Human milk remains in short supply for preemies. We solved this child’s feeding over more than a week by alternating feeds instead of mixing and then she did just fine with her oral feeding advancement. I fully understand her preferences since I was obligated in my pediatric gastroenterology training to taste all the formulas I ordered on our GI kids to appreciate what they had to tolerate. She was quite picky with her meals and was only willing to take her mother’s milk straight up with no added flavors. We recently had a preemie girl who had a strong family history of bovine intolerance and we needed to supplement mother’s milk volumes with an amino acid based formula to keep up with her feeds. All babies love it and once they taste it they want more.įor some babies that’s all they want to drink, period. It gives you energy, boosts your immunity, changes your intestinal microbiome, strengthens your bones and gives you deep restful sleep. We have a great drug to sell that carries with it an amazing assortment of tricks. So how should we feel being human milk traffickers? Personally, it feels great. They too collect, store and process, almost like a distillery in the case of the commercial donor milk entity, in order to secure a safe and consistent product.Īs we move to increase human milk use in the NICU we take on greater ownership of the movement or traffic of human milk. The donor human milk industry plays a major role in milk handling too. We are figuring out ways to collect it in its most purest form, we are finding fashionable ways to carry the milk around, and in larger hospitals the milk “trafficking” is busy approaching a high throughput operation. Many of us in the human milk advocacy and quality improvement arenas are really pushing human milk drug. The last point has been somewhat of an impediment for some NICUs in using donor milk for their babies. Unfortunately too this also increases the stringency of requirements for managing and handling human milk in hospitals in these three states, such as the need to hold a tissue bank license. To date, in three states, California, New York and Maryland, human milk is fully recognized as a liquid tissue. Human milk contains a myriad of biologically active compounds as well as cellular parts. This makes it not unlike another more familiar liquid tissue, blood. One of the first ways was through the classification as a liquid tissue. 6, 7 Interestingly though, once improved methods for human milk fortification overcame the nutritional deficiencies of intake of plain human milk, many preemies were continued on preterm formula.įortunately, over the past decade the recognition of human milk as a natural medical miracle has emerged. Despite these positive attributes, however, infants feeding preterm formula were still getting sicker at higher rates from sepsis and necrotizing enterocolitis compared to human milk feeding. Preterm formula contained more of practically everything compared to human milk, more energy, more protein, more mineral, more vitamins and more trace elements, all promoting overall better growth. And rightly so since many early studies demonstrated that human milk alone in a small preterm baby would lead to poor growth, bone mineralization and long-term neurodevelopmental outcomes. It was not long ago when most preemies everywhere were being fed solely preterm formula. Frankly if we could grade the quality of sleep thereafter it would be off the charts. It is common to hear in the NICU talk about our babies experiencing “milk coma.” They are down for the count, they are in heaven. While there are no clearly discovered compounds in human milk that convincingly lead to chemical addiction (aside from maternal medications that may cross over), there is indisputable observational evidence that infants breastfeeding or bottle feeding mother’s milk reach a state of complete relaxation and level of satisfaction that if we were able to get a verbal response, infants would confess to euphoria. There are two aspects to any drug addiction, chemical and psychologic. 4, 5 These facts have been supported by numerous other studies over the past decade and this is driving up the number of preemies that are getting hooked on mother’s milk. Like other drugs, human milk has a dose dependent effect in preterm infants on reducing the incidence of necrotizing enterocolitis (NEC) and on reducing neurocognitive impairment. Human milk is a drug, and made up of not just one but many compounds. Now that it is clear that we are seeing an epidemic in adult prescription narcotic abuse and thereby maternal narcotic addiction, and downstream neonatal abstinence syndrome across the country, it seems fitting that we take some time to discuss a counter movement that has come upon us, the rising positive “addiction” of many preterm infants to mother’s own milk.
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