While Santa Clara Valley Medical Center (SCVMC) places prime importance on breastfeeding and babies receiving their own mother’s milk, the organization knows that human milk – even from someone other than the mother – brings benefits that strongly outweigh formula. For those mothers who cannot provide breast milk to their own babies, SCVMC relies on the Mothers’ Milk Bank located on SCVMC’s campus to ensure its most vulnerable newborns receive the crucial ingredients of human milk, which can be vital for their survival.
“The use of human milk is really important for the general health of all babies, and especially premature babies,” says Sudha Rani Narasimhan, MD, medical director of lactation services for SCVMC. “Outcomes are better in terms of infection, growth and overall health due to the prevention of serious prematurity complications.” For this reason, SCVMC’s neonatal intensive care unit (NICU) focuses on breastfeeding and breast milk expression. “These benefits are seen most with mother’s own milk and to a lesser degree with donor milk,” Narasimhan explains, “so we promote mom’s milk from the beginning.”
Narasimhan also notes breastfeeding’s benefits to the mother. “It helps with decreasing postpartum bleeding, return to baseline weight and decreases in breast and ovarian cancers further down the line,” she explains. “Sometimes we forget about the maternal aspects of it, but there are benefits to both sides.”
In 2006 SCVMC began a lactation program with a designated lactation consultant for the NICU. The lactation consultant holds weekly support groups and rounds every day to meet with the mothers and their babies. The program also provides electric pumps to mothers so they can continue producing milk at home. Lactation services has also received several grants from First 5 of Santa Clara County – a local commission that funds and sponsors essential programs and services for young children and their families. One of the grants was used to help train nurses in the 10 Steps to Successful Breastfeeding outlined by the United Nations Children’s Fund and the World Health Organization. “We’ve trained more than 300 nurses in a 15-hour, 2-day curriculum,” Narasimhan says, “which has helped our initiation rates because the bedside nurses know how to support moms in breastfeeding.”
According to Balaji Govindaswami, MD, MPH, MCH, NICU director and chief of neonatology, “The passion of Alga Kifle, RN, the NICU lactation coordinator, Priya Jegatheesan, MD, the mother-infant director and Dr. Narasimhan has inspired about 16 key NICU personnel to become internationally board certified lactation consultants. These individuals have made tremendous contributions to our hospitals’ successes in NICU lactation support.”
Since the introduction of these services, SCVMC’s rates of premature infants receiving breast milk have increased dramatically. As of 2011, nearly 85 percent of premature babies were discharged on some amount of their own mother’s milk. The number tops 90 percent for the larger babies in the NICU. Comparable regional NICUs in the state of California had average rates of about 65 percent and 75 percent, respectively.
However, in some cases, a mother isn’t producing enough milk to feed her baby, or there may be a medical indication that doesn’t allow for the use of the mother’s milk, such as severe illness or illicit drug use by the mother. Babies weighing fewer than 1,500 grams are most at risk for gut problems and other infections, and for these newborns, human milk is essential. “For our sickest and smallest babies, we typically use donated milk from the milk bank for the first few days or weeks after birth if mother’s milk isn’t an option,” Narasimhan says.
The San Jose Mothers’ Milk Bank screens, collects, processes and dispenses donated human milk to prematurely born infants in more than 65 NICUs in the United States. Since 1974, the milk bank has provided millions of ounces of mother’s milk not only to infants in NICUs, but also to other recipients, including the following:
- babies who are failing to thrive on formula
- babies and toddlers with life-threatening diseases or conditions
- children with failing immune systems or catastrophic diseases
- multiple birth babies, often with lactating mothers who can’t keep up with the milk required to nourish two or three infants
- adopted infants, whose moms believe in the value of breast milk but can’t produce their own
- babies of mothers whose breast milk isn’t suitable for consumption, either because of disease or prescription medications that pass through the milk
SCVMC enjoys a close partnership with the milk bank, which is facilitated by its proximity on the medical campus. “It’s very helpful to have them so close by,” Narasimhan says. And SCVMC’s ability to readily supply human milk to its NICU patients drastically improves these babies’ health. “Many studies have shown that using fresh breast milk reduces the risk of a severe intestinal infection called necrotizing enterocolitis, [which occurs when the lining of the intestinal wall dies and the tissue falls off]. It has significant morbidities and at times mortalities for babies,” Narasimhan says. “And in general, human milk is the natural feed for babies. Formula is produced from cow’s milk and the composition is much different than human milk. It doesn’t contain a lot of the immune properties that fresh breast milk has.”
While the medical community already knows the general makeup of breast milk and the benefits it brings, Narasimhan is involved in a study that is researching the composition of breast milk at the micronutrient level. “We know what’s generally in breast milk – the fat, the carbohydrates, the proteins – but we don’t know what micronutrients may be in there and what’s different between term and preterm human milk,” she says. “We’re really trying to better understand the composition of breast milk and why breast milk is so good for babies.”
For more information about SCVMC’s breastfeeding practices, please contact:
Sudha Rani Narasimhan, MD
Medical Director of Lactation Services
Santa Clara Valley Medical Center