We've all seen the photos of bare infant formula shelves in the stores over the past few weeks. This is undoubtedly putting stress and panic into the minds of parents with babies who already feel the stress of caring for a newborn. Parents who are exclusively providing human milk are encouraged to continue breast/chestfeeding as well as pumping (as applicable) to protect and sustain their supply.
Some parents have significant risk factors that prevent their body from making sufficient milk for their baby despite their best efforts. Some parents may use formula to supplement their human milk diet. Others may use formula to give their baby the additional protein and calories if their baby was born prematurely or with special health conditions. Every baby has a different story, and truly the most important thing is that babies receive optimal nutrition for growth and development.
Considering the shortages, one may be tempted to accept human milk from another providing parent. This can be considered risky as human milk is a body fluid and dangerous viruses like HIV, CMV, HTLV and hepatitis B or C can pass through milk. More likely and just as important, maternal medications and other lifestyle choices (such as nicotine, alcohol, or recreational drugs) can pass into the milk.
There are also concerns about bacterial content being present if the milk sharing parent was not washing their hands, cleaning and sanitizing their pump parts, or following best storage guidelines and proper temperature regulations of refrigerating/freezing milk.
Parents who are partially giving human milk may wonder about ways to increase their milk production. Evidence-based strategies to boost milk supply include increasing stimulation and emptying of the breast/chest. This can be done by latching the baby more often or increasing pumping. Recommendations for this include:
Use of a high-quality breast pump
Increasing pumping frequency
Pumping after a breast/chestfeeding session
Power pumping – pumping 10 minutes on and ten minutes off for 1 hour, 1 time per day in addition to your normal pumping schedule.
Cluster pumping - pumping every 45-60 minutes for about ten minutes throughout the day for one to three days.
Using hand massage before, during, and after pumping.
Good self-care for the providing parent (eat, hydrate, nap, and stress reducing techniques while pumping).
Parents who were providing milk but have stopped may wonder about relactating. Relactation is the process by which a person works to re-build milk production after any period of time since having stopped producing. This can be possible, but it does take time.
In general, the less time since a parent stopped, the easier it can be to relactate. The longer it has been, the longer it could take to rebuild. Even relactating a partial supply of human milk could help decrease the volume of formula needed for your baby. A Lactation Consultant or Practitioner who specializes in Breastfeeding Medicine would be able to give you an individualized plan to try.
Parents with an oversupply of milk can be encouraged to reach out to a Human Milk Banking Association of North America (HMBANA) Milk Bank to see if they can become a milk donor. In Central Ohio we have the OhioHealth Mother's Milk Bank that supplies pasteurized donor milk to our most critical hospitalized babies. To donate call (614) 566-0630 or email milkbank@ohiohealth.com. OhioHealth Mother’s Milk Bank can be a resource to obtain donated human milk. Milk from HMBANA has been screened before donation and pasteurized before it is distributed. This can be an option if funds are available or if there is a prescription need due to a specialized health concern.
Please reach out to your Healthcare Provider or Lactation Consultant to talk further about any of the strategies discussed above to decide the safest course of action for you and your baby.
For more information on the Clinical Nutrition and Lactation team at Nationwide Children’s Hospital, please call (614) 722-3060 or visit the website.
Karen Rachuba RD, LD, IBCLC is a pediatric dietitian and international board certified lactation consultant who has worked at NCH since 2007. With previous expertise in gastroenterology related nutrition concerns, Karen now works full time with the Lactation Team supporting parents and babies with their human milk journey.
Michelle Ross, MHA, RD, LD, ALC
Clinical Nutrition and Lactation
Michelle E. Ross, MHA, RD, LD, ALC is a Registered and Licensed Dietitian and Advanced Lactation Consultant at Nationwide Children's Hospital. She is the Program Manager for Clinical Nutrition and Lactation. Her focus is in department operations, budget and leadership of Dietitians, Lactation Consultants, Dietetic Technicians, Breastfeeding Peer Advisors and networking with the multidisciplinary team in current nutrition and lactation practices to promote Best Outcomes.
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