WIREDGOV

New guidance published today (24 February) by the National Institute for Health and Clinical Excellence (NICE) aims to reinforce the safety of donor breast milk by making recommendations to maintain high standards of practice in specialist milk banks in the UK.

New mothers can choose to donate their breast milk to a dedicated milk bank. It can then be used by hospitals that request it. This practice has been taking place for over one hundred years but some healthcare professionals are still unsure how donated breast milk is handled, processed and stored to reduce the risk of harmful bacteria or disease being passed on through the milk.

There are 17 main milk banks in the UK. This new guideline serves as a practical guide to the effective running of these services. It makes a series of recommendations designed to promote consistent standards of practice across the country and ensure the safety of donor breast milk.

Christine Carson, Programme Director for the Centre for Clinical Practice at NICE, said: "Our national milk banks provide a valuable service to those who need donor breast milk by collecting, processing and storing donated milk safely, to reduce the risk of any harmful bacteria being spread. However, some misconceptions still exist around the processes used by milk banks to ensure the safety of donor breast milk.

"This new guideline, which has been developed by a range of experts, will help reinforce the message that specialist milk banks operate to the highest safety standards and our recommendations will make sure good practice is consistent across the UK."

The guideline is primarily aimed at milk banking staff and healthcare professionals who support women who are, or who want to become, breast milk donors or who care for patients who may be given the milk. These include, but are not limited to, midwives, health visitors and neonatologists. Recommendations include:

• Using serological testing to screen all potential breast milk donors for diseases including HIV, hepatitis and syphilis. This is to ensure those who test positive do not become breast milk donors because of the risk of these diseases being spread through breast milk.
• Pasteurising all milk to reduce the risk of any potentially harmful bacteria being passed on. A sample from each batch of donated breast milk should be tested for bacterial contamination before pasteurisation and at regular intervals post pasteurisation. Milk should be discarded if samples exceed levels stated in the guideline.
• Ensuring that all equipment used in milk handling and processing is regularly inspected using the manufacturer’s instructions.
• Only supplying donor breast milk to hospitals or neonatal units who agree to comply with the tracking procedures for milk as outlined by the milk bank. The receiving hospital or neonatal unit should also keep a record of how the milk is used.

Damien Longson, Consultant Liaison Psychiatrist for Manchester Mental Health & Social Care Trust, and Guideline Development Group (GDG) Chair said: "During the development of this guideline we consulted extensively with a wide range of organisations, NHS trusts and charities, amongst others. All available evidence was also thoroughly evaluated to ensure the accuracy of the recommendations and I believe this guideline will help raise the bar for safety standards within these services."

Gillian Weaver, Milk Bank Manager at Imperial College Healthcare NHS Trust in London, and GDG member said: "This new guideline on the operation of donor breast milk banks is greatly welcomed. It provides good, clear advice on the effective operation of these services by staff, and also includes important information for current and future breast milk donors, such as how to express and store milk at home hygienically and what issues to bring to the attention of milk bank staff."

GDG member Shel Banks co-ordinates the Blackpool Mother’s Milk Depot which feeds the Wirral Mothers Milk Bank and is a former two-time breast milk donor herself. She said: "When my second child was born in 2005 I got in touch with our newly-opened local milk bank about becoming a donor. I just wanted to do my bit to ensure that every baby who needs breast milk can receive it even if their own mother is not able to produce it for them. I donated for just over 10 months and then when my youngest child was born in 2007, I donated again for 12 months through the local depot that I had helped set up in the meantime. I now co-ordinate milk donations from local mums through the depot. Donor breast milk can literally be a life saver for sick infants and I hope this guideline will help make it more widely available to those who need it by reassuring healthcare professionals that it is safe to use. This guideline is a real step towards standardising services across the UK."