Working as a lactation consultant for the past decade, Denise O'Connor was well aware of the benefits of breast milk — particularly for premature babies in intensive care units.
She knew that babies in Pittsburgh-area hospitals who couldn't get their mother's breast milk were receiving formula, instead of "donor" breast milk available in other parts of the country.
But it wasn't until this summer, when she saw a news report that mentioned the closest milk bank was in Columbus, Ohio, that she decided she would be the one to do something about it.
O'Connor of McCandless set out to create a milk bank in Pittsburgh, where mothers with extra breast milk could donate to sick babies in hospitals.
Less than six months later, the Three Rivers Mothers' Milk Bank is on its way to becoming a reality. "It's beyond my wildest expectations how far we've gotten," O'Connor said. "The time was just right."
Thanks to a $5,000 donation from the doctors at West Penn Hospital, the milk bank has now applied for official recognition from the Human Milk Banking Association of North America — the first in Pennsylvania to do so.
Breast milk is recommended by the American Academy of Pediatrics for babies. But for those born prematurely and at low birth weights, breast milk can literally be life-saving, said O'Connor. For that reason, the AAP adopted a new standard of care last year recommending that all premature infants receive human milk, including pasteurized donor milk if their own mother's milk is unavailable.
At least 42 percent of neonatal intensive care units around the country now provide donor milk to premature babies, according to a study this year in Pediatrics. But no Pittsburgh-area hospitals currently do so, in part because there is no milk bank nearby.
"We're a little bit behind," said O'Connor, noting that when she recently got statistics from the state, "there were 14 hospitals in Pennsylvania utilizing donor milk and not a single one was in the western part of the state."
Pittsburgh hospitals say that thus far, the cost of donor milk has been an obstacle. Breast milk from a bank costs around $4.50 per ounce, and is not separately reimbursed by health insurers. Breast milk banks affiliated with the Human Milk Banking Association of North America are nonprofit organizations, but blood tests to screen donors are costly, as is pasteurizing and shipping milk.
For the hospitals, "we're hoping that we can bring down the cost a little bit having one in the area," said Jennifer Kloesz, medical director of the neonatal intensive care unit at Magee-Womens Hospital of UPMC.
Breast milk is most promising for premature infants in preventing a stomach infection called necrotizing enterocolitis — "the big bad wolf in the NICU," said O'Connor.
Necrotizing enterocolitis, known as NEC, has a fatality rate of 10 to 15 percent, said Alan Lantzy, a neonatologist at West Penn Hospital, with a much higher percentage of babies diagnosed with the disease requiring serious surgery.
One recent study found that babies fed human milk were 77 percent less likely to contract NEC than babies fed cow-milk based formula. The same 2010 study in the Journal of Pediatrics calculated that for every eight babies fed breast milk instead of formula, one case of NEC requiring surgery or death could be prevented.
"The decrease that we're seeing not only in deaths but in severity is pretty significant," said Dr. Kloesz, who serves on the board of the Three Rivers Mothers' Milk Bank.
Premature babies fed human milk versus formula also leave the hospital an average of three days sooner than formula-fed babies and have lower rates of sepsis, said Ms. O'Connor.
While donor milk that is frozen and pasteurized doesn't have all the immunity-boosting benefits of fresh milk from babies' own mothers, it is still recommended over formula.
"Every neonatologist would rather use human milk that has been frozen than cow's milk formula," said Lantzy, also a Three Rivers Mothers' Milk Bank board member.
O'Connor has received letters of intent from Pittsburgh hospitals to use the milk and has also heard interest from hospitals in Erie and West Virginia. She does not anticipate any trouble finding demand for the milk: HMBANA milk banks distributed more than 2 million ounces in 2011, but the group estimates the national need for NICU babies to be around 9 million ounces per year.
To fill that demand, the milk bank must also find donors. Typically, said O'Connor, milk donors might be working mothers who have pumped more than they need to feed their own baby or mothers who have had previous experiences with premature babies. There are also cases of mothers who pump for other babies after their own premature babies have died, she said. She is confident that willing Pittsburgh donors exist, having been told by the Mothers Milk Bank of Ohio in Columbus that it regularly fields calls from Pittsburgh mothers looking to give away milk.
Some mothers now share milk informally, usually through websites or social networking, but that milk isn't pasteurized or screened, she said. An October study in the journal Pediatrics found almost three quarters of such samples contaminated with bacteria, including salmonella. Milk shared informally is also generally going to babies who are much healthier than hospitalized babies, said. O'Connor.
Making the milk bank a reality would take $200,000 to $300,000, said O'Connor, who was previously on the board of the Midwife Center for Birth and Women's Health. While their application for official tax nonprofit status is pending, they are accepting donations through the Midwife Center for the benefit of the Three Rivers Mothers' Milk Bank.
She is hoping to get the bank up and running by the end of 2014 or the beginning of 2015, depending on funding. "If someone thought this was a great cause and decided to give us a quarter million dollars, we could have it up and running in a few months," she said.
Information from: Pittsburgh Post-Gazette, http://www.post-gazette.com