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Thursday, January 31, 2013

Pearls from the Compostela Valley Breastfeeding Mission Experience - Part 3


This is the last of three parts.  Please refer to Parts 1 and 2. This is a guest post written by Dr. Lei who participated in all the aspects of the breastfeeding mission. Dr. Lei also runs an online store, Caleb's Closet and shares her thoughts in her blog, Lei's Anatomy.

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4. Human Milk transport and storage requires a lot of logistics but tapping on to the right network, we have available resources to make things work. 
Breast milk is a precious commodity that requires care in handling. Refrigerated human milk is good for 3-4 days. In the usual one-door domestic freezers, this extends to 3 weeks. For deep freezers, viability stretches from 6 months to 1 year. However, when frozen breast milk is thawed, it should be refrigerated, consumed or discarded within 24 hours.



Region 11 Vaccine House in Davao
In an ideal setting, IFE requires a baseline needs assessment to guide the conduct of relief efforts. This needs assessment was hampered by the sheer magnitude of the devastation. Thus, Team UnangYakap strategized that we would go ahead and mobilizes the donor milk collection, stockpiling and transport while awaiting statistics from the needs assessment.

Another logistical challenge is keeping the milk rock frozen. The pasteurized breast milk batches were personally escorted by our Team to the DOH CHD Region 11 Vaccine House in Davao City and the HEMS Nerve Center in Nabunturan. The donor milk is properly stored in -20degree freezers – viable for 6 months.
We brought with us to New Bataan a batch of previously transported milk stored in an appropriate private household freezer. Pediatric Residents from UP-PGH flew this to Davao and Atty. Jenny Ong’s parents so kind as to accommodate the milk in their household when there were no arrangements with DOH HEMS yet.
Breast milk in Davao kept in a private freezer. 
Some of the thawed breast milk was cup fed to malnourished babies in New Bataan. We demonstrated cup feeding to the mothers and emphasized that this is the safest way to give donor milk (much safer than bottle feeding as bottles are very difficult to keep clean). We also taught the mothers how to hand express breast milk (neither electricity nor batteries needed). We emphasized hand washing before hand expression and advised them against using bicycle horn breast pumps (AKA torture devices!).

Most of it however, was earmarked for priority recipients. At that time we had identified an orphaned 3-week old baby under the care of the DSWD. On the Feast of the Ninos Innocentes, triplets were born in remote Baganga (Davao Oriental) and they would definitely benefit from the milk sent by generous and concerned mothers.

The remaining milk, still rock frozen, was left for safe keeping at the Provincial HEMS vaccine freezer under the care of the Provincial Nutrition Officer of Compostela Valley, Ms. Nena Mirafuentes. During our limited encounter, I felt her sincerity and commitment to promote breastfeeding among the mothers.

5. We need more health workers and people doing this kind of work.
With our limited time and resources, we were only able to visit a single evacuation center in Compostela Valley out of the many. It is possible to protect and support breastfeeding mothers and babies through simple interventions. It is our dream that ALL future evacuation centers would emulate the Woman-Friendly Space as the first step in the IFE strategy and mothers who are pregnant and with nursing children be affirmed, encouraged and protected. This is particularly crucial for a disaster-prone country like ours. Currently, we have community-based experts from Arugaan but we need more health workers skilled in doing this aspect of public health.

If you’ve come to the end of my essay and have not been put to sleep, thank you so much. I hope you could pass the knowledge on. And if you are one of the mommy donors, rest assured that your milk will help save lives. Thank you very much on behalf of the network of volunteers who made this activity possible!
Sharing a sumptuous lunch with my mentors and fellow moms:
Dr. Donna Capili, Dr. Lei Camiling-Alfonso (the author), Dr. Mianne Silvestre,
childbirth educator Alex Hao and Atty. Jenny Ong (COANM)

You may want to read more about the IFE strategies on this link: http://www.ennonline.net/pool/files/ife/guide-for-mothers-english-who-1997.pdf


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About the Author:
Dr. Lei Camiling-Alfonso graduated from UP Diliman, B.S. Molecular Biology (cum laude) before pursuing medicine at the UP-Philippine General Hospital. Fresh out of medical school, she served a far-flung island group in Palawan as a DOH Doctor to the Barrio until a sensitive pregnancy forced her to return to Manila. Her personal encounters with our public health system as well as her own difficulties as a breastfeeding mother prompted her involvement with Unang Yakap (Essential Intrapartum and Newborn Care), a WHO initiative for evidence-based labor/delivery and newborn care practices, for almost a year now. She is currently trying to pursue a career in the local field of Breastfeeding Medicine and would probably go into Obstetrics as a back-up plan. She runs an e-commerce site that promotes mindful parenting. Her son Caleb is still breastfeeding past 2 years of age.

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