VISITING HOSPITAL

All hospital visitors are recommended to wear a medical face mask. Expand this message for information about visiting hospital.

Last updated:
13 March 2023

Some visitor restrictions for all Te Whatu Ora Waitaha Canterbury hospitals and health facilities remain in place, but we have relaxed others.

There is still a heightened risk to vulnerable people in hospital and so we recommend all people wear a mask when visiting any of our facilities and follow other advice designed to keep patients, staff and  visitors safe.

To keep everybody safe:

  • Visitors or support people must not visit our facilities if they are unwell. Do not visit if you have recently tested positive for COVID-19 and haven’t completed your isolation period.
  • Patients may have more than one visitor, except in some situations such as multi-bed rooms where it can cause overcrowding.
  • Surgical/medical masks are recommended to be worn at all sites. Masks will be provided if you don’t have one.
  • For Specialist Mental Health Services everyone is strongly encouraged to wear a face mask in all inpatient areas and areas where consumers are receiving care (i.e. community appointments, home-visits, transporting people). Discretion may be applied in cases where masks impair your ability to communicate effectively.
  • Visitors must not eat or drink in multibed rooms because of the increased risk when multiple people remove their face mask in the same space.
  • Hand sanitiser is available and must be used.

Thank you in advance for your patience and understanding as our staff work hard to protect and care for some of the most vulnerable in our community.

Visiting patients with COVID-19

  • People can visit patients who have COVID-19 but they must wear an N95 mask – this will be provided if you don’t have one.
  • Other methods of communication will be facilitated e.g. phone, Facetime, Zoom, WhatsApp etc where visits aren’t possible.

All of our Hospitals

Visiting hours for our hospitals have returned to pre COVID-19 hours with the exception of Christchurch Women’s Hospital.

All visitors are recommended to wear a medical face mask.

Parents/caregivers are able to be with their child in hospital and visitors are now allowed, except for the Children’s Haematology and Oncology Day stay where just one parent/caregiver is able to attend their appointment with their child. Exceptions by special arrangement only.

Patients and visitors should also read the additional more detailed visiting guidelines for each specific hospital.

More COVID-19 information

Human Milkbank

Human Milk Bank

Te Whatu Ora, Waitaha Canterbury, has a level III Neonatal Intensive Care Unit (NICU).The NICU is Baby Friendly hospital Initiative accredited and as such protects, supports and promotes Ūkaipō/ breastfeeding. Te Whatu Ora (Ministry of Health,[2020]) promotes mother’s own breast milk(MOM) as “the perfect food for a baby”. Research shows that breastmilk provides all essential immune system boosters, vitamins, minerals and nutrients for the health and growth of pēpi. Exclusive breastfeeding is recommended for a minimum of 6 months and breastmilk feeding is encouraged alongside complimentary foods for at least the first 2 years of a child’s life.

Breastmilk is particularly important for babies who have been born prematurely or any ill or unwell baby admitted to the NICU. These babies have higher nutritional and immunity needs. When a parent’s own milk is not available the milk bank offers support by providing screened and pasteurised donor milk while the parent builds their milk production. Donated breastmilk is precious resource that is gifted by healthy breastfeeding parents who have breastmilk surplus to their needs. The Neonatal Service honours the extraordinary commitment of these parents who donate their surplus whilst breastfeeding their own baby.

The Waitaha Canterbury Human Milk Bank (HMB), pioneered human milk banking in New Zealand and continues to support the expansion of human milk banking locally and on a national level. Waitaha Canterbury HMB has been operating from its offices at the Christchurch Women’s Hospital, since February 2014. The offices of the Human milk bank are conveniently located in close proximity to the NICU and Maternity ward.

Providing Pasteurised donor milk has been implemented in stages.  Initially, the focus of the human milk bank was to provide a pasteurised donor milk service to the babies admitted to the NICU. It took a few years for milk banking practice to establish in the community and with that stock of milk donations fluctuated. In October 2017, the milk bank was able to offer pasteurised donor milk to babies on the Maternity ward, as stock levels permitted. In 2020, the milk bank was able to extend availability of pasteurised donor milk, on a case by case basis, to other NICUs and hospitals in the country, again as milk stock permitted. March 2022 saw a further extension of pasteurised donor milk to the Te Nikau Maternity ward (West Coast), and yet again as milk stock levels permit. Most recently we have been able to afford an emergency pasteurised donor milk stock at the Community Birthing Units in Canterbury, Ashburton Maternity Unit, Timaru Hospital and Kaikoura Health (as milk stock levels permit).

The first community based milk bank called the Rotary Community Milk Bank, opened in 2018. The HMB provided information pertaining to operational processes, as well as a compilation HMB forms and guidelines which have been adapted for their use. The HMB supported the Rotary milk bank by pasteurising their milk donations until July 2020 when their pasteurising service came on line. In 2021, Mothers Milk Bank Pataka Miraka was established at the Te Whatu Ora Capital, Coast and Hutt Valley Wellington NICU. The Community Milk Bank, Whāngai Ora was also established in 2021. Most recently, HMB supported the commissioning of the Nelson and Wairau Maternity Unit Milk Banks by providing onsite training and tailored milk banking documentation. The HMB is a national resource for milk banking information and resources.

 

The aim is to support parents who plan to breastfeed by providing pasteurised donor milk until their milk production establishes. The milk bank also provides support with pasteurised donor milk for those babies who are critically unwell or those very premature babies at risk of developing necrotising enterocolitis (NEC), which is a life-threatening condition.

The Human Milk Bank is managed by a specialist clinical nurse who oversees all day to day operations of the milk bank. The milk bank manager is supported by a staff compliment who are highly skilled and trained in the most up to date milk banking practice. A panel of experts meet regularly to discuss current milk banking practice and ensure the safety and quality of donor human milk at every stage of processing.

Together the milk bank team,  members of the health team such as the doctors, nurses, infant feeding specialist and dietician staff to identify both potential donors, parents presenting with delayed milk production and babies (premature and ill/unwell) who meet predetermined criteria to receive pasteurised donor milk. A panel of experts meet regularly to review research, discuss and update current milk banking practice and ensure the safety and quality of donor human milk at every stage of processing. They are known as the Milk Bank Executive and includes the following :

  • Schol O’Bery (Clinical Nurse Specialist and Milk Bank Manager)
  • Bronwyn Dixon (Clinical Director)
  • Nicola Austin (Neonatal Consultant)
  • Nicky Clark (Dietician)
  • Hazel McGregor (Infant Feeding Specialist)
  • Graeme Webb (Quality Coordinator, Child Health)
  • Kathy Simmons (Community Maori Advisor)
  • Hui Wang (Microbiologist)
  • Mike O’Callaghan (Infection Control)
  • Barbara Robertshawe (Pharmacist)

Why Human Donor Milk?

The benefits of pasteurised donor milk are that the human milk, which is pasteurised for use, contains more than 200 components that are useful for growth and health for a baby. Pasteurised donor milk is recommended as the next best option to mother own milk. It assists the baby to build a healthy immune system and also acts as protection against infections. It contains easily digestible proteins, reduces the risk of bowel problems in preterm infants and contributes to nervous system and brain growth.

History of Human Milk Banks, Donor Milk

Feeding a baby with another woman's breast milk has occurred since time immemorial. In some cases it was merely a matter of convenience when mothers, particularly wealthy ones, did not want to suffer what they perceived as the 'indignity of breastfeeding', so wet nurses were employed and this became a thriving industry in some countries. Wet nurses provided milk for healthy babies who were able to actively suckle at the breast, but sick, small premature babies, who were unable to latch and breastfeed, were unable to benefit from being given to a wet nurse for nourishment.[1]

The first recorded milk bank opened in Vienna, Austria, in 1909. Wet nurses expressed their breasts and this milk was given to sick babies. Now there are over 500 milk banks worldwide in 44 countries. The 1980s saw the decline of milk banks, not only due to the rise in HIV infections, but also partly due to the development of formula milks designed for preterm babies by industry. Although it was known that pasteurisation deactivated the HIV virus, (HIV did not result in a decline in blood banking) the perceived costs of screening potential donor mothers and the processes involved in donor milk banking, versus the easy availability of preterm formula, resulted in many, but not all, milk banks closing globally.

With increasing knowledge of the unique composition of breast milk and the health impact of infant formula, the interest in milk bank development re-emerged globally. The protective components of breast milk such as the immunoglobulins IgA and SIgA, the anti-bacterial/anti-infective proteins lactoferrin and lysozyme, and the many oligosaccharides that provide bioactive factors, prebiotic, immunomodulatory & antimicrobial effects, have helped reduce necrotising enterocolitis (NEC) and late onset sepsis rates in premature and unwell babies admitted to the NICU.

[1] American Academy of Paediatrics. (2012). A policy statement: Breastfeeding and the use of human milk. Paediatrics, doi: 10.1542/peds.2011-3552. (update on the 2005 statement)

​​From Donor to Baby - The Process

Donated milk is received from screened healthy breastfeeding parents. This milk, known as raw milk. At this stage it is stored frozen until it is pasteurised. The batches of raw milk are defrosted and each donor's milk is pooled into batches (milk from different donors is not mixed) for tracking purposes. The defrosted milk is poured into 250ml pasteurising safe and BPA free bottles and pasteurised using the Holder method of pasteurization. The HMB uses a S90/USB (closed pasteurising refrigeration system) where milk is heated up to 62.5 °C and kept at that temperature for thirty minutes. This heat-treatment neutralised most known viruses and bacteria. This phase is followed by rapidly chilling the milk to 4°C.

The Holder method is the most commonly used and internationally acclaimed method of treating human breast milk. It is known to be gentle and to preserve up to 95% of the goodness of breast milk. The milk is then measured and decanted into smaller sized volumes, and refrozen. This milk can then be dispensed for use.

The Sterifeed S90/USB Pasteuriser holds up to 8.5 litres of milk. Samples of milk are taken post-pasteurisation from every batch and the milk and sent to the laboratory for testing. This milk is then held in a ‘quarantine’ status until results are verified and cleared. This usually takes forty-eight hours. A tracking and tracing system of all milk inventory, allows the pasteurised donor milk to be tracked from donor to recipient.

Milk Bank Process

The below video outlines the process.

If you are using an older browser and cannot see the video above, it can be viewed on www.vimeo.com instead.

Transcript

Welcome to the Human Milk Bank.

This video takes you on a journey through the human milk bank and the stages of pasteurizing donated breast milk.

This is the raw and pasteurized milk freezer.

Where bags of donated breast milk are stored until required for pasteurizing.

They can be stored for up to three months from the day of expressing.

These are the yellow quarantine milk freezer on the left.

Where milk awaiting microscopy results is stored.

The green freezer on the right is the dispensing freezer.

This fridge is used to defrost milk overnight ready for pasteurizing.

Meet “Louis” the nine litre sterifeed eco pasteurizer

As breast milk is a body fluid and a food, hygiene standards are required.

This is Mary Cleave the Milk Bank Aid who pasteurizes the milk.

The number of bottles used in the pasteurization process is determined by how much milk is in each batch of raw milk.

An electronic Data Logger is used to ensure the pasteurization process is correct.

Once programmed the Data Logger is attached to the pasteurizer.

Donor mother’s milk is tested for bacterial count before and after the pasteurization process.

If it is too high, the milk is discarded.

One donors milk is pooled to about 2.5 litres and agitated for uniformity.

Once pulled, the raw milk is poured into special pasteurization bottles. At this point a sample of unpasteurized milk is sent for bacterial count.

Once all the milk has been poured into the pasteurization bottles.

These are then placed into a basket ready for the pasteurizer.

Each bottle holds about 240 mils.

A total of about 8.7 litres of milk can be pasteurized at one time.

A temperature probe is part of the Data Logger system.

The probe is placed into a bottle of water amongst the bottles of milk in the basket and into the pasteurizer.

The temperature probe reflects the temperature of the milk throughout the pasteurization process.

The baskets of raw milk are placed into the pasteurizer of hot swirling water at about 63 degrees.

This photograph shows two baskets of milk ready for the pasteurizer.

Once the bottle probe is attached to the pasteurizer on the right.

The Data Logger is started to record the temperature of the water bottle every minute throughout the pasteurization process which takes about two hours.

The pasteurizer warms the milk to about 62.5 or 63 degrees, holds it at that temperature for 30 minutes, and then quickly chills the milk again to four degrees centigrade.

Once the milk has been pasteurized the baskets are removed, and the lids are tightened.

The data from the logger is downloaded to ensure the milk has been pasteurized correctly.

The pasteurized milk is decanted into smaller sized bottles for ease of use.

A post-pasteurization sample is sent for microscopy to ensure the pasteurizer has been effective.

Pasteurized donor milk is stored in three sizes 50 mils 100 mils and 200 mils.

And the appropriate size bottle is dispensed according to the recipient’s needs.

Every bottle of pasteurized milk has a unique identification number and expiry date.

And can have other information such as calories, protein, and the fat content of that milk.

The number does not identify the donor, but does allow for tracking and tracing of the milk from donor to recipient.

Once opened, the milk expires after 24 hours.

Once the microscopy sample has been sent, the batch of milk is bagged and labelled.

And then is placed in the quarantine freezer until the microscopy results are obtained after 48 hours.

Once the microscopy results are obtained and the milk has been cleared for use. The batch of milk is placed in the dispensing green freezer.

When a baby has been consented for pasteurized donor milk.

The appropriate amount of milk is dispensed, recorded in the inventory, and double checked against the baby’s ID.

The Milk Bank accepts breast milk from parents who have surplus to their own baby's requirements. Mothers are provided information about becoming a breast milk donor and what is involved. Additionally, parents are asked to complete a general health questionnaire and have a blood screening test to ensure that they are free from infections known to be transmitted in breast milk. If the parent meets the screening requirements to become a milk donor, they will be asked to sign the consent to donate form and given further information about the process of expressing, storing and transporting milk. A donor starter pack (includes single use only bottles, bag tag, and labels to label each bottle of milk) will also be provided.

If you would like to know more about becoming a donor contact us;

Phone: (03) 364 4344
Mobile: 021 190 5008 (Manager) or 021 241 2931 (Milk Bank Office)
Email: MilkBankNICU@cdhb.health.nz

For more information download the following documents

Human Donor Breastmilk Health Screen
Human Milk For Our Babies
Mother Wishing to Donate Human Milk Consent Form
Donating Breastmilk and Taking Medication

Waitaha Human Milk Bank Projects

Current: Emergency stock of PDM to Canterbury Primary Birthing Units

Goal:

  • To provide interim/ short term nutritional support while parent establishes milk production and /
  • To provide short-term support until PDM support is initiated from the Community Milk Bank

Project description

This project aims to extend a pasteurised donor milk service to remote areas such as Te Nikau (West Coast) and Kaikoura Health, Other Hospitals – Timaru and Ashburton Hospitals and Community Maternity Units – Oromairaki (Rolleston), and Rangiora Health Hub.

NB:  Pasteurised donor milk (PDM) is a limited resource. PDM from the Waitaha Human milk bank is prioritised for the premature and unwell babies of the Christchurch Neonatal Intensive care Unit. Therefore pasteurised donor milk availability is not guaranteed and can only be extended as ilk stock permits.

Ongoing

  1. Goal: To promote individual nutritional support

Project description:

This project aims to offer macronutrient analysis of human breast milk, raw (mother’s own milk) or heat-treated donor milk (pasteurised donor milk) to individualise clinically indicative nutritional supportive measures.

  1. Goal: To support national human milk banking operations

Project description:

This project aims to offer and support a New Zealand approach while working in accordance with international milk banking recommendations. This assures that the milk banking sector in New Zealand is managed with highest safety and quality standards.

 

See what some our Donors and Recipients have to say…

Milk Donors

Fabulous staff.  Appreciated milk collection from home. Donating milk was a rewarding experience. The staff at the milk bank made the process very easy and even collected milk form my doorstep. Emma

It was wonderful to be able to give something back to NICU after all the amazing care they provided our son. A great team and they made donating milk convenient, easy and very rewarding. Sophie

I have loved being able to donate milk to the Human milk Bank. It is truly a gift that I am grateful for to feed my beautiful boy and many other babies. Charlotte

Donating to the milk is a rewarding and satisfying experience. It was a great way to get into a pumping routine and also became a bit of a personal challenge to see how many bottles I could fill. Very motivating.  Kerry

I love being able to donate to such a worthy cause. They make the process super easy so it fits right into my schedule with my baby boy. Jessica 

Being a milk donor was simple and easy. It fitted in alongside what I was already doing. Regular pick- ups and open communication allowed for me to not fuss over what to do. If you have extra milk, I encourage you to join in. Theresa

I felt so supported during donating. They made it so easy to donate milk, although you are a busy mum. Uncomplicated communication and pick up and you can always be sure it reaches to babies who need it most. Christin

I was fortunate to be able to breastfeed and have surplus milk to donate. Having community pick-ups of frozen milk is so handy. Anthea made the whole process very easy. Unfortunately after starting solids my supply dropped so I was no longer able to donate.   However hope to be able to donate again in the future. Thank you for the opportunity. Kadie

Milk Recipients

I was given a lot of information upon receiving the milk but I think there was some confusion amongst the staff over admin of donor milk. I was put onto a very strict pumping regime within 24 hours of giving birth because we received donor milk and it made my time in the hospital post-birth quite stressful. Kirrily

Note: It is normal practice for all mums in the neonatal unit, who wish to breastfeed, to be encouraged to express 2/3 hourly during the day and once at night to achieve 8 expressions in 24 hours in the early weeks. This is based on good research that early, effective, frequent expressing helps to support a potential milk supply as the baby is either too premature or sick to breastfeed directly. It may seem harsh as a mother already has the stress of having a baby in the neonatal unit but there is more stress when mothers are unable to produce milk for their baby because their bodies weren’t stimulated to produce milk in those early days and weeks.

Donors to the milkbank

These photos were taken with the last donations by the mothers. (Donors can continue to donate until their child reaches their first birthday).

Charlotte DaviePhilippa making her last donation

Frequently Asked Questions About Becoming a Breast milk Donor

​​The follo​wing frequently asked questions focuses specifically on the types of questions that potential donors commonly ask.

Gold standard nutrition

Parent’s own milk is the best nutrition for their baby.

Colostrum (first milk)

All babies should receive their own mother's colostrum (first milk) where possible. Colostrum is high in protein and low in fat and sugar. It's filled with white blood cells that produce antibodies. These antibodies will strengthen your baby's immune system. Colostrum is highly concentrated and nutrient-dense even in the smallest doses, so your baby's tummy doesn't need a lot to reap its benefits. In terms of duration of donor milk supply, the Milk Bank Executive committee have set the following guidance:

When breastfeeding is not possible

For families where breastfeeding is not possible, the Human Milk Bank can provide donor milk for:

  • Extremely low birth weight (premature) babies up to 36 weeks to prevent serious gut infection followed by a transitional period where infant formula is introduced slowly over a week or two as tolerated by the baby.
  • High risk Low birth weight babies up to 36 weeks or during neonatal period (4 weeks), followed by a transitional period where infant formula is introduced slowly over a week or as tolerated by the baby.
  • Low risk, low birth weight during neonatal period followed by a transitional period where infant formula is introduced slowly over a week or as tolerated by the baby.

For parents where a delay in milk production is being supported, there is no definitive cut off. The aim is to provide donor milk during the window of opportunity that there is to maximise maternal milk production. The use of pasteurised donor milk can therefore be very variable, and is treated on a case-by-case basis. Sometimes only small volumes are needed; at other times support can continue for several weeks.

This is all dependent on the availability of Pasteurised donor milk which may mean that the HMB does not have sufficient PDM stock to meet the needs of all families.

Can all babies in the NICU receive pasteurised donor milk?

Premature and unwell/ sick babies who have been admitted to the NICU are prioritised to receive Pasteurised Donated Milk (PDM) when their parent’s own milk production is not enough to meet their nutritional requirement. PDM is a very precious resource with a finite supply. Availability of PDM stock is reviewed regularly and Dispensing is updated using a traffic light system.

My baby is admitted to hospital, can my baby receive pasteurised donor milk

The stress associated with hospitalisation can impact breastmilk production. In such instances parents are encouraged to continue breast feeding as able and commence regular expressing to promote increased milk production.  Introduction of a galactogogue may be necessary in some cases to support milk production. PDM use may be extended as a bridge to supplement mother’s own milk. PDM use outside of the NICU is influenced by the availability of pasteurised donor milk. All requests for PDM are submitted to the Milk Bank Executive Committee (HMB’s prioritisation panel) for clinical prioritisation. Review of PDM use will be daily.

Other hospitals or NICUs

Other NICU /hospital requests are reviewed by the Milk Bank Executive team or Neonatal Clinical Director. The priority for PDM support is given to recipients with high risk factors for necrotising enterocolitis (NEC).

 

All babies should receive their own mother's colostrum (first milk) where possible. Colostrum is high in protein and low in fat and sugar. It's filled with white blood cells that produce antibodies. These antibodies will strengthen your baby's immune system. Colostrum is highly concentrated and nutrient-dense even in the smallest doses, so your baby's tummy doesn't need a lot to reap its benefits.

The parents of a potential recipient baby will be approached and given information, which will include the following documents:

Recipient of Pasteurised Human Donor Milk Consent

Human Donor Milk For Your Baby

One of the parents (usually the mother) will be asked to sign the consent form and pasteurised donated milk will then be allocated to that baby.

What does donated milk mean to parents?

Caroline and Annabelle.

Baby Annabelle Milk Bank Donor Recipient

New Zealand's first Human Milk Bank was possible through the generous support of the Canterbury Neonatal Unit Trust. They provided funding for pasteurisation and storage equipment making this service a reality for which we are very grateful. If you wish to support the trust which supports us, visit the www.canterburyneonatal.org.nz or contact them;

Phone: 00 64 27 229 5689
Email: info@canterburyneonatal.co.nz

On Tuesday 4th February 2014 the human milk bank opened its (freezer) doors, making it possible to provide pasteurised donor breast milk to babies in the Christchurch Neonatal Intensive Care Unit (NICU). This is the first hospital-based formal donor milk bank in New Zealand.

 

The Human Milk Bank offers a pick-up service for all donors registered with The Human Milk Bank donors.

Page last updated: 12 February 2024

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