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Deborah Howell (Host): Welcome. We all know about the importance of mother's milk, but how much do we know about the milk donation process and experience? I'm Deborah Howell and our guest today is Andrea Klotz, a Registered Nurse and Lactation Consultant at Deaconess the Women's Hospital. Welcome Andrea.

Andrea Klotz, RN, BSN, IBCLC (Guest): Thank you. Hi, Deborah. I appreciate the opportunity to discuss the Women's hospital's Milk Depot, and being a donor for it.

Host: Well, we're super glad to have you. So, why is there a need for donor milk in general, who uses it?

Andrea: The donor milk it's to give an option for especially early on that's the bulk of the time that it's used in the hospital. The more we're closer to mom's milk, the better that it is on babies gut, the better they do long-term. So, the bulk of who uses donor milk are our NICU babies. That's what we see. Those babies are the most fragile, the most vulnerable, the ones that we want to delay introducing formula and foreign proteins, if at all possible, but at least, for awhile. So, that's who uses the bulk of it. It's also the Women's Hospital used inpatient with our babies who aren't in the NICU. Reasons for that would be sometimes if their blood sugars a little bit low, if for a variety of reasons, they're having trouble eating and latching.

We want to make sure that they're getting enough. Often, that's our babies that are early. They're not early enough to be in the NICU. They're strong enough that don't have to go to the NICU, but they still struggle a little bit with the feedings. So, those are kind of the main, main reasons that people would need donor milk.

Host: Sure. And what is the donor process? Can you tell us a little bit about it?

Andrea: So, the process, there's actually a lot that is involved with it. So, we get our milk through the milk bank, which is based out in Indianapolis. They service a decent amount of the Midwest. We're actually one of about 65 depots over four states. So, to become donor through the milk bank, they're actually pretty strict with it because they want this milk to be the best that it can for newborns.

So, there's sort of a four step process. If a mom has extra milk and is interested in donating, she gets in contact with the milk bank. There's a brief interview that they do over the phone. And I think it can even be done over text at this point. And that just goes over the main things that would be disqualifiers. Then once they get through that, there's, they call it a packet now, it's online. Just a big questionnaire, similar to if someone's donated blood, a lot of lifestyle type questions, and it also gives permission for the milk banks to contact mom and baby's health care providers to ensure that they're healthy.

And then once they're approved from that standpoint, the mom will receive a package in the mail. That's a kit she can take to any lab that just does a simple blood draw, which checks for bloodborne diseases. Once the milk bank gets the okay on the blood work, she receives a donor number and that donor number's kind of the magic thing that she needs to have to contact the Women's Hospital, outpatient, as a Depot.

And then she can arrange a time to bring in the milk. We store it in our freezers and we usually ship off about 2000 ounces a month back up to the milk bank.

Host: That's fantastic. And you covered a little bit about this, but who can be a donor?

Andrea: So, really any mom that has excess milk above and beyond what her baby takes that meets the criteria. Like I said, they are a little bit strict with that, but I'd encourage any mom who is interested, to look into it. Medications are what lot of times moms are concerned about because sometimes mom can be on a medication. A lot of medications are safe for breastfeeding with her baby who is a little bit older. But the milk bank takes milk for the first two years of life. A lot of times it's fine to take as a breastfeeding mom, but with a lot of the babies that get donor milk, NICU babies, they are pretty strict. So, sometimes that disqualifies, but as we're learning more about medications in breast milk, a lot of times, it may not. So, really just anyone who fits the criteria, the milk bank asks, they donate at least a hundred ounces over the time that they donate, which most moms that have extra milk are able to donate wwll more than that.

Host: Interesting. And it could also be for a mom who maybe their child has just done, just says, I'm done. I'm done with it. I'll take a bottle now.

Andrea: Right. Yeah. Sometimes that happens for sure. And of moms that donate, the bulk of what we get for moms who are donors, are the moms who are working outside the home. They're pumping because they're at work anyway. They just make lots of milk and they just have extra and lots of times, their babies are done and they still have a freezer full.

That's kind of the bulk of it. We also sometimes get moms who had babies in NICU and just respond to a pump well, because they do so much of that early on when their baby's small. Also moms that have difficulty with latching or for whatever reason do what we call exclusively pumping, where they don't put the baby to their breasts, but they're doing pumping and sometimes those moms will end up with a lot of milk. Mom's some that have had NICU babies want to give back and find that very rewarding. And also I do want to mention it's the small amount of our donors, but we do sometimes get bereaved moms who've lost a baby, whether that was intrauterine demise, a very premature baby, or just lost unexpectedly, unfortunately, at some point in the breastfeeding journey and the milk bank has a special program for those moms and none of them are turned away if they don't meet the criteria. So, that's something I did want to mention those moms are very special.

Host: Yeah. How long does the milk last once donated?

Andrea: All right. So they ask, the milk bank asks that the milk is donated within eight months of it being pumped because they process it. Milk, it can be in a deep freeze for about a year. So, the milk bank wants to do everything that they do, they test it, they pasteurize it and then it's turned around and sent back to the hospitals, whoever purchases it, and they want that to be within that year.

So, I tell Moms, if they're interested in donating, try to give it a few months to make sure that their supply's doing well, they have enough for their baby. But also not to wait too long because it takes a little bit with the process so that they have enough time to get that milk donated to the milk bank.

Host: Sure. And how much need is there?

Andrea: There is a lot of need. We have a lot of babies that are in the NICU that it really helps them to thrive, helps their outcomes to be better. A lot of babies that may not need a whole lot, if they're using donor milk in the hospital or we also have they can purchase it to go home with. It's just kind of a bridge to get them to where they are if they're struggling to produce enough or baby's struggling. Sometimes our moms go home at 24 hours now, so their milk may not be in yet. So, there's a lot of just kind of ongoing need. It may not be for very long. It may not be very much, a lot of times, especially the non NICU babies, we're supplementing with a third to half of an ounce, which isn't very much.

Host: I understand that you yourself are a donor or have been a donor. How rewarding is that experience?

Andrea: It is incredibly rewarding and I'm fortunate that I'm surrounded by this every time I'm at work. I have the knowledge as a lactation consultant about how important breast milk is early on, especially with these fragile, vulnerable babies. So, it helps keep me motivated. It is a lot of dedication and hard work. I'm on my third kiddo. I can have the finish line in sight. My last kid is going to be two in about three months. So, I'm wrapping up with donating, but it's been very rewarding to do with all three of my kids. I come from a place of gratitude with it that I know as a lactation consultant, that it's not always possible to make extra milk and to be able to share in the grand scheme of things, this is a gift I can give for really a short span of my life.

Host: Well, I'm getting the benefits just to hearing you talk about it. It's a wonderful thing all around and it's like a connective tissue between all of us, right? You know mother's milk.

Andrea: Yeah. And it's great to see moms be able to altruistically to support each other in this way.

Host: So, wonderful. Well, thank you so much for all this good information, Andrea, and for all the donating you're doing, we thank you so much for being with us today.

Andrea: Thank you so much. I'm glad to help share about this. And if moms have any questions or are interested in becoming donors through our Depot, we would love to talk to them and help support them in any way we can.

Host: Perfect. Well, this is the Women's Hospital, a place for all your life and to schedule an appointment or to learn more, you can call 812-842-4525, or head on over to www.deaconess.com/lactation to get connected with one of our providers. This is Deborah Howell. Thanks for listening and have yourself a great day.