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November 8, 2016

Donor Human Milk for Very Low-Birth-Weight Infants

Author Affiliations
  • 1Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City
JAMA. 2016;316(18):1875-1876. doi:10.1001/jama.2016.16142

The concept of donor human milk reaches back many centuries, with the first milk bank established in the United States in 1912.1 In 1985, the nonprofit Human Milk Banking Association of North America (HMBANA) was founded, which established standards for donor milk.1 In the 2000s, milk banking increased in the United States, from 6 active HMBANA banks in 2003 to 22 banks in 2016.2 Milk dispensed by HMBANA is obtained from volunteer donor mothers, most of whom delivered healthy infants at term. Donors are screened for eligibility by verbal interview and serologic testing for human immunodeficiency virus, human T-lymphotropic virus I and II, hepatitis B, hepatitis C, and syphilis. Donors express milk according to HMBANA guidelines and deliver it to the milk bank frozen. Milk from 3 to 10 donors is pooled to create uniform nutritional properties and undergoes Holder pasteurization (62°C for 30 minutes). A sample from each batch is sent for bacteriologic screening. It is then dispensed primarily to neonatal intensive care units for use in preterm infants, although HMBANA also serves a limited number of infants who have been discharged from the hospital.