Stories from the Nanay Bayanihan Center #yolandaPH

It all started with a private message.  A fellow breastfeeding mom was concerned because she had been seeing calls for formula milk donation at Villamor Airbase.  She had been helping out in Villamor Airbase because she found herself not being able to leave.  Camille Favorito shared that her officemate experienced first hand how it was in Villamor during the early days, when they were waiting for their own relatives from Tacloban.  There was no receiving process - no food, no medical teams.  They volunteered to help and have not left.

The scene at Villamor Airbase #yolandaPH

I went to Villamor this morning for a meeting on setting up mother-baby friendly spaces with several breastfeeding groups.  However, we realized that action was immediately needed and ended up talking to and assisting evacuees with babies.

C130 just landed

I also had the chance to see a C-130 land in Villamor and streams of people from varying ages and conditions streamed into the waiting area.  The system at the Villamor Airbase is organized by the Army wives, let by Mrs. Kintanar, Mrs. Ona and Mrs. Rayos.

New arrivals are ushered into the waiting area. People with injuries are immediatel y and people stream into the waiting area - moms babies, families, old people, people with injuries, the latter being directed immediately to the clinic area for medical assistance.

This waiting area is filled with monobloc chairs where they are given food, water, allowed to rest. Volunteer stress de-briefers interview them - 1 per family - name/ages of family members, what area did they come from (Tacloban, Tanuan, Guian, etc).  Then, the volunteers check what their immediate needs are: may sugat, may sakit, may karamdaman, or if with kids, nappies?

breastfeeding mom gets
interviewed by meda

If they have wounds or feel unwell, they are immediately brought to the clinic area where register and then get interviewed by a nurse. then a doctor checks them and prescribes medicines if needed. Then they go to a pharmacy area where medicines are dispensed.   If they need clothes, there is also an area where they can get some clothes - clothes are not randomly given to them but they get to pick what fits them.

Next, if they have relatives, globe/sun/smart have set up calling booths. They call their relatives to get picked up. Some are ferried to bus stations by transport volunteers. Those who have nowhere to go are sent to another waiting area and will be transported to the DSWD shelter in Mandaluyong.

view from the back

So what is needed there? Volunteers to be transport coordinators. If you can volunteer to be one, contact Golda Benjamin 09178117007. Hot food - they are asking if per food donation can be good for 150 people. Sana healthy nutritious food arroz caldo or monggo and not fast food. Clothes for the infants and the children.

Several breastfeeding groups have banded together and will be working with DOH/IYCF Coordinators to set up mother-baby friendly places where moms can get affirmation and breastfeeding counseling. I want to correct the misconception na --pano na mga formula fed babies? mamatay? It is DOH's duty to dispense formula milk to babies who truly need them.   Donations of formula milk are prohibited when made to the general public, when included with the individual relief good packs.  However, if it is found that there are moms in the evacuation centers or crisis area who need it, they can get it from the DOH coordinator.

waiting for transport to
the DSWD shelter

Earlier, we saw several babies and most were breastfeeding. I only saw 2 who were formula feeding and they were already older children - past 1.  The goal for these kids is to help them get past reliance on milk and eat more solids. The babies at the evacuation centers all came with their mothers.

What we want aim to do is to encourage them to breastfeed and not drown them in donations of BM substitutes. Breastmilk given to the kids if needed is pasteurized. Donated BM is not the end. it is a stop-gap. the end is put the babies back to breastfeeding.

There are no numbers of how many babies are currently without mothers - even the Philippine government does not have this figure.  The number we have is that on the ground - in this case in Villamor Air Base.  Babies need medical assistance - medicines which are dispenses accordingly but not formula milk.

If this morning's visit was going to be a barometer, I would say that there were only 2 kids - old kids who could've been recipients of the breastmilk donation.  All the other babies there were breastfeeding.  If you are worried about the health of the milk donor, milk is pasteurized.  In all transport of milk,  we ensure that the cold chain is preserved - milk will not be spoiled.  Spoiled milk will never be fed to the babies.  Again the end goal is put the babies back to breastfeeding.  If you give formula milk, you can never ensure that the powdered milk is clean, that the water used to mix it is clean - that the bottle you use is BPA-free.  Finally, you cannot promise a continuous supply of formula milk for 6 months.

The negative effects of distributing formula milk or breastmilk substitutes have been proven internationally and locally and is evidence-based.  Hindi ito sabi-sabi or gawa-gawa lang.  These are international standards and I am ashamed to say that by allowing formula milk donations on site - given and distributed generally, paatras tayo as a country.

To end, if you want to help this Villamor Air Base activity, here are concrete things you can do:
1. Sign up for a shift at the mother-baby friendly space - bit.ly/NanayBayanihan
2. Volunteer transportation by contacting the coordinator Golda Benjamin 09178117007
3. Donate hot food - good for 150 people at least.  Pool your resources with your friends.  I'm actually looking for manangs/manongs who cook and sell hot food on the street.  Perhaps we can buy their entire day's sales and ask them to distribute their food in Villamor.  To donate food, please contact COMBI Officer Ms. Rose Villarin 09159299292 or contact Pasay City Health Office 8318201
4. Donate usable clothes for the infants and the children.

Bayanihan iFE | Infographics

#yolandaPH

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
09486509194/09275619889

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.

Once More: No Milk Donations During Calamities

Every time there is a calamity in the Philippines, I have to share posts on my Facebook and Twitter accounts about the prohibition on milk donations.  This time, I feel that a blog post is in order because I saw these posts on Facebook:

https://www.facebook.com/photo.php?fbid=10151975909124911&set=a.58908059910.66243.645444910&type=1

Newborns and infants are, probably, the most vulnerable in times of tragedy.

Let us help some of them who have no access to breastmilk. Since

powdered formula milk is prohibited due to lack of clean water, pre-mix formula 

is the best option. Unfortunately, one of the biggest drugstores here

in the Philippines does not sell pre-mix. 

To our kababayans abroad who have the means to acquire premix formula,

may the spirit of bayanihan be with you. From drop off points, all donations will be sent to Philippine Red Cross. For transparency, please label your donations with your names.

Preferred package: pre-mix formula with disposable teats/nipples

(There is no water and electricity to sterilize bottles.)

Compilation of Emergency Posts - Again - No Formula Milk Donations Please!

I have written several posts about breastfeeding during emergencies and calamities.  They are spread out through 4-5 years.  In this post, I will attempt to compile them so you can easily click and refer to the ones relevant to you.

For breastfeeding moms, a top worry during storms would be brownouts especially on how these affect frozen breastmilk.  Visit my post "Brownouts and Breastmilk" to read how you can preserve your breastmilk during power outages and information on refreezing milk.

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.

Pearls from the Compostela Valley Breastfeeding Mission Experience - Part 2

This is the second of three parts.  You can read Part 1 here.  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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3. Substantial amounts of human milk can be collected and stored for the above babies.

We were able to collect 67 liters of milk in less than 2 weeks. (Having talked with Velvet, they actually came up with 100 liters in a single day, involving just one barangay!!). Substantial amounts of human milk can be collected and preserved properly.

After UNICEF’s call for milk donations went out to our Team UnangYakap, the response was crazy. In a matter of 24 hours, we helped mobilize private individuals (e.g. Maricel Cua of Medela Moms, Davao-based childbirth educator/advocate Alex Hao, blogger/advocate/lawyer Jenny Ong and mother support groups at the BangkoSentralngPilipinas etc,), the Lactation Units of The Medical City, St. Luke’s Global Hospital (through the leadership of Dr. Cristina Bernardo, IBCLC and Breastfeeding Committee Head of the Philippine Pediatric Society), and the 3 Human Milk Banks in NCR (Fabella, PCMC and the UP-PGH through the coordination of Dr .Fay de Ocampo, kangaroo mother care expert and Team UnangYakap).

Pearls from the Compostela Valley Breastfeeding Mission Experience - Part 1

I was quite blessed to be part of the breastfeeding drive for babies of Compostela Valley.  Through this drive, I was finally able to meet Dr. Lei Camiling Alfonso of Caleb's Closet Ecostore.  We had been email and FB-mates but never got to meet each other in person.  She was very involved in the drive and we finally met in my hometown when she flew in to transport breastmilk to ComVal.  I asked Lei to share her story and experiences during the trip to ComVal and she generously agreed.  Aside from her online store, Lei also shares her thoughts and blogs at Lei's Anatomy.  Read on and learn!

This is the first of three parts.
============================
Face it, our country is disaster prone. And relief work is something that has really sparked my interest because of the sheer need and urgency. This has taken a whole new meaning with my new understanding of breastfeeding and its implications for infants in disaster areas. Most health workers have little knowledge of breastfeeding and lactation management during crisis. I have read the theories and the expert recommendations, but I haven’t seen them work on the ground. During the holidays, I was privileged to be with my Team UnangYakap mentors, Dr. Maria Asuncion Silvestre and Dr. Donna Isabel Capili supported by WHO Philippines (thru the United Nations Central Emergency Fund) to conduct a breastfeeding mission for Pablo victims in one of the evacuation sites. I am thrilled to report to you some realizations:

Unang Yakap's Breastmilk Collection and Storage Guidelines for Donor Moms

Whether we express milk for donation or for immediate consumption, we should always keep in mind the guidelines on collection and storage.  Dr. Lei Camiling-Alfonso shares some information on collection and storage of breastmilk by donor moms.  These guidelines have been reviewed by Dr. Francesca Tatad-To (who we sorely miss at LATCH) and was written for the Unang Yakap campaign.  Team Unang Yakap allowed me to reprint these guidelines for easy access to potential donor moms.

A Call for Breastmilk Donations for Victims of Pablo

STOP! Are you going to donate milk? Read THIS first.  Please donate frozen and not thawed milk.  Thank you!

We are mobilizing again and calling for breastmilk donations to share to the victims of Pablo in Compostela Valely, Mindanao. Here is the call from Dr. Mianne Silvestre:

I just received an SMS from Dr Paul Zambrano of UNICEF who is at an emergency meeting in Davao with Sec Dinky Soliman of DSWD. Sec Dinky is appealing for donations of human milk. 

Let's do this, friends! Let's stand by the principles of Infant Feeding in Emergencies IFE and show how Breastfeeding Missions should be done. 

Team Unang Yakap - EINC will be networking with contacts in Davao while I am committing the UP-PGH Lactation Unit and Milk Bank to help with the pasteurization of donor milk. Calling on the other Milk Banks - Fabella and PCMC and if already set up the Zamboanga City Medical Center to help out. Let's give responsibly. Let's save lives. Let's give hope.

Breastmilk Donation Updates

I just got off the phone with Ms. Bessie Borja of DOH.  Breastmilk donations are continuously being accepted at UP-PGH Milk Bank, under Dr. Aurora Libadia.  Aside from UP-PGH, Fabella and PCMC also have pasteurizers.  However, the PCMC pasteurizer is small while Fabella has regular breast milk supply from the mothers who give birth at their hospital.  The best place to donate would be to UP-PGH.  The donations brought to Medela House also eventually end up in UP-PGH. 

UP-PGH needs about 80 liters of milk to run their pasteurization machine.  The milk is then ready to be deployed to the evacuation centers, if necessary.  The contact person to request for breastmilk donations is CHD-Metro Manila's Ms. Myrna Lapuz.  

As of today, Ms. Bessie Borja has been in touch with local health officers and mentioned that there is no immediate need yet for deployment of breastmilk.  However, it would be best if we can continue the breastmilk drive and transfer to UP-PGH so that the milk can be pasteurized. 

For breastmilk donations, you can bring them to:

a. UP-PGH Milk Bank, contact Nurse Tina or Grace 0921-453-5310 or 5362867

b. The Medela House, No. 29, 1st Steet, New Manila, Quezon City - 09175614366 or 7253723

*The milk here will be pasteurized at UP-PGH Milk Bank and ready for deployment.

If you want to give to a specific recipient, you can donate breastmilk directly to CRIBS Foundation, Inc.

#15 Major Dizon St., Industrial Valley Complex, Marikina City 1802; (632)681-5921, (632)681-8078, (632) 576-7693; (632) 647-1329  Cellphone no. :  0917-5112742

Just a reminder, if you are asking for formula milk donations or offering formula milk donations, please note that it is illegal under the Milk Code UNLESS you apply for and have clearance from the IAC.  Please read these guidelines - http://www.fda.gov.ph/AO/AO%2003-B,%20s.%202000.pdf  SCROLL TO IV-B.  

NO! to formula milk donations

We are again in the middle of an emergency.  There have been several calls for donation and despite previous reminders about not asking for formula milk donations, here's another one:

I previously posted about why formula milk donations should not be accepted during emergencies and disasters but here is a recent and first hand sharing by Dr. Zeka Tatad-To:

Guest Post: Baby Leaf's Sendong Experience

Today's guest post is written by Trisha Lim, the mom behind Baby Leaf Diapers.  Aside from being a cloth diapering mom, Trisha is also a breastfeeding mom.  Trisha is based in Cagayan de Oro City.  At the height of Sendong, despite having her store flooded, Trisha stepped up and donated her breastmilk.

Trisha approached me to host a giveaway for Baby Leaf.  However, I decided to ask her to share her Sendong experience via guest post.  As you know, a very important issue that I am currently focused on is the consolidated House bill which seeks to amend the Milk Code and allow donations of formula milk during disasters or emergency.  I want to use Trisha's post to highlight that it is possible to obtain breastmilk donations during emergencies and disasters.

Meanwhile, come back on Monday to join the Baby Leaf Diapers giveaway.

Decoding the Monster Bill - Part 2

Read Part 1 HERE. 

*Please note that when I wrote this post, it was originally based on the May draft.  There is now a July 9 draft and you can see the quick comparison here - https://docs.google.com/a/chroniclesofanursingmom.com/spreadsheet/ccc?key=0AhSdlPvu96IKdFRqYjVkSmZEMldRSTZHaGxzYmJhUXc#gid=0

The monster bill also seeks to limit the advertising restrictions to products targeted to babies 0-6 months (Sec. 32).  This means that for products for babies 6 months and up, advertising and promotions shall be freely allowed.  There are just so many things WRONG with this provision.  Under the current laws, all advertising, promotions, etc. require prior approval or permit from the IAC.  Here is the position of the Save the Babies Coalition on this matter:

Allowing promotions for products for six (6) months and above, will cause an irreparable damage to the growth and development of our country. Allowing this does not protect and support breastfeeding but it only favors milk industry gains and commercial interests.

This was already surfaced by the late US Senator Kennedy, in 1978, when he himself called for a senatorial investigation on the review of marketing and promotional practices of the milk industry that resulted in requesting UNICEF and WHO to help member countries in developing appropriate measures that will regulate and if necessary prohibit certain marketing practices.

Decoding the Monster Bill - Part 1

*Please note that when I wrote this post, it was originally based on the May 2012 draft.  There is now a July 9 draft and you can see the quick comparison here - https://docs.google.com/a/chroniclesofanursingmom.com/spreadsheet/ccc?key=0AhSdlPvu96IKdFRqYjVkSmZEMldRSTZHaGxzYmJhUXc#gid=0

My Facebook and Twitter accounts have been flooded with updates and messages about killing the monster bill.  But I realized that not everyone really understood what it was.  You can read the text of the monster bill HERE.  The monster bill is a consolidation of 4 bills - namely HB3396 (Bondoc bill which is the good bill), HB3525 (Gunigundo Bill), HB3527 (Noel/Rodriguez Bill) and HB3537 (Mercado/Torres Bill).  Click the names of each HB to get to the actual document from the House of Representative (HOR) website. The HOR website also has a summary and flowchart on how a bill becomes law.

Why milk product donations shouldn't be allowed during disasters

In the 23 February 2012 edition of the Inquirer, a letter to the editor was sent by Corazon del Mundo, chair of Women Involved in Nation-Building, directing the readers' attention to the Sendong disaster and listing down reasons why donations of milk products should be allowed and be coursed through government agencies.  This letter was in response to the column by Rina Jimenez-David on milk and malnutrition where she wrote about the perils of donations of powdered formula or milk.   

This brings us to the problem of donations of powdered formula or milk, which are among the first and most common items sent in response to disasters. “In the confusion that surrounds emergencies, these products are often distributed in an uncontrolled way and used by mothers who would otherwise breastfeed their babies,” says Unicef, adding that indiscriminate use of donated milk “results in unnecessary illness and death for infants.”

Calling for Formula and Breastmilk Donations during Emergencies

Yesterday, I was offline most of the day because I attended a Breastfeeding Congress in Tagaytay.  Apparently, Twitter got busy with tweets from various individuals calling for formula milk donations (yikes!) and breastmilk donations.

Red Cross and Juday

I want to share 2 things I read about last week that made me quite sad

On Red Cross and Bottlefeeding:

what message do you think this poster sends?

I first read about Red Cross' poster over at Blacktating. When I saw this poster - the first thing that came into my mind is - how the heck are they going to clean that bottle?! I am again reminded of previous experiences on emergencies in Haiti and in the Philippines, during Ondoy.

As Tanya over at Motherwear blog shares, in times of emergencies, it is more important to feed the nursing moms so they in turn can feed their babies -- rather than providing them with boxes and cans of milk and bottles.

Two years ago (2009), World Breastfeeding Week's theme was Breastfeeding, a crucial priority for child survival in emergencies. Since then, the world has faced several more emergencies - Haiti, Ondoy, Indonesian earthquake, New Zealand earthquake, conflicts in the Middle East and now the tsunami and earthwake plus potential nuclear disaster in Japan! Even locally, there are tornadoes in Lanao del Norte and floods in the Visayas.

Despite several issues on sanitation, water supply, it seems that the message being sent out by donation agencies is still "send us milk"! According to this report, breastfeeding rates in Japan are lower than the US. I wonder how the rates will be after this emergency?

*On 21 March 2011, UNICEF released a Joint Statement with the Nutrition Cluster which you can access here. Although the statement is focused on emergencies in Northern Africa, the same points are applicable in the Japan situation. Emphasis on the critical protection from infection conferred by breastfeeding in environments without safe water supply and sanitation. Further, IT IS NOT TRUE that during emergencies, mothers can no longer breastfeed adequately because of stress or inadequate nutrition.

Juday and Lactum

I was even more disappointed to see this paid advertorial entitled "Judy Ann Santos-Agoncillo, now a 100% panatag mom".

A friend told me that while she was pregnant with Lucho, she had already signed a contract with Mead Johnson and among the terms of the contract was that she will not promote breastfeeding. But I know for a fact that she DID breastfeed Lucho and she requested a breastfeeding class to help her successfully breastfeed.

I posted this on my FB page and got varied reactions. Several pointed out that the milk being promoted is for her 6-year old daughter and not her baby son. My position is that she could have chosen to promote breastfeeding to her legions of fans and by choosing to endorse a formula company - even if it is a kid formula, she has effectively shut the door on her being called on and be considered as a breastfeeding advocate.

Then again, if Mead Johnson paid P2M to partner with a nutritional organization, it makes me wonder how much they paid Judy Ann for this endorsement. You can just imagine how much Mead Johnson pays for their advertising and marketing - aside from Judy Ann, they have other panatag moms - Carmina Villaroel, Jodi Sta. Maria and Claudine Barreto. Milk formula is a huge $$$ business!

*Update: Here's a link to the column of Ricky Lo. At 5 months, Juday is mix feeding Lucho with breastmilk and formula.

Brownouts and Breastmilk

I received several texts and emails from friends and acquaintances as a result of the power outages brought about by the recent storm Basyang. I decided to compile information and tips on brownouts and breastmilk in this post.

According to La Leche League International, the accepted practice is not to refreeze thawed milk:

Previously frozen milk that has been thawed can be kept in the refrigerator for up to 24 hours. While there is limited evidence to date that milk thawed for a few hours may be refrozen, this results in further breakdown of milk components and loss of antimicrobial activity. At this time, the accepted practice is not to refreeze thawed milk. While some mothers and caregivers reheat expressed milk that was leftover and refrigerated after a previous feeding, there is no research on the safety of this practice. There is also no research about whether freshly expressed milk left unfinished at room temperature should be discarded, or can be saved for a short time (perhaps up to one hour as reported by some mothers and caregivers) to finish the feeding if the baby wakens from having fallen asleep or still appears hungry.

Breastmilk is food and the general rule is that once it is defrosted, you don't freeze it again, unless you cook it. In the Philippines however, it is common practice for households to defrost huge slabs of meat, then if they don't use it all up, freeze it again. Even in supermarkets - frozen meat is placed outside then back in the freezer at the end of the day. In my opinion, the statement that thawed milk can't be refrozen follows that same principle - primarily to prevent bacteria contamination. In the first place, once breastmilk is frozen, it already loses some of its immunological properties - which is why the hierarchy of feeding is direct, room temp, cold (refrigerated milk) then last is frozen.

Another comparison would be that of reusing previously unfinished milk. The general rule is once the breastmilk is warmed and fed to baby, any leftover milk should be thrown away. I don't *strictly* follow this rule because (1) I don't want to waste my precious breastmilk; and (2) other studies have shown that it is okay to save milk leftover from a feeding for reuse immediate at the next feeding. So what I do is, when I've thawed or warmed milk then Naima doesn't use it all up this feeding, I put it back in the refrigerator and use it again for the next feeding. If she still doesn't finish it, that's when I throw it out. I go by the taste/smell test -- I ask Naima's nanny to taste or smell the milk before giving to baby before giving it to her or deciding to throw it out.

Anyway, back to brownouts and breastmilk. I'd like to share this article which I got from fellow N@Wie Mimi. This article cites a 2006 Breastfeeding Medicine Article entitled "Effect of Environmental Conditions on Unpasteurized Donor Human Milk" and states that even if the milk thaws, it is good to use provided it was not at room temperature for more than 8 hours:

The even better news is that, according to new findings in the journal Breastfeeding Medicine, checking breastmilk is actually a fine option. The researchers took frozen breastmilk and thawed it, refroze it, refrigerated it and left it out at room temperature. Essentially, they beat it up. What did they find? Breastmilk is fairly robust and does not grow bacteria easily nor lose vitamins A and C or free fatty acids (FFA) to any degree that would harm a full term baby. Breastmilk fresh from the breast or thawed in a clean container can be left at room temperature for less than 8 hours.

The author was actually writing about traveling with expressed breastmilk. Here is another portion of her article which I find to be highly applicable for breastmilk during brownouts.

What do you do with frozen milk you pumped on your trip? Don't mess with ice. Ice is warmer than frozen milk and will actually hasten to thaw your milk —who knew? This is because water freezes at 32° F and milk freezes at around 0° F. Use frozen gel packs to keep your frozen milk frozen longer in your insulated cooler in your checked luggage. Crumple paper all around the milk and gel packs to further insulate it. The study in Breastfeeding Medicine found that even if the milk thaws, it is good to use provided it was not at room temperature for more than eight hours. If it is cool when you unpack it—it is good to go. It is also safe to be refrozen. This is important because moms think they have to use it right away if thawed and may feed it to the baby instead of actually breastfeeding as soon as they get home. Better to get baby on the breast as soon as you return home, and refreeze or refrigerate the pumped milk for the next mother-baby separation.

To find out whether your milk indeed thawed during the power outage, here is a tip from Dot:

I read also to put an icecube in a plate inside your freezer. In case of brownout, check the ice. If the shape changed (which means that the ice cube melted then froze again). The same thing happened to your milk.

Note however - according to the Mothering Article, water has a higher freezing point than milk. Makes me wonder though if it defrosts faster than breastmilk? The ice cube tip still helps as it makes you aware if the cold level in your freezer changed.

Meanwhile, if you don't want to use the thawed milk, don't throw it away. Here is a tip from Mi'Ann:

Instead of throwing it away, you can donate it to the hospital where you gave birth. Just call the nursery nurse before going so you can check if you still need to be screened or if they ll just accept it when you give your pedia's name. For ex. cardinal santos said that theyll accept my thawed out milk.

Aside from your birth hospital, there are also several institutions which accept donated milk. Check out my previous post on milk banks for the contact details of these institutions. It's still the 2nd storm of typhoon season and I'm sure that more power outages will come. Breastfeeding mamas certainly need to make extra preparations to prevent wastage of that precious milk.

Check out this related post - Preventing Freezer Burn on Breastmilk


Update: 28 September 2011
Here's a quick note that Babymama Mi'Ann posted on her Facebook page during the height of Typhoon Pedring:

If you want to read the full text of the study - "Effect of Environmental Conditions on Unpasteurized Donor Human Milk", you can do so by clicking HERE.

Breast Milk for Haiti

Since the Haiti earthquake, I've been reading a lot of blogs and news about the call for breastmilk donations for children. Then came the news articles and more blogs on the "controversial call".

On 21 January 2010, the UNICEF issued a statement discouraging breast milk donations:

Human milk donations while safe when processed and pasteurized in a human milk bank also require fully functioning cold chains. Such conditions are not currently met in Haiti and human milk donations cannot be used at present. All queries and any donations that do appear should be directed to UNICEF, the designated nutrition coordinating agency in Haiti.

Then came the International Breast Milk Project and Human Milk Banking Association's calls for breast milk donations. About 500 ounces of milk was couriered on 28 January 2010 to the US Navy's ship called Comfort which was stationed near Haiti. However, this donated milk remains unused to date. Plus, the U.S. Navy spokesman has been promoting the use of infant formula rather than this donated milk!

But the staff on the U.S. Navy ship said they haven't used the milk out of concerns raised by OFDA and other agencies. Mothers aboard the Comfort are urged to nurse their own babies and there’s infant formula available to children whose mothers cannot or will not breast-feed, said Lt. David Shark, a U.S. Navy spokesman.

Comfort has been identified as the world's only nautical milk bank but apparently it is ill-equiped to handle the flood of breast milk donations.

Eager to do something to alleviate the suffering of the smallest, many lactating women are wishing the Comfort had more storage space to handle donated milk. At least one Navy staffer, who had to leave her 10-week-old baby behind when she deployed, was "pumping and dumping" — nursing slang for pumping then discarding milk. Now that there's a use for her milk, she's ferrying it to the ship daily from the mainland, where she is currently working. Beard Irvine has a name for that milk: "Comfort food."

It is just sad that instead of addressing the upgrade on the facilities or promoting relactation or cross nursing, Dr. Nune Mangasaryan, senior adviser on infant nutrition for UNICEF, instead promoted the use of ready to drink formula and this is despite the joint statement issued by WHO, UNICEF and WFP discouraging the donation and use of breastmilk substitutes or formula.

Dr. Mangasaryan: At this point what we recommend for them is ready-to-use infant formula, that's already in a liquid form, meaning no risk of contamination by mixing powdered formula with water, for example. It's already ready-to-use, and there are certain numbers already available in the country.

The Philippines faced a similar disaster (Ondoy and Parma) in October 2009. We were also involved in breastfeeding missions and brought donated, pasteurized breast milk in coolers to evacuation sites. But as I previously shared, out of the 15 liters (about 507 fl. oz.) of milk we brought, only 1.5 liters (50.72 fl. oz.) were used up. We wanted to leave the unused milk there but the health workers told us that they had no facility to keep the milk cool and prevent spoilage. So we ended up lugging it back to the milk bank.

I learned that in times of calamaties such as this, what is more important or useful would not be breast milk donations but rather breastfeeding information - relactating, switch nursing, protection of milk supply, encouragement. As fellow LATCHer Mec also shared, sharing of strategies, loot bags and the use of wet nurses were also particularly useful.

I'm not saying that moms with extra milk should stop donating milk. Even without calamities, milk banks are continuously asking for donations. In fact, every time I call up the PGH Milk Bank, they always excitedly ask me if I have extra milk to give. Moms should continue to donate milk but just have an expectation that their milk may not be directed towards Haiti but to other needy babies within their locality. I'm not sure if it is feasible in evacuation centers in Haiti but instead on focusing on calls for milk donations or promoting ready-to-drink formula, maybe international organizations can instead focus in information drive with strategies, tips and tricks on relactating and the promotion of direct breastfeeding.