Physicians
How are milk donors screened?
Donors of human milk are healthy lactating mothers who are screened through medical and lifestyle histories, blood tests for HIV, HTLV, hepatitis B and C, and syphilis, and microbiology cultures of the milk. Medical records for the donor and her baby are obtained from their physicians. Donor screening meets the guidelines set forth by the Human Milk Banking Association of North America.
Is the milk pasteurized?
Yes. All donor human milk is pasteurized using the Holder Method, a process of heating milk to 62.5° C for 30 minutes in a shaking water bath. The processed milk is then rapidly cooled and frozen and stored at -20°C or colder. Milk is only dispensed once a post-pasteurization culture shows no growth. Our pasteurization processes strictly follow the guidelines set forth by the Human Milk Banking Association of North America.
How is donor human milk packaged?
Donor human milk from the Mothers’ Milk Bank of North Texas (MMBNT) is packaged in 100 ml. glass bottles. The bottles are labeled with the expiration date, the batch number and nutritional information. All milk dispensed by MMBNT is pasteurized and labeled with an expiration date. Bottles have tamper evident shrink wrap security bands.
How does a hospital order milk?
A representative from the hospital need only call the Mothers’ Milk Bank of North Texas Monday –Thursday 9am-3pm to place an order. We accept Friday orders from 9am-noon only in urgent situations. Many hospitals set up MMBNT as a vendor account and provide us with a purchase order number with each milk order. Some hospitals simply order by phone and an invoice is sent for each order.
How is the milk delivered?
Milk is delivered to Dallas-Fort Worth area hospital by courier and can usually be delivered the same day (although we always appreciate 24 hours notice if possible).
For hospitals outside of the Dallas-Fort Worth area: Milk is shipped by Fed Ex in insulated shipping containers frozen on dry ice. Orders placed by noon will be received by the hospital by 10:30 am the next day.
What nutritional information is included?
All milk dispensed to hospitalized infants is tested for nutritional value using the York Dairy Analyzer. The York is calibrated to detect and measure the human milk macronutrients (fat, protein, and lactose) using a mid-range infrared spectroscopy. Calibrations are periodically tested against the industry standard for these components by the USDA office in Carrollton, Texas. Each bottle of milk is labeled with the calorie and protein values. The instrument is calibrated with bias and slope as well as automatic linear regression. The accuracy of the York is as follows:
Fat <0.03 grams/Liter against Rose Gottlieb
Protein <0.03 grams/liter against Kjeldahl
Lactose 0.03 against Polarimetry
Can we specify a caloric value?
Milk for hospitalized infants is pooled selectively to attempt to target caloric content. Most of the milk we pasteurize is 20 Kcal/ounce when analyzed. We have much smaller supplies of 22 Kcal/ounce and sometimes 24 Kcal/ounce milk. We asked recipient hospitals to limit ordering the higher calorie concentrations for specific babies.
Is the milk cultured after pasteurization?
Yes. All donor human milk dispensed by MMBNT is cultured for bacterial growth. Once a final report of “no growth” is received from our medical laboratory the milk is available to dispense.
How long can we use an open bottle of milk?
Donor human milk is sterile when dispensed. Some recipient hospitals store and use refrigerated thawed donor human milk within 24 hours of thawing and some hospitals use it for 48 hours before discarding. Milk that has been fortified should be discarded at 24 hours because of potential contamination during the fortification process, or from fortifier itself.
What steps are taken to maximize the safety and security of the milk?
All milk is shipped to NICUs in new, clean insulated containers using new foam packing material to minimize contamination of the outside of the bottles that will be at the bedside of vulnerable infants. Milk bank staff packing the donor milk use clean technique. Each container is packed with dry ice to insure the product remains frozen. Each bottle cap is sealed with a tamper evident shrink wrap band. Each insulated box is sealed with tamper evident tape. The NICU staff member that receives the shipping container should inspect the box to make sure the milk arrives completely frozen solid and the tamper seal is in place.
Milk dispensed in the Dallas/Fort Worth area is delivered by bonded courier in rolling ice chests. Milk is transported in sealed bags to prevent contamination of the outside of the bottles. Each ice chest is thoroughly cleaned and sanitized between deliveries. Milk never leaves the possession of the courier and is signed in with the designated person at the receiving institution.
How much does Donor human milk cost?
The milk is donated to the milk bank by mothers who are not compensated, much like blood donation. The milk bank charges recipients a processing fee. The processing fee helps to offset the cost of testing and screening donors and processing and testing the milk.
Processing fee structure is as follows:
Pasteurized Donor Milk
Prices as of January 1, 2010
100 ml bottle
20 Calories/ounce $12.40
22 Calories/ounce $17.30
24 Calories/ounce $19.80
Please order by the number of bottles desired not the number of ounces. Processing fees do not include shipping. Actual shipping charges are billed to the recipient hospital.
Is there a standard consent form for the use of donor human milk?
There is no standard form required by MMBNT for hospitalized infants. Many hospitals require parents to sign a consent form that the hospital has generated. Some hospitals require no specific consent form. We are happy to provide your hospital with a standard sample of a consent form.
What record keeping is required?
Each feeding of donor human milk should be documented in the medical record with the batch number, expiration date and milk bank name. Records of donors, donor screening information and pump dates are kept at the milk bank for each batch pasteurized and dispensed.