328 R.M. Shaw and M. Morgan
women who are tested and have latent CMV are discounted from being
donors (unless the milk can be pasteurised), to avoid any risk to these
babies. As a large number of women have latent CMV, usually only one
in five women who offer their milk is eligible to donate. If a donor has a
clear health and blood screen, then donation is commenced.
Commonly, donor milk banks receive breastmilk from mothers with a
term baby, although this is not always the case for NICUs. As Hartmann
et al. ( 2007 : 672) document in relation to the first five months of oper-
ation of the PREM Bank in Western Australia, only two of a total 47
batches of donor milk were donated by mothers who gave birth to term
babies. Donor milk is bacterially tested and may be pooled from several
donors, as is the case in the USA. Bromberg Bar Yam ( 2010 ) comments
that the pooling of donor milk is designed to help reduce the nutrient
variability of the milk. Using pooled milk means that a baby may receive
milk from several donors. However, where milk kinship is involved, this
may not be acceptable, as Islamic law forbids marriage between persons
related by milk kinship (see Pappano 2016 ; Shaw 2015 ). Because donor
milk screening guidelines in the UK are based on the National Blood
Service, donor milk is not currently pooled between donors. In addition,
and where practicable, recipients are fed donor milk from as few donors
as possible (Weaver in Shaw 2015 :190). In all cases, milk donations in
milk banks are traceable even when pooled.
The Use of Raw Donor Milk in the NICU
Despite the absence of neonatal milk banks in New Zealand hospitals,
NICU staff receive requests from mothers wanting to use milk from
other women. Some staff are uncomfortable with the practice of using
donated milk, and they may express disgust or concern about donated
breastmilk due to contamination and the risk of infection, as Bartle
( 2010 ) documented prior to the establishment of the Christchurch
neonatal milk bank. At Maggie Morgan’s workplace, most staff agree to
facilitate milk sharing if mothers are given appropriate advice.
The Use of donor breast milk policy guideline was developed at Morgan’s
workplace once access to documentation on the screening, consent
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