Resources for Recipients of Pasteurized Donor Human Milk
was your baby a donor milk recipient? We’d love to hear your story!
Instructions for Using Pasteurized Donor Human Milk
- Before handling milk or feeding equipment:
- Actively lather hands with soap and water for 15 seconds, with special attention to the area around and under the finger nails
- Dry hands with a single-use towel
STORING FROZEN MILK
- Store the milk in a freezer that always keeps ice cream hard
- Do not store in the door of a refrigerator or freezer because the temperature changes when the door is opened and shut
THAWING FROZEN MILK
- Thawing of milk must be gradual. Human milk must NOT be warmed to a a temperature warmer than body temperature. Never thaw frozen human milk in a microwave oven or hot water
- The prefered way to thaw frozen milk is to place it in the refrigeraator over a 48 hour period
- Milk may also be thawed as follows:
- Frozen milk can be thawed quickly in a container of warm water (not to exceed 98 degrees Fahrenheit). Take care that the water does not touch the lid
- Milk can thaw slowly at room temperature, but check often to make sure it is still chilled
- Once the milk is liquid, it may be maintained at room temperature for four hours and 48 hours in the regrigerator (32-39 degrees Fahrenheit)
TIPS FOR HANDLING PASTEURIZED DONOR HUMAN MILK
- Milk must be refrigerated after thawing
- Thawed milk should NOT be left at room temperature
- Once milk is thawed, it cannot be refrozen
WARMNG FOR FEEDING
- Warm an individual feeding by standing the container of milk briefly in warm water or holding under warm water. Care must be taken to keep the cap dry.
- NEVER microwave human milk either to thaw or warm it
- Before feeding - SWIRL BUT DO NOT SHAKE the containter to ensure an equal districution of the nutrients
Best Practice for Expressing, Storing and Handling Human Milk in Hospitals, Homes and Child Care Settings (2005). Human Milk Banking Association of North America, p. 19.
Safe Handling of Dry IceHANDLING
Dry ice temperature is extremely cold at -109.3 F or -78.5 C. Always handle dry ice with care and wear protective cloth or leather gloves whenever touching it. An oven mitt or towel will work. If touched briefly it is harmless, but prolonged contact with the skin will freeze cells and cause injury similar to a burn.STORAGE
Do not store dry ice in a completely airtight container. The sublimation of dry ice to carbon dioxide gas will cause any airtight container to expand or possibly burst. Do not store dry ice in a refrigerator freezer.VENTILATION
Dry ice converts to carbon dioxide gas. If left in a confined space the carbon dioxide will displace oxygen and present a suffocation hazard. If dry ice has been in a confined space for more than 10 minutes open the doors and windows before entering or you could experience difficulty breathing.BURN TREATMENT
Treat dry ice burns the same as a regular heat burn. See a doctor if skin blisters or come off. Apply antibiotic ointment to prevent infection and bandage only if the burned area needs to be protectedDISPOSAL
Unwrap and leave dry ice at room temperature in a well-ventilated area. It will sublimate from a solid to a gas.
Safety, Quality, and Analysis
In order to ensure the safety and quality of PDHM supplied to premature and ill infants, The Milk Bank adheres to strict guidelines and protocols developed by the Human Milk Bank Association of North American (HMBANA).
- A verbal and written medical history and lifestyle screening of potential donors is performed.
- Blood testing for HIV -1/2, HTLV-1/2, Hepatitis B & C, and syphilis is required for all donors and is repeated every six months if they are actively donating.
- Ongoing education is provided to our donors on the importance of notifying TMB if any new medications or illnesses arise. They receive information on the appropriate handling and storage of milk to be donated.
- In addition, TMB staff are required to communicate with approved donors frequently to ascertain any potential changes to their health, medical or lifestyle status.
- The Milk Bank staff must meet or exceed certain HMBANA specifications to be certified to pasteurize.
- Holder pasteurization eliminates viruses or bacteria that may be present in the milk.
- After pasteurization, a culture is sent to an independent laboratory to ensure sterility. The Milk Bank does not dispense any PDHM until the lab certifies it as sterile.
- Donor human milk from The Milk Bank is analyzed for Fat, Lactose, Protein and Solids, using the Delta LactoScope FTIR Advanced, this analyzer uses Fourier Transform Infra-Red Technology, which is calibrated for human milk, to evaluate macronutrient content. Working with the USDA, Federal Milk Market Administration, and Perten Instruments, the accuracy of the calibrations is maintained within the dairy standard of .02, with a repeatability factor of .006. Although no instruments for human milk analysis are currently FDA approved, we feel this additional step ensures that the milk that hospitals receive from The Milk Bank contains adequate calorie and protein content. While this does not replace monitoring infants for growth, it is an extra tool to insure optimum growth.
Since the establishment of HMBANA , there have been no cases reported of harm being done to a recipient due to the use of PDHM. For more information, please contact The Milk Bank.
Notice of Privacy Practices
The Health Insurance Portability and Accountability Act (HIPAA) took effect on April 14, 2003. One of the goals of this legislation is to set standards for the security and privacy of health information. The Milk Bank understands that medical information about clients is personal and we are committed to protecting this information. This notice describes how medical information about clients in our office may be used and disclosed, and how clients can get access to this information. We also describe client rights and certain obligations we have regarding the use and disclosure of medical information. Please review this carefully.
The HIPAA law of 1996 requires The Milk Bank to:
- Keep medical information that identifies clients private
- Give clients notice of our legal duties and privacy practices with respect to medical information about them
- Follow the terms of this notice
Any protected health information (i.e. individual identifiable information such as name, date, phone/fax numbers, email addresses, demographic data) may be used in connections with our services to a client, payment of an account or health care operations. It is expected that any organization with which we share information is HIPAA compliant and therefore ensuring the security of client information.
These are ways in which we may use or disclose medical information about a client:
- Health care providers may request information about a client to meet our needs. For instance, a prenatal care provider may request verification of a patient’s birth date before releasing results of their prenatal blood work to us. In another example, a baby’s pediatrician may request information on how milk has been supplied for the baby receiving donor milk.
- Medical information may be discussed with health insurers to verify eligibility for benefits, obtain prior authorization, or to bill and receive payment for the treatment and service provided by The Milk Bank.
- Certifying, licensing and accrediting bodies may request information about our donors or recipients to verify our operation and compliance with standards.
- Staff of The Milk Bank may use information to contact clients to check on pumping progress, paperwork needs or to inquire how an infant is progressing on donor milk. If we try to contact a client and they are not available, we may leave a message with a family member or on an answering machine unless a client specifically asks us not to do so.
- We may display photos on our office bulletin board of donors or infants if they are sent to us by the donor or infant’s parent.
- We may provide medical information to our business associates so that they can perform certain functions or services on our behalf. The associates could include hospitals, blood and tissue laboratories or fundraiser organizations.
- We will disclose medical information about a client if we are required to do so by federal, state or locallaw.
- We may disclose medical information about a client when necessary to prevent a serious threat to a client’s health and safety or that of another person or the public.
- We may disclose medical information about a client for public health activities. These activities may include the prevention or control of disease, reporting of donor milk recipients, or reporting laboratory test results.
- We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of a client’s health.
- Inadvertent disclosures of information may happen as a result of people overhearing conversations in The Milk Bank offices. Every effort will be made to prevent this from happening.
These are the ways in which we keep personal health information private:
- Personal health information is kept in individual locking files in our office. The office is unlocked during office hours when staff members are present but locked at all other times.
- Staff and volunteers who access files will be trained in issues of confidentiality and privacy.
- Publications coming from The Milk Bank office will contain no personal health information.
- If someone requests information from a medical record for a legitimate reason, this will be documented in the client’s file.
- Personnel trained in confidentiality and privacy issues access the electronic records only through The Milk Bank computers.
- Milk containers with personal identifiers on them will be kept in bags in the freezer, accessed only by staff and volunteers trained in confidentiality and privacy issues.
Persons potentially inadvertently exposed to private information include:
- Staff of The Milk Bank
- Breastmilk donors
- Students working at The Milk Bank
- Breastmilk recipients or their guardians
Individual rights under this agreement:
- A client has the right to inspect or copy their record. To do this, please submit your request in writing to the privacy officer of The Milk Bank.
- Amend the information contained in your record. Please send your request to the privacy officer in writing.
- Request an accounting of all disclosures of health information. Please send requests to the privacy officer.
- Request restrictions of access to a client record. Please send written request to the privacy office.
- A client may also issue a complaint, without risk of retaliation, to the privacy officer of The Milk Bank or to the US Department of Health and Human Services. You can learn more about your rights, including how to file a complaint, from the website at www.hhs.gov/ocr/hipaa or by calling 1- 866- 627- 7748.
Janice Sneider O’Rourke, MPA, RD
The Milk Bank 5060 E. 62nd Street, #128
Indianapolis, IN 46220
Please keep this notice for your records. When you sign the Donor Consent Form you acknowledge that you have received and understand this notice. Thank you.