Open-i Logo
Submit this form
Results 1-1   << Back

 
Milk for Low Birth Weight Babies: WHO Hierarchy of Feeding Choices [14].
© Copyright Policy

Figure 1: Milk for Low Birth Weight Babies: WHO Hierarchy of Feeding Choices [14].

Mentions: Breastfeeding at the breast is number one in the World Health Organization's hierarchy of infant feeding choices for infants who have the ability to breastfeed. For premature and sick infants it may be that actual breastfeeding is impossible for a variety of reasons (e.g., gestational age, oromotor abnormalities) in which case the mother's fresh expressed milk becomes the choice. Figure 1 is a diagram of the Hierarchy of Feeding Choices for Low Birth Weight Infants [Savage, personal communication, 1998; [14]]. Publication of this hierarchy has become mired in international HIV politics, particularly in relation to the choice of fresh milk donated by a biologically unrelated mother (options 2 and 3). Countries such as the United States have difficulties with these two options because of the risk of disease transmission, in particular HIV. In the US the risk of disease transmission outweighs the benefits of fresh human milk from an unrelated donor. Even though pasteurization negatively affects some of the protective factors in donor milk and may increase infection rates slightly, the use of infant formula with NO protective effect dramatically increases infection rates [33]. In developing countries, where human milk substitutes carry a much higher risk of infant mortality than in a developed country, and where pasteurization of the donated milk is not widely available, the two "raw milk" alternatives in the feeding hierarchy might be preferable because the risk of potential disease transmission and death from the raw donor milk is outweighed by the much higher risk of death from the use of infant formula. Newer guidelines relating to wet nurses in these countries recommend that all wet nurses be screened for HIV [34]. The use of pasteurized donor milk in populations of infants orphaned by HIV has proved efficacious in one setting in South Africa [35]. In the absence of the mother's own milk and in light of the high risk of infant formula feeding in countries with a high rate of HIV/AIDS, donor milk collected and processed in a systematic way through donor screening, bacteriological testing of the milk, and pasteurization may protect a large segment of the population and foster child growth and development that will assist individuals in becoming future contributing members of society.

Global health policies that support the use of banked donor human milk: a human rights issue

Arnold LD - Int Breastfeed J (2006)

Bottom Line: The three methods used in triangulation were 1) writing as a method of inquiry, 2) an integrative research review, and 3) personal experience and knowledge of the topic.Discussion of the international human rights documents and global health policies shows that there is a wealth of documentation to support promotion, protection and support of donor milk banking as an integral part of child health and survival.By utilizing these policy documents, health ministries, professional associations, and donor milk banking associations can find rationales for establishing, increasing or continuing to provide milk banking services in any country, and thereby improve the health of children and future generations of adults.

Affiliation: National Commission on Donor Milk Banking, American Breastfeeding Institute, 327 Quaker Meeting House Road, East Sandwich, MA 02537, USA. milkbank@capecod.net

ABSTRACT
This review examines the role of donor human milk banking in international human rights documents and global health policies. For countries looking to improve child health, promotion, protection and support of donor human milk banks has an important role to play for the most vulnerable of infants and children. This review is based on qualitative triangulation research conducted for a doctoral dissertation. The three methods used in triangulation were 1) writing as a method of inquiry, 2) an integrative research review, and 3) personal experience and knowledge of the topic. Discussion of the international human rights documents and global health policies shows that there is a wealth of documentation to support promotion, protection and support of donor milk banking as an integral part of child health and survival. By utilizing these policy documents, health ministries, professional associations, and donor milk banking associations can find rationales for establishing, increasing or continuing to provide milk banking services in any country, and thereby improve the health of children and future generations of adults.

View Similar Images In: Results Collection              View Article: Pubmed Central HTML PubMed      Show All Figures 
getmorefigures.php?pmc=1766344&rFormat=json&query=null&fields=all&favor=none&it=none&sub=none&sp=none&coll=none&lic=none&vid=none&req=5
Show MeSH

Lister Hill National Center for Biomedical Communications
U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894
National Institutes of Health, Department of Health & Human Services
Privacy, Accessibility, Frequently Asked Questions, Contact Us, Collection
Freedom of Information Act, USA.gov