Giving of themselves: Excess breast milk helping infants around the world

Somewhere in South Africa, a baby could be thriving today because of life-saving breast milk donated by a mom in Savoy.

The story of how milk from the Midwest winds up halfway around the globe begins with another local mom, Jill Youse. Her freezer full of breast milk led to the creation of a nonprofit agency that has supplied more than 277,000 ounces of milk to underweight babies and orphans across the world.

In 2006, while nursing daughter Stella, now 6, Youse found herself with an abundance of frozen milk she had stored for when she wasn't home to nurse her baby.

"I had a ridiculous amount," said Youse, who was then living in Missouri.

In fact, her freezer was overflowing, a fact her husband, Jeremy, now a dermatologist at Christie Clinic in Champaign, firmly pointed out one night.

Youse decided to see if she could donate it, so she Googled "donate breast milk." Up popped the name of an orphanage and milk bank in Durban, South Africa — the iThemba Lethu Breastmilk Bank, founded in 2001 by Professor Anna Coutsoudis and a group of friends to help babies orphaned or abandoned as a result of HIV.

Youse emailed the orphanage, asking if she could send her milk to help babies there. Coordinator Penny Reimers wrote back thanking her but politely explaining that it would cost far too much to fly the milk 9,000 miles and keep it frozen.

"But Jill, I discovered, is not a woman you say 'impossible' to!" Reimers said Friday in an email interview.

Youse went through the qualifying process to become a donor, which involved medical questionnaires and blood tests, and the next time she emailed the agency, Reimers' husband was in Chicago on business.

"Before he knew it Jill was at the airport to meet him," she wrote.

Youse had driven to Chicago from Missouri with 1,000 ounces of breast milk packed in "heaps of dry ice" that Reimers' husband refilled in New York before the flight to South Africa — getting some curious looks in the process.

Soon, Youse received pictures from South Africa of babies drinking the milk.

"It was unbelievable to see a part of me way over there," she said.

Several friends joined in on the next shipment, and after a local newspaper story, the number grew to 10. More media coverage followed, including a feature on "ABC World News" and a mention on "Oprah." Youse had formed a nonprofit group, the International Breast Milk Project, in April 2006, but realized the logistics were more than she could handle alone.

After hearing a story on National Public Radio about Prolacta Bioscience — a California company that developed a "human milk fortifier" prescribed for preemies in neonatal intensive care units — Youse contacted the company's CEO. She formed a partnership with Prolacta, which covers the cost of collecting, processing, bottling and packaging the milk as well as testing donor moms.

Through that partnership, 25 percent of the milk goes to babies in South Africa, and 75 percent is used for Prolacta's milk fortifier, which the company sells to hospitals in the United States.

Prolacta also donates $1 to the International Breast Milk Project for every ounce of milk that stays in the U.S. The money is used to support the nonprofit's operations and its grants to charities in South Africa — $184,000 to support milk banks, for example.

Quick International Courier — a company that specializes in shipping blood and other medical supplies — also agreed to cover the substantial overseas shipping costs. Chief Operating Officer Dominique Bischoff-Brown has said the project "speaks to her heart" as a mother, a spokeswoman said. She is now president of the project's board.

Youse quit her job as a medical sales representative to direct the nonprofit, but in 2009 turned it over to Amanda Nickerson, a donor who had previously worked for the American Cancer Society. Youse remains on the board of directors.

"I never wanted to do it for my career," Youse said.

Looking back, Youse said, she had no idea at the start how big the effort would become.

"It wasn't about changing the world," she said. "I had something to give."

Today, the organization ships milk twice a year to South Africa, and has sent emergency shipments to Haiti and the Philippines. The next shipment — 11,000 ounces, or about 2,750 bottles of milk — will go out Monday to Durban and a network of milk banks in Cape Town that supplies 27 hospitals there.

Youse notes there are multiple milk banks in the United States where moms can donate. She was drawn to support those in South Africa, where HIV infects almost 40 percent of pregnant women in some provinces.

"The donations from IBP have been a lifeline often when supplies are running low and enabled us to save many babies and improve the quality of life of others," Reimers said.

Youse also sees it as a way for new moms, who are often consumed with caring for their own babies, to give back.

"It connects you to other moms and other babies across the world," she said.

Laura Bleakney, 37, a mother of two in Savoy, donated milk to the project about a year ago, when her younger son was ready to quit breast-feeding. She had a stockpile in the freezer and liked the fact that some of the milk from Youse's project went to Africa.

After going through the required testing, she donated four gallon-sized zipper storage bags full of milk bags — several hundred ounces.

"It was extremely easy," Bleakney said. "I just thought it would be really cool to help somebody, a baby in another country or within the U.S. that was in the (hospital)."

For information

International Breast Milk Project: http://www.breastmilkproject.org/

Human Milk Banking Association of North America: https://www.hmbana.org/

iThemba Lethu Breastmilk Bank, Durban, South Africa: www.ithembalethu.org.za

Milk Matters, Cape Town, South Africa: http://www.milkmatters.org/

Mothers must qualify to donate milk

The logistics of supplying milk to South Africa are intricate, but officials there say the project has had a big impact.

Mothers who want to donate to the International Breast Milk Project go through a qualifying process that can take six weeks or more. The donor must complete an application with 52 medical-related questions. If there are no red flags, a nurse is sent to the donor's home for a blood test, to screen for drug use, alcohol, HIV and hepatitis.

The mother's doctor and the baby's pediatrician also must fill out forms saying that the mother is healthy and that donating milk won't harm the baby. The project wants only "extra milk that the baby's not going to use and would have been thrown down the drain," said Executive Director Amanda Nickerson.

It will accept milk that's been stored for up to 10 months if kept in a deep freezer, as long as it's clearly marked with the date, she said.

Once a mom qualifies and has enough milk, a cooler is shipped to her home via FedEx. When it's filled, FedEx returns to pick it up.

After it's processed in California, the milk is packed in dry ice with alarms inside the coolers if the temperature inside gets too warm. Quick International teams monitor the shipments all the way to South Africa.

There, the milk is sent to two milk banks in Durban and Cape Town. It's prescribed by physicians for babies whose mothers have died or can't breast-feed, sometimes just temporarily.

The goal is to have the mother breast-feed if at all possible, even those infected with HIV, health officials said. Mothers and babies are put on antiretroviral medications, which lowers the risk of HIV transmission considerably.

Previously, the government handed out formula for children of HIV-infected mothers, but the babies often died from diarrhea and respiratory infections because they didn't get the protective immune properties from breast milk, said Penny Reimers, former coordinator of iThemba Lethu Breastmilk Bank in Durban. Babies can tolerate breast milk from a variety of donors, she said.

Reimers and others say publicity about the U.S. shipments has raised awareness in South Africa about the importance of breast-feeding and the need for donor milk, from baggage handlers at the airports to the doctors who use it to treat premature infants.

Reimers' organization was the only milk bank in South Africa in 2001; now more than 50 operate across the country.

"People realize how important breast milk is if we are flying it from the USA to feed babies here," Reimers said in an email interview.

Linda Glynn, who co-founded Milk Matters milk bank in Cape Town in 2003, started working with the International Breast Milk Project in 2007 and it now supplies milk to 27 hospitals. Glynn said the effort has resulted in a "huge shift" in the attitude of doctors as they see how well preemies do on breast milk.

"What IBMP milk has done is elevate the importance of donor milk throughout society," she said.

 

Comments

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GRose wrote on July 09, 2012 at 10:07 am

This is so wonderful.  When I had my first child I had so much extra milk and tried to google to see if I could donate.  I didn't find information on this at the time but would have loved to have done this.  If I have a third child I will definitely do this.  Thank you for the article.

ashrprice wrote on July 09, 2012 at 12:07 pm

Donating breastmilk is a wonderful thing, but frankly collecting a bunch of breastmilk from US mothers, shipping 25% of it to South Africa and "donating" the rest of it to a company so they can sell it to premie mothers for a tidy profit is just absurd and NOT charity. There are thousands of babies in C-U who need breastmilk and aren't getting it either through a total lack of structural support for breastfeeding or because donated milk is unavailable or too expensive. The medical practices in C-U are consistently cutting back support for breastfeeding; Christie just eliminated it's one IBCLC position because breastfeeding isn't "profitable." Dozens of moms in C-U have lots and lots of breastmilk available to donate, and many donate informally (which is discouraged by every single health organization including LLL)  because there is no milk bank in the area and the screening protocols for milk banks are a huge obstacle to donation (no prescription medication use whatsoever, frequent blood tests, no alcohol ever). In the US 80% of moms initiate breastfeeding, but only 1 in 3 are exclusively breastfeeding by 3 months. The US also has the worst breastfeeding rates in the industrialized world, possibly the entire world, and the highest infant mortality rate of the industrialized world. We need breastmilk HERE, in this community, NOW. Considering how many sick children we have on formula I find it offensive that this amazing resource is being shipped across the world and sold for a profit.

I want to remind people that there are several breastfeeding resources in C-U. La Leche League is very active and offers free in person support and support groups. The Carle Breastfeeding Clinic (assuming it survives this round of budget cuts) is also free and staffed by lactation consultants. Christie no longer has any lactation consultants, but there are some at the public health department attached to the WIC program.

 

RyanB wrote on July 09, 2012 at 2:07 pm

I don't want to downplay the need for milk here in C-U, but I have to say that the facts add up to:  NO Comparison.  In South Africa, where HIV infects almost 40% of pregnant women and in the recently ravaged Haiti, where HIV is also a huge struggle, milk is a matter of life or death to more children.

Furthermore, if Prolacta must take 75% to cover the cost of collecting, processing, bottling and packaging the milk as well as testing donor moms, it is unfortunate, but more an indication of the extreme cost of American healthcare services, rather than an indictment against this nonprofit or Prolacta.  Our healthcare system is failing, yes, but let's not fail eachother.

If you read until the end of the article, Linda Glynn, who co-founded Milk Matters milk bank in Cape Town in 2003 said,

"What IBMP milk has done is elevate the importance of donor milk throughout society."  

Isn't this the same idea you'd like to promote?

Ashley for Prolacta wrote on July 09, 2012 at 5:07 pm

 

Hi ashrprice,

We appreciate your comment because it is a great opportunity for us to clarify what we do versus non-profit milk banks. Our fortifier is the only fortifier made from donated breast milk and is prescribed by neonatologists in the hospital, for very fragile premature infants who are fighting for their lives. You may have read the new policy statement that was recently released by the American Academy of Pediatrics, which stated that “human milk should be fortified, with protein, minerals, and vitamins to ensure optimal nutrient intake for infants weighing <1500g at birth.” Unfortunately, without our fortifier available to preemies in the NICU, the only option for them is to be fed fortifier made from cow's milk. We do not bill parents for our products, as the cost is typically covered by insurance or by the hospital and administered only under a physician’s care. We understand and appreciate the need to spread awareness of breast milk donation and the benefits of breastfeeding in general, and we are glad you are doing so. We hope this helps increase awareness for the option to donate extra breast milk, regardless of where moms chose to donate. If you have any questions, please feel free to ask.

All the best,


Ashley @Prolacta

ashrprice wrote on July 09, 2012 at 9:07 pm

Ashley, I appreciate what your company is doing, but as it is most premies in this country are being fed formula because there is barely any donor milk available. I spoke with a friend who has a 32 weeker and she said that at Carle you can only get donor milk if your baby was born before 34 weeks and only until a certain gestational age, at which point if mom isn't producing enough milk the baby goes on formula. And considering how difficult it is for NICU moms to pump enough to bring in a full supply, Prolacta isn't useful without an adequate donor milk base, which our area doesn't have.

The nearest non-profit (non-Prolacta) milk bank is here: http://www.immilkbank.org/

Ashley for Prolacta wrote on July 11, 2012 at 12:07 pm

 

You hit on the root of the problem - "without an adequate donor base." It's up to all of us to spread the word about breast milk donation in general. This is something we are very focused on doing, and it is clearly needed for many, not just in the states, but all over the world.  - Ashley @Prolacta

hjw8383 wrote on July 09, 2012 at 1:07 pm

I don't like the comment made in the article about formula feeding being a contributing factor to infant deaths though! Medical care is less than ideal in Africa and that's the contributing cause. Breast milk does provide passive immunity and does better their chances to thrive, BUT they are getting breast milk from moms in the U.S. who are not necessarily carrying the antibodies ideal to protected an infant who lives in Africa. Exposure to various antigens (viruses, bacteria, etc.) is different than what African people are exposed to.  With that being said, I still think something is better than nothing!  It's pretty crappy though that 75% is kept here and sold at high costs for the same thing that's getting donated to a different country.  We wouln't be in the U.S. without having to pay for things that are donated!   

ashrprice wrote on July 09, 2012 at 9:07 pm

I actually looked up the studies today and formula feeding in HIV infected babies is shown to increase death rates. The recommendation for babies of HIV infected mothers is being fed donor milk or EXCLUSIVE breastfeeding (only 14% HIV transmission with exclusive breastfeeding and much better longterm prognosis).

Yes, formula feeding is contributing to the high infant death rate of HIV ravaged communities in Africa.

Jen C wrote on July 09, 2012 at 1:07 pm

I personally think that if it is benefiting even one person anywhere in the world...it is an accomplishment!  My sister recently donated a freezer full to someone in the Southern part of Illinois. She too was overflowing!  I think that what you do is nothing less than amazing...

esotiro2 wrote on July 09, 2012 at 4:07 pm

Jen, would you mind sharing the information for the Southern Illinois milk bank? Now supporting that would make far more sense than supporting an international effort! :)

ashrprice wrote on July 09, 2012 at 9:07 pm

There is no milk bank that serves downstate Illinois. Most moms who donate do so informally, which is not recommended by any health organization including LLL.

djquik wrote on July 09, 2012 at 1:07 pm

Although I am not a mother, I admire and find beauty in a person that can see a vital resource getting wasted and chose to find a more beneficial end.  Can we not see the positive influence and hope this gives? This is a wonderful story about giving a chance for a healthier life to those who desperately need one. Is there a local need? I am sure, and perhaps this story will inspire action instead of criticism.

beautyineverything wrote on July 09, 2012 at 2:07 pm

I couldn't agree with you more! I mean there will always be a need here at home but that shouldn't mean we can't give from what we have!

beautyineverything wrote on July 09, 2012 at 2:07 pm

I don't understand how people could not think this is just amazing! and as much as it sucks that it is pricey you have to consider the fact that it isn't cheap to make and in order to get more they have to charge. I think its wonderful what they do! and if anyone is to be scolded its the insurances, they should cover this and see that it helps and should be a part of the regular insurance process. the 75% kept here isn't just milk from moms it's processed! and I think it's nice that we send ANY to  anywhere else! and just think the more we moms donate the more will be left here and sent!

RyanB wrote on July 09, 2012 at 2:07 pm

Great article! A thorough look at the practice and history of a truly unique nonprofit.  And thanks for providing the links for us to learn and do more here and abroad.  

I am very impressed with the amount of milk IBMP has gotten to AIDS orphans, depsite the extreme cost of such US healthcare services as the collecting, processing, bottling and packaging the milk, and testing of donor moms.   I think the nonprofits mission is also smart in that it helps create healthy infastrucsture, with $184,000 also donated to support milk banks.

Keep up the wonderful work!

beautifulgrace wrote on July 09, 2012 at 2:07 pm

What an inspiring story! Here's a woman, who unlike most, would've probably thrown away the excess milk, because let's face it, mom's of young children are busy! But no, she gave it some real thought. Then, she took action and got personally involved in helping others in need. How many of us can say we've done something like that? We need more caring, compassionate, and selfless people like her in this world!

kdevin495 wrote on July 09, 2012 at 3:07 pm

I cannot imagine how anyone would criticize Mrs. Youse for founding International Breast Milk Project.   It is clear to me that her intentions were purely altruistic. Unfortunately, there are costs associated with everything, whether for-profit or not-for-profit.  Once she discovered that the need was much larger than what she could support, she had the choice to partner up with a company or let good milk be thrown down the drain.  I, for one, am happy that she chose to continue her project.  The milk that is sent to Africa and fortifying preemies here in the USA is a blessing.  Anyone who takes the time, effort and resources to make a positive impact in our world deserves high praise in my book! 

esotiro2 wrote on July 09, 2012 at 3:07 pm

I have such conflicting thoughts about this story. I have been exclusively breastfeeding for 5 months, so there's no question that I recognize the importance of breast milk. I can also appreciate the spirit of donating and helping others. I can't get over, though, how many babies in Central Illinois could benefit from donated breast milk, and rather than pushing for a milk bank locally, we are sending breast milk to Africa. We don't send canned goods to Africa, do we? Of course not. We support our local food banks. We may also pay for international groups to deliver food and other things to needy areas, and usually, these vital shipments come from a closer range (which means it's less expensive and uses far fewer resources for transportation). I support funding a local breastmilk bank and drive in South Africa, but spending all of that money and using resources to fly breast milk? I'm sorry. I just can't get behind that. It just doesn't make any sense - why are Americans so eager to help everyone else in the world, but we are very hesitant to help our own neighbors?

Carissa wrote on July 09, 2012 at 5:07 pm

Bravo Ms. Youse!  I can only imagine what this world would be like if we all took one another's well being so personally.  After reading this article and a bit more about the International Breast Milk Project, I can't help but be inspired!  Your mission, "To create awareness of the need for donor human milk, mobilize donors and provide donor human milk to infants in need," seems to be exactly what you are accomplishing.  That in 2001 there was only 1 milk bank in South Africa and and now there are 50 speaks volumes about how this organization has shined a spotlight on a subject that has been long neglected.  I'm sure you and these organizations will continue to be admired and criticized as you, IBMP, and Prolacta keep this subject afloat via media outlets, but take heart!  You are accomplishing your mission!  You are creating awareness and through this discussion children will continue to live and thrive, be it here in the US or abroad.   

Stacy W. wrote on July 09, 2012 at 6:07 pm

What a worthy cause!  Thank you to Jill Youse for stepping up and actually doing something.  One person can make a difference.

Loril wrote on July 10, 2012 at 5:07 am

I appreciate anyone willing to give of themselves to a world in need.  Good for you Jill!  More people need to look beyond themselves and do unto others. In America, we seem to be focused on ourselves, which I believe has turned us into a selfish society. I would consider this a random act of kindness or paying it forward. You are an example that needs to be followed. Bless you!