New virtual network saves global milk banks

COVID-19 pandemic which presented unprecedented challenges for the global milk banking movement has also boosted collaboration between milk banks from around the world that previously worked in silos.

The challenges which are partly driven by early uncertainty over whether the coronavirus could be transmitted through breast milk.

Human milk banks saw increased demand and decreased donations, due to reasons ranging from lockdowns to some women’s fears of leaving their houses to donate. Challenges continue in places such as India, where one factor driving the demand for donor milk is new mothers dying of the coronavirus, experts told Devex.

But COVID-19 also boosted collaboration between milk banks from around the world that previously worked in silos, despite their many shared challenges.

In the early days of the pandemic, dozens of milk banks and associations came together in a WhatsApp group to help each other navigate the rapidly changing information landscape.

COVID-19 created major setbacks on progress around initiating early breastfeeding, keeping mothers and babies together after delivery, and ensuring donor milk is available when needed. That made a virtual collaborative network more critical than ever.

Now these groups are working to formalize the Global Alliance of Milk Banks and Associations, or GAMBA, which aims to bring together milk banks from across the globe to share information, discuss evidence, and develop consensus around best practices in milk banking in the context of the pandemic and beyond.

Most of GAMBA’s members are milk banks and associations, though several NGOs are also involved, including the Seattle-based global health organization PATH and the global nutrition initiative Alive & Thrive.

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“The entire field needs innovations [including] developing guidance and standards, advocacy, generating evidence.”

Evidence increasingly shows that providing donor breast milk to premature, vulnerable, or low birth weight infants who cannot access their mothers’ milk leads to better outcomes compared with formula.

The milk often comes from milk banks, which recruit donors, collect their milk, and process, screen, and store it before distributing it to infants in need — with the goal of providing a bridge to breastfeeding.

There is inequity in the milk banking system, particularly in low- and middle-income countries and regions such as sub-Saharan Africa, where demand outweighs supply and newborns are 10 times more likely to die compared with infants in high-income countries.

PATH has worked on technology solutions to solve these inequities. For example, it has developed an app to guide flash-heat pasteurization, a simple method of manually killing bacteria in breast milk.

More recently, the NGO has been developing a digital tool to support data-driven decision-making related to lactation and breastfeeding, infant feeding and diet, and the use of donor milk.

But over time, leaders at PATH realized that the barriers to scaling up safe milk banking in low- and middle-income countries extended far beyond technology.

“The entire field needs innovations,” said Kiersten Israel-Ballard, who leads the human milk initiative at PATH, adding that this includes “developing guidance and standards, advocacy, generating evidence.”

PATH has been involved in efforts to share best practices in milk banking from place to place. For example, it organized a learning exchange in 2015 that brought technical experts from India to Brazil. The exchange was one factor in the eventual formation of an association for India’s milk banks.