestinal infection) and who are for adoption.

10.    Maternal Factors

10.1    Medical contraindications for breast feeding (verified by physician in liaison with a      lactation consultant) AND infant <1.8 kg and <14 days of age. 

10.2    Maternal death/mother critically ill AND infant <1.8 kg and <14 days of age.


11.    Time Factors

Short-term use, i.e. 14 days (danger period for the development of necrotising enterocolitis)*


ALL OTHER INDICATIONS FOR DONOR BREASTMILK TO BE DISCUSSED WITH A MEDICAL SUPERVISOR AFFILIATED THE SABR (contact details available from the SABR).


* Due to the limited supply of donor breastmilk in SA.  

12.    Terms of Agreement For NICUs(Neonatal Intensive Care Units and Hospitals Receiving DBM  from SABR.

          Hospitals receiving DBM from SABR are required to:

12.1 Support and abide to the above stated guidelines:

12.2 Under no circumstance private DBM donation, in exchange for money or goods, should be encouraged. Breast milk acquired privately does not undergo adequate screening or pasteurisation and is unsafe for feeding of infants other than mothers own.

12.2.1    SABR will not supply NICUs that use privately sourced donated breastmilk. The organisation does not wish to be associated with unsafe infant feeding practices and does not promote private donations in principle. All infants, in public and private care should have equal access to DBM. Financial means should not determine access to DBM.

12.3    Actively promote the donation of breastmilk to SABR with their patients in maternity, NICU and follow up clinics (eg. Storks Nest)

13.    SABR Medical Advisory Board

13.1    We invite paediatricians and medical practitioners affiliated with SABR to join the Medical Advisory board if they whish to participate in the drafting of human milk banking guidelines for Gauteng in the year 2008. Submission date closes on 31st January 2008.

13.1.1     Applications may be sent in writing to info@sabr.org.za, accompanied by a short CV and details of previous involvement with SABR.

13.1.2    Candidates will be required to make themselves available for 4 yearly board meetings.



CONTACTS FOR MEDICAL CLARIFICATIONS OF BREASTFEEDING ASSESSMENT:

Prof Suzanne Delport: 082 334 1575 (Paediatric Medical Adviser)
LC Doc. Jennifer Naude: 083 216 6893 (Pretoria)
Sr Vanessa Booysen: 082 820 2215 (Bloemfontein)