For many parents who want to give their children breast milk but are unable to, they sometimes have few options. Mary Ruguru, who gave birth to her last-born child in August 2022 knows this too well.
“During my pregnancy, I was under a lot of pressure from work and I slowly fell into depression. On the evening of August 29, 2022, I was feeling very weak and tired as I went to bed. I woke up in the middle of the night and noticed that my water had broken, but it was yellowish. I was rushed to hospital. The doctor recommended surgery as it was a breech birth.”
The next day, the baby was born frail, through C-section and had to be incubated.
“She had to be fed through pipes and the nurses asked me to express milk for the baby but I was not able to get any. Seeing my struggle, I pleaded with the nurses to give me milk from the donor bank. I was given some milk but asked to get donors to come and give me milk as there was not enough milk in the hospital. I had to reach out to friends to come donate some milk for me,” Ms Ruguru recalls.
When a woman gets pregnant, she imagines that it is second to nature to get breast milk, and the lack of it causes stress. Reliance on donated milk is even more stressful, especially in the absence of easily accessible and affordable donor milk banks.
This forces many parents to end up going the informal route and swap breast milk with people they know.
Tracy Ahumuza is another parent who has struggled to get breastmilk for her baby. In 2021, she gave birth to her daughter, Alyssa Taha.
“Two days after her birth, I was told that the baby was weak and needed breast milk and not baby formula. The doctors said that the milk formula could cause infections. I tried to express milk but had no milk so I had to get someone to donate breast milk for my baby,” she says.
In a tragic turn of events, Tracy’s baby passed on, just when her body had started producing milk.
Tracy Ahumuza is the founder of ATTA Breastmilk Community. POOL
“I was finally able to breastfeed, but my baby had gone, I thought to myself that I should donate the milk. I called the hospital where I had given birth, and my doctors were dismissive and told me that I need not donate and should rest.
I tried reaching out to another hospital, but they required that I go to the hospital to donate. I found this to be triggering for me as I had just lost my baby, and I did not feel comfortable going to the hospital and seeing other mothers with their children. Eventually, I took the tablets given to stop the breast milk,” says the 35-year-old.
Having seen that there are not a lot of options for milk sharing, especially in Africa where milk donation centres are few, Tracy formed Atta Breastmilk Community to help end preventable newborn death through breastmilk donation.
Atta is an acronym for Alyssa Taha and Tracy Ahumuza, representing the mother-child dyad.
“We would like to support every mother, but we only have very little milk we can give at a time. So, we prioritise babies who are born too soon, too small, or too sick. In the past three years, we have supported about 500 babies and given out 680 litres of milk. We hope to make breastmilk available to all who can access it and eventually set up a breastmilk bank,” she says.
To encourage formal donor milk sharing and reduce the hassle on new mums, Tracy says they make the trip to the milk donor rather than having them go to the hospital.
“We feel that mothers are already doing too much so why should they bear the burden of going to the hospital for the screening? We screen the mothers from their houses and check their blood for diseases. We then pick up the milk from the mothers,” she says.
Receiving donor breast milk can help more women exclusively breastfeed and Esther Kimani, a maternal and infant care specialist, emphasizes that breastmilk is the optimal meal for an infant because of its numerous nutritional benefits.
“Breastmilk helps in the body development of the baby, particularly the brain and the gut. It also has other benefits, including enhancing the hormonal balance of the baby and preventing diseases,” she says.
Breastfeeding, Esther says, also helps the mother and child bond.
“When the mother is very ill, they are often not able to breastfeed the baby. The mother could also have insufficient glandular tissue, which means that the breast tissue did not develop the mammary glands to be able to breastfeed.
Some mothers may have medical conditions that make it unsafe for them to breastfeed their babies. We encourage HIV-positive moms to breastfeed their babies. However, if their CD4 count is very high and they have not been under treatment, that could be a threat to the child’s well-being. A mother could have other issues such as hepatitis or syphilis, which if not treated, could be passed on to the baby,” Esther says.
Esther advises that where mothers are unable to breastfeed their babies, the second best option is to rely on donor milk rather than baby formula.
Esther Kimani is a maternal and infant care specialist. PHOTO | POOL
“There are two ways of receiving donor milk. Some donors breastfeed the babies directly while others express the milk, package it and deliver it is delivered to the recipient mother. The donor mother must be screened for Hepatitis, syphilis, and HIV. It is also important to ensure that the donating mother is not exposing themselves to the risk of contracting these diseases,” Esther says.
As a lactation expert, Esther, says that her work involves counselling the milk donors and the recipients on the best way to take care of the milk to ensure it is safe for the baby’s consumption.
“For the milk donor, we advise that the milk be frozen immediately when it is expressed. The milk should be stored in small portions of between 80 to 100 millilitres. Once you defrost the milk, it should not be frozen again. Seeing how precious a commodity it is, you do not want to waste it when you store it in large milk bags and the baby cannot finish all of it. The milk should be transported in a cooler box to ensure that it remains frozen,” she says.
When the recipient gets the milk, Esther advises that it be frozen immediately. The milk donor should label it according to when it was produced so that “it is first in and first out. When feeding the baby, the milk should be put out to defrost naturally and then in warm water.”
The nutritional qualities of milk change as the baby grows, so Esther says the donating mother should be as close as possible to the newborn.
“For example, if my baby is eight months old, I may not be a good candidate to give milk to a new baby. But if my baby is four weeks old, then I am closer to a new baby’s age. Of course, if there is no other choice, breast milk is still better than formula,” she says.
Despite the numerous benefits of milk donation for babies, Esther, says that there are people who are reluctant to receive donated milk.
“Many are worried that the baby will pick up the DNA or characteristics of the milk donor. All these are myths that we are trying to educate them on. However, the younger generation is more prone to milk donation as they are more knowledgeable,” she says.
“Some women have so much breastmilk and can even feed three babies; other times, we induce relactation. I have a grandmother whose daughter died during childbirth and we induced her to breastfeed her daughter’s baby. You can induce relactation for a person who has stayed long without breastfeeding or one who has never been pregnant,” she says.
This is the second part series on Breastfeeding to mark World Breastfeeding Week. [email protected]
