Donor Milk in the NICU

By Dr. Kenneth Herrmann, Medical Director, Newborn Services, The Women's Hospital

Premature infants tolerate human milk better than cow’s milk based formula because they have less emesis, less diaper rash and most important, less necrotizing enterocolitis. Necrotizing enterocolitis (NEC) is a serious and sometimes fatal intestinal complication of very low birth weight infants. The frequency of NEC ranges from 4 to 18% and depends on an individual NICU’s feeding practices. Since changing to an exclusively human milk diet, the rate of feeding associated NEC in our NICU has declined to 1%.

We use donor human milk when a mother’s own milk is not available in order to achieve an exclusively human milk diet. The amount of donor milk needed depends on the mother’s ability to provide milk. We always prefer to use a mother’s own milk ahead of donor mother’s milk. Mothers that intended to breast feed before delivering prematurely typically need about a half-pint of donor milk while waiting for their milk to come in. Mothers that planned to feed formula before delivering prematurely typically provide less of their own milk; we use about a half-gallon of donor milk to feed their babies.

Our donor human milk comes from the Indiana Mothers' Milk Bank. When we recommend using donor milk, most of the mothers tell us that they do not know about milk banks. They often wonder about the donor mothers. Similar to blood donation, donor mothers are screened for health safety. The donors are required to avoid most medications and a list of foods and drinks. The typical donors are highly educated professional women, often employed in health professions. Milk donors are not paid for their milk.

While breast feeding is a labor of love, the donor mothers labor above and beyond to provide a precious gift.

Mothers of infants that receive donor milk often prefer that their babies receive only their own milk. “I want my baby to have my milk.” However, when mothers consider the health advantages of human milk they prefer donor human milk to formula. When a mother cannot provide enough of her own milk, we recommend using milk from the Indiana Mother’s Milk Bank.