For Healthcare Professionals

Safety of donor milk

Donor health screening
Donor mothers are screened verbally and by written forms for lifestyle and medical history, as well as medication and herbal supplement usage, according to HMBANA guidelines. This screening follows American Association of Blood Bank (AABB) guidelines, wherever applicable to human milk.

Serological screening for HIV/I/II, HTLV I/II, Hepatitis B and C, and syphilis must be negative at the time of donation. Donated milk is pumped and frozen before donation. Once delivered to the Milk Bank, it is kept frozen at -20 degrees C. until thawed for processing. Mothers donate their milk to the Milk Bank on a volunteer basis and do not receive financial compensation.

Exclusions
Many women are eligible to donate, but many are also excluded – even if they are breastfeeding their own infants. It is assumed that the fragility of the infant receiving donor human milk necessitates careful scrutiny of the health and medical status of the donor, and avoidance of anything that would burden the already compromised recipient. Some of the reasons for deferral include:

  • medication use (more common medications are allowed now, call us with specific questions)
  • herbal product use
  • tobacco product use
  • illegal drug use
  • risks for HIV or hepatitis, including obtaining tattoos, body piercings, or acupuncture with non-sterile needles, or the receipt of a blood transfusion within the past year
  • risks for Kreutzfeld Jakob Disease
  • daily alcohol use

All donor applications are reviewed by the donor intake coordinators (all IBCLC certified) prior to acceptance. Some medications (such as progestin-only birth control pills or low-dose estrogen OCPs; thyroid replacement hormone; insulin; prenatal or multivitamins, and iron or calcium supplements) are acceptable. Some allergy medications and anti-depressants are now allowed. Donor mothers are temporarily deferred if they require other medications for short periods. Please call us if you have specific medication questions.

Milk processing
Milk is pooled from one to five donors, most commonly three, to assure an acceptable nutritional content, a variety of immune factors, and to create a consistent average calorie count.

The milk processing protocol includes these steps, using clean technique throughout:

  • Pre-cultured frozen donor milk is thawed.
  • Milk is pooled, homogenized and aliquoted into bottles.
  • Bottled milk is then pasteurized at 62.5 degrees C using the Holder method of pasteurization.
  • Microbiological cultures are obtained by an independent laboratory from individual donors’ deposits prior to pasteurization and pooling, to verify that no heat-resistant pathogens are present.
  • Microbiological cultures are obtained from each batch of milk after pasteurization, to verify that there is zero growth of bacteria after the heating process.
  • Milk that cultures positive post-pasteurization is discarded. Only milk that remains negative for 48 hours is dispensed.
  • Pasteurized milk bottles are labeled with an expiration date 12 months after the earliest expression of milk in the pool, in addition to the batch number and pool number of the milk.
  • Pasteurized milk bottles remain sealed with a tamper-evident cap until opened by the hospital staff or outpatient guardians who are preparing to feed an infant.