Safe rules for donating breast milk and inducing lactation for babies

Not all newborns have the opportunity to receive breast milk directly from the mother. While on the other hand, there are breastfeeding mothers with abundant milk production which can exceed the supply for their babies. That is why finally there is a trend known as breast milk donors for babies.

So, before you give or receive a donor, you should first consider the various things you need to know about breastfeeding donors.

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Is donor breast milk safe?

Every mother wants to give the best for her baby, one of which is by providing intensive breastfeeding since the little one is born.

Breast milk is the food with the most complete nutritional content for babies at least until they are six months old.

This is because there are various benefits of breast milk that are good for mother and baby.

For breastfeeding mothers who experience one thing or another so that they cannot give breast milk to their babies, they are usually allowed to donate breast milk.

The breast milk that is given to this baby is not obtained from the biological mother, but from other breastfeeding mothers. Basically, giving breast milk for babies is fairly safe.

With a note, the donation has gone through a series of examination processes (screening) to ensure cleanliness and safety.

Breast milk that has been donated is usually also pasteurized to remove infectious organisms that could be present in it.

In fact, breastfeeding mothers who provide breastfeeding donors will usually pass the disease testing stage first. A breastfeeding donor can be said to be safe when it has gone through a series of inspection processes.

Meanwhile, breastfeeding donors who do not go through the examination stage, aka given directly, are not recommended by the Food and Drug Administration (FDA).

This is because breast milk that is obtained directly without going through a test poses a health risk to the baby who receives it.

Unfortunately, there are still mothers who don't know about its importance screening or examinations before breastfeeding donors.

The high cost is also sometimes the reason why prospective mothers who are breastfeeding donors and donors are hesitant to do so screening Breast milk.

However, examinations are highly recommended to be carried out so that the milk that the baby receives will be guaranteed its health and safety.

What are the requirements for breastfeeding donors?

Quoting from the Info Datin page issued by the Indonesian Ministry of Health, babies aged less than six months who cannot get breast milk are sought so that they can get breastfeeding assistance.

This assistance can be obtained from breastfeeding donors, but with several conditions. Here are some conditions that need to be met:

• There are requests for donors from the birth mother or the baby's family
• The identity of the nursing mother providing the donor is clearly known
• There is agreement from the donor after knowing the identity of the baby to be breastfed
• The health condition of the donor's body is fairly good, healthy, and does not have any medical problems
• Breastmilk that has been given from donors may not be traded

If the conditions above have been met, then the giving and receiving of breast milk donors can be done.

What are the stages of breastfeeding donation?

Breastfeeding donors should not be done carelessly because of the risk of endangering babies who are breastfed. That is why, to minimize the risk of harm to the baby, every mother who performs this procedure must pass two stages of examination.

First selection

According to the Indonesian Pediatrician Association (IDAI), here are some requirements that a potential donor needs to fulfill:

• Have a baby who is less than six months old and who is breastfeeding him
• Physically and mentally healthy
• The mother has no contraindications to breastfeeding, for example because of certain diseases or infections
• The supply of breastmilk that they have for their own babies is sufficient and they are willing to give donors because of their excess production
• There is no history of blood transfusions or organ or tissue transplants in the past 12 months
• Not taking medication regularly, including insulin, thyroid hormone, or other treatments that have a risk of affecting the baby. Medicines or herbal supplements must first be assessed for safety for breast milk
• Not smoking, drinking alcohol, or using illegal drugs that can affect the baby
• Do not have a history of infectious diseases such as hepatitis, HIV and HTLV2
• Not having a sexual partner is at risk of becoming infected with HIV, HTLV2, hepatitis B, hepatitis C, CMV, and syphilis.
• Do not have a sexual partner who is a person with hemophilia and is regularly receiving blood transfusions, consumption of illegal drugs, smoking, or drinking alcohol
• It has been declared clear of HIV, hepatitis B, hepatitis C, CMV, and syphilis through tests

In addition, make sure that the breasts of the breastfeeding mother who will give the donor are healthy and that there is no mastitis or other infections that are susceptible to transmission.

Second selection

After passing the first selection, there are several other requirements in the second selection that breastfeeding mothers as prospective donors must also fulfill.

• If the donor is to be given to a premature baby, the potential donor must be tested for hepatitis B, hepatitis C, CMV (cytomegalovirus), and syphilis.
• If there is any doubt about the health status of the breastfeeding donor, the test can be done every 3 months.

After the prospective donor has passed all the stages, the prospective breastfeeding donor needs to carry out the procedure for breastfeeding.

Breastfeeding procedures include maintaining cleanliness by washing hands and a breastmilk pump until clean and using a non-plastic breastmilk container.

This is because plastic containers are at risk of tearing, leaking, causing contamination to enter. Instead, you can use a breast milk bottle or bag.

This procedure applies not only to breastfeeding donors, but also to mothers whose babies are breastfeeding donors.

In this case, mothers whose babies get donors must ensure that the breast milk is free of viruses or bacteria by pasteurization, aka heating.

Tips for mothers who give breast milk donors

Mothers who want to give donors are expected to understand the quality and safety of breastmilk that has been expressed. The quality and safety includes how to express, store, and maintain good hygiene and quality of breast milk.

Here are some tips that should be considered by mothers who provide breastfeeding donors:

• Understand about cleanliness, how to pump, and how to store breast milk properly.
• Wash hands with running water and soap before pumping breastmilk then dry with a clean towel or cloth.
• Use a breast pump that is clean.
• Try the mother to pump breast milk in a clean place.
• Store expressed breast milk in closed containers such as glass bottles, plastic bottles made of polypropylene or polycarbonate, or breast milk bags.

Tips for mothers whose babies are breastfeeding donors

Before giving it to babies, mothers need to ensure that the milk is clean and healthy. Therefore, mothers are advised to do the breast milk pasteurization procedure.

Pasteurization is used to remove bacteria while preserving most of the beneficial nutrients in the milk.

Here are two methods that can be applied in the process of breastfeeding donation based on the Indonesian Pediatrician Association:

Pasteurization pretoria

Pretoria pasteurization is a pasteurization method by immersing a bottle of breast milk in boiling water for about 20-30 minutes. Here are the stages of pretoria pasteurization in the breast milk donor process:

1. Put about 50-150 milliliters (ml) of breast milk in a 450 ml glass container.
2. Close the glass container until it is tight then place it in an aluminum pan that can hold about 1 liter of water.
3. Pour about 1 cup (450 ml) of boiling water or until the water level reaches 2 centimeters (cm) from the top of the pot.
4. When finished then remove the breast milk, cool it, and give it directly to the baby or store it in the refrigerator (refrigerator).

Flash heating

Flash heating is a pasteurization method by immersing a bottle of breast milk in a tub filled with water at a temperature of 100 degrees Celsius for 5 minutes. Here are the stages flash heating in the breast milk donor process:

1. Put about 50-150 ml of breast milk into a 450 ml glass container.
2. Close the glass container until just before doing flash heating.
3. Unscrew the glass container while doing flash heating and put the container in 1 liter hart port (milk heater).
4. Add about 1 pound (450 ml) of water or until the water level reaches 2 cm from the top of the pot.
5. Bring the water to a boil until bubbles appear then move the container of breast milk quickly.
6. Before giving it to babies or storing it in the refrigerator, it's best to chill the donor's breast milk first.

Do breastfeeding donors need to be if you want to breastfeed an adopted child?

Even if you did not give birth to an adopted child, it turns out that there is a possibility that you can breastfeed your little one. Yes, breastfeeding adopted children without pregnancy or it is called lactation induction is possible.

Generally, milk production (lactation) is triggered by a complicated interaction between three hormones, namely estrogen, progesterone, and human placenta lactogen (HPL) during the last months of pregnancy.

During childbirth, estrogen and progesterone levels drop, allowing the hormone prolactin to increase and promote milk production.

Well, lactation induction is a process that is done to encourage the release of breast milk even though you are not pregnant.

The existence of lactation induction opens the opportunity for you to breastfeed adopted children. The success of this lactation induction depends on the process of preparing for the breastfeeding.

If you have months to prepare, your doctor may recommend hormone therapy such as supplemental estrogen or progesterone.

This is done to mimic the effects of hormonal changes during pregnancy. This hormone therapy usually lasts six months or more.

Mothers who are breastfeeding adopted children using the lactation induction method can also use a breast pump to increase milk production.

The rest, the method of breastfeeding adopted children using the lactation induction method is the same as breastfeeding babies in general.

Don't forget, mothers whose babies receive breastfeeding donors must also pay attention to how to store breast milk so that it can be given according to the baby's breastfeeding schedule.

If you have questions about the myths of breastfeeding mothers, the challenges of breastfeeding, to problems with breastfeeding mothers, consult your doctor immediately.

The doctor can provide treatment and medication that is safe for breastfeeding mothers according to your condition.