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Thursday, November 14, 2013

Milk Donation for #YolandaPH - Where your milk goes

Let me start this post by listing down places where you can donate your milk.

In Davao City, here are the contact persons:

Moms in Cagayan de Oro can also donate breastmilk and you can see where in the poster below.
Plus more:
1. Favorita Store at 1718 JR Borja Ext., Sta. Cecilia Village Gusa.
2. Ororama Cogon Superstore -store hours

Cebu moms can donate milk to Dr. Lilibeth Espinosa at Vicente Sotto Memorial Medical Center NICU.

For Metro Manila,drop off your milk at the following locations:
Makati Human Milk Bank
1126 E. Rodriguez Ave. Cor. MH Del Pilar St. Bangkal Makati City

Alay Gatas Headquarters Human Milk Bank
Philippine Children’s Medical Center, Quezon Avenue, Quezon City
(02)924-6601 to 25 loc. 288

Dr. Jose Fabella Memorial Hospital
Lope de Vega, Sta. Cruz, Manila
(02) 734-5561 loc. 156

The Medical City Lactation Unit
The Medical City, Ortigas Avenue
(02) 635-6789 loc. 6720

St. Luke's Medical Center Lactation Unit
8th floor North Wing, Bonifacio Global City
(02) 789-7700 loc. 7118 

The Medela House,
29 1st St., New Manila, Quezon City
(02) 725-3723

If you noticed, I excluded UP-PGH Milk Bank in the list because they are simply inundated with calls and donations.  In normal conditions, you can donate milk at the UP-PGH Milk Bank. However, during these times, on top of preparing and pasteurizing the milk, they also have to coordinate distribution.  Hence, drop offs will now be focused on other locations and milk will be transported to UP-PGH Milk Bank when they are ready to pasteurize.

I am sure you have encountered this article in Slate about not sending breastmilk donations.  I would like to emphasize that this article refers to international donors.  E.g. if you are not in the Philippines, it is better for you to send cash donations instead of breastmilk as transportation and preservation will be additional issues to contend with. However, if you are in the Philippines, particularly, Metro Manila, Davao City and Cagayan de Oro City - where drop off points have been identified for the milk.

Moms have been concerned where their milk goes after bringing them to the drop-off point - how milk gets transported, where milk gets stored in the evacuation centers where there is no electricity.  Let me try to explain the process and hopefully assuage the concerns of donor moms.

Whatever milk you send to the drop-off point - whether it be in Cagayan de Oro City, Davao City or in Metro Manila (e.g. with Medela House), all the breastmilk collected are brought to UP-PGH and will be pooled with other donations.  The breastmilk is pooled because you can only pasteurize the milk in batches. The breastmilk is then stockpiled at UP-PGH Milk Bank.

Then there is a needs assessment. Breastmilk is not arbitrarily sent to anyone or any group or contact who is working at the calamity area.  Unang Yakap - EINC in coordination with DOH-HEMS coordinates with counterparts on the ground, to ensure that whoever receives the milk has the knowledge and capacity for infant feeding during emergencies including breastfeeding counseling.  Please also note that breastmilk donation is not treated as formula milk - but merely as a stop gap, as an assistance to help the moms on the ground go back to full breastfeeding. This is why the donations must always come with breastfeeding counseling.

Again - breastmilk donations come with breastfeeding support and breastfeeding counseling.  Let me share this post from Dr. Lei Alfonso of Unang Yakap.  You can read her entire comment at this link.
Integral to infant feeding missions, beyond the milk donation, is the affirmation, protection and support to mothers who are breastfeeding or returning their babies to breastfeeding. Babies beyond 6 months DO NOT need milk formula but they can thrive on their mother's milk and solid foods.
x x x 
This drive is for stockpiling purposes only until the need is called out from the different affected areas. We are still waiting for updates from DOH HEMS and other agencies who may want to work with us on this. All donated human milk will be pooled together for pasteurization. Just like when we donate blood, we cannot earmark a batch for a specific area/people. When it goes to the milk bank, it will be properly handled and stored. Priority recipients of donor milk will be the orphans and multiple births. As part of the human milk pool in the milk banks, very sick babies in the neonatal ICU can also potentially benefit from milk donations. As such, we encourage milk donations even without crisis.
Transfer of breastmilk cannot be done to just anyone because if so, there is no proper breastfeeding support and the use of breastmilk will become like formula milk, which will undermine the breastfeeding mothers.

On the concern of how will breastmilk be stored in the evacuation center when there is no electricity.  The amount of breastmilk that gets transported is enough only for immediate consumption.  There is no long-term storage involved.  Milk is never left in the evacuation center.  The people who bring the milk will always look for a place to safely store the milk - if not available, breastmilk is brought back (as we experienced during Ondoy).

Again, as I shared in my last post, the reason why we are focused on enforcing the prohibition on donation of formula milk is because of evidence-based studies that proved that families who received formula milk donations fed it to their children EVEN if they were breastfeeding and there was an increase in diarrhea following infant formula distribution.

Thus, it really saddens me that despite these studies, there are media personalities who confuse the public and influence them by insisting that they would rather get stomach aches than not have formula milk at all.

If you see similar comments, tweets, etc. please do not tire of replying and explaining.  Often, we just need to educate and send the links, information to help them understand why formula milk or breastmilk substitutes cannot be freely given in times of emergencies and calamities.

Again, donations of formula milk do a lot more harm than good when brought to evacuation centers.  Formula milk donations MUST BE coursed through the Department of Health and not indiscriminately distributed among the evacuees.  Formula milk has a place and it must be used only in specific instances:
Human milk substitutes (infant formula and/or milk) are NOT always needed
Providing infants and young children caught in an emergency situation with substitutes for human milk is extremely risky. It should be undertaken only after careful consideration and full awareness of the problems that may result. Good guidelines exist on the use of human milk substitutes and other milk products in emergencies: the 47th World Health Assembly Resolution WHA 47.5 (May 9, 1994); UNHCR guidelines on use of milk substitutes (July 25, 1989); the International Code of Marketing of Breast-milk Substitutes, WHO (1981). Common elements of these guidelines are that human milk substitutes must be:
  • limited to special circumstances as defined in WHA 47.5; 
  • guaranteed for the lifetime of emergency; 
  • not used as a sales inducement (therapeutic feeding, never in general distribution); 
  • accompanied by additional health care, water, fuel, and diarrhea treatment; 
  • include plans for the re-establishment of optimal feeding from the outset of the emergency.
Again, there must be an assessment and no indiscriminate distribution which will happen if formula milk donations are freely allowed.  This is a very helpful triage approach to decision-making:

Breastmilk substitutes ARE available from the Department of Health coordinators.  If you want to donate formula milk, donate it to the Department of Health ----> this is not prohibited.  What is prohibited is donations for general distribution.

I am truly saddened because the Yolanda situation has proven that we are already living in a formula feeding culture.  Earlier today, a fellow breastfeeding mom messaged me that there are evacuees now in Villamor Airbase and they will be helping out.  Her friend called out for formula donations because there were moms with babies.  However, when they went to see the evacuees, they found the moms breastfeeding their babies! Clearly, there was no need for formula milk donations or even breastmilk donations.

Similarly, because there are pregnant moms in the evacuation center, it is abnormal to assume that there is a need for formula milk donations.  But government officials assume that because of the formula feeding mentality that has been instilled in us by formula milk companies.

Let me end this post on a positive note.  I want to share this photo from Becca Villegas Posadas of CPL Annjannette Obligado - a military mom who was stationed in Tacloban City and breastfed babies in evacuation centers.
The goal is to put babies back to their mothers breast and this is faster achieved with the help of the community that needs to be formed in the evacuation centers in calamity-stricken areas.

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