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 :
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.
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)
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.
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.
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.
Phone: (03) 364 4344
Mobile: 021 190 5008 (Manager) or 021 241 2931 (Milk Bank Office)
Email: MilkBankNICU@cdhb.health.nz
Human Donor Breastmilk Health Screen
Human Milk For Our Babies
Mother Wishing to Donate Human Milk Consent Form
Donating Breastmilk and Taking Medication
Current: Emergency stock of PDM to Canterbury Primary Birthing Units
Goal:
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
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.
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.
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
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.
These photos were taken with the last donations by the mothers. (Donors can continue to donate until their child reaches their first birthday).
The following frequently asked questions focuses specifically on the types of questions that potential donors commonly ask.
Parent’s own milk is the best nutrition for their baby.
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:
For families where breastfeeding is not possible, the Human Milk Bank can provide donor milk for:
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.
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.
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 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.
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.
Milk Banking is a common practice across Australasia & worldwide and is endorsed by the World Health Organization, societies within the medical profession and the New Zealand Breastfeeding Authority.
Pasteurised Human milk contains over 200 components that are useful for growth and infant health:
Donor mothers have to successfully complete a health screen and undertake blood tests to ensure they are free of known communicable diseases and infections. The Health screen also ensures that donor milk is free from medications/drugs and nicotine. Additionally the Donor milk is heat treated (Pasteurised) to ensure the milk is as safe as possible.
The medical team use the following criteria to assist in determining who can receive Pasteurised Donor Milk. The purpose of the criteria is to ensure that the most vulnerable of our babies are offered pasteurised donor milk following parental consent.
Currently Pasteurised Donor Milk is provided free of charge to babies meeting certain criteria who are admitted to Christchurch Women's Hospital Neonatal Unit.
Any mother producing more milk than their baby needs who successfully completes:
See Human Milk For Our Babies for more information.
The screening blood tests will include HIV 1 and 2, Hepatitis B and C, HTLV 1 & 2. HTLV 1 and 2 are risk factors for the onset of adult leukaemia and lymphoma. The blood tests are done at no cost to you.
No. This is a voluntary donation to help our most vulnerable.
New Zealand Breastfeeding Alliance
United Kingdom Association for Milk Banking - (UKAMB)
World Health Organization - (WHO)
Page last updated: 12 February 2024
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