326 R.M. Shaw and M. Morgan
Donor Milk Banks and the Benefits of Donor
Milk for Premature Infants
From the opening of the first donor milk bank in Vienna in 1909 until
the mid-1980s, milk banks proliferated around the world. A combi-
nation of factors, including the development of artificial formulas for
preterm infants, concerns by neonatologists that infants fed on banked
human milk were not meeting the growth recommendations, and the
emergence of HIV/AIDS and cytomegalovirus (CMV) found in breast-
milk, led to the closure of many banks. Guidelines were developed to
ensure that appropriate screening and management was in place to
protect vulnerable infants (see HMBANA 2013 ). Over the last 15 to
20 years, there has been increased research into nutrition for premature
babies, leading to an awareness of the benefits of human breastmilk for
this population. As such, human donor milk banking has made a resur-
gence, with the majority of emerging milk banks now attached to neo-
natal units.
Groups such as The Human Milk Bank of North America
(HMBANA), Human Milk Banking Association of South Africa,
European Milk Banking Association, and the National Institute of Clinical
Excellence (NICE) guidelines for donor breastmilk banks in the UK all
provide comprehensive guidance for the setting up and operation of
donor milk banking services. Australian milk banks and New Zealand
neonatal facilities have also obtained best practice guidance from the
Western Australia PREM Bank guidelines (Hartmann et al. 2007 ).
There are now five donor milk banks in Australia, including one that
is community based (Australian Government Department of Health
2014 ). Currently, in New Zealand, there is one hospital based donor
milk bank at Christchurch, which was set up in 2014 to provide pas-
teurised donor milk for babies in the NICU.
Current recommendations and practices for human milk donation
specify donor screening, safe expressing and collection, bacterial testing,
pasteurisation, and freezing. Some recommend the pooling of milk. The
process of pasteurisation of human milk is designed to reduce or elimi-
nate the risk of transmission of bacterial and viral disease (O’Connor
et al. 2015 ; Stock et al. 2015 ). Pasteurisation does negatively affect some
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