The pasteuriser

There is a post I have been itching to write for nearly 4 months.   Drops4Life received a brand new pasteuriser in mid March, and I naively believed I would simply plug it in and start using it.

However I had a lesson in patience.  First we had to get permission from the landlords to make the structural alterations necessary .  The system needed 5 extra plug sockets and hot and cold running water installed.

I had a brief training session.  Now I’ve done a batch of pasteurising on my own, just me and the manual, which is heady stuff .  Unexpected beeps and flashing to show that things were on the move.  But eventually I had 2.5 litres of processed milk to put away in our freezer, in about… um, well, the same period of time that it would have taken me processing 2.5 litres in batches of 300 mls at a time before.   I anticipate that I will get more slick with practice.

How did I pasteurise milk before?   That’s a good question, and I did it properly with a fairly low-tech method, but it’s a story for another day.

At this point, it’s worth saying that mother’s own fresh milk is *always* better for a baby; however if there is no milk available from the mother, screened tested pasteurised milk is the only milk considered a safe replacement for sick and premature babies, because of the small but important possibility that some viruses can be passed via human milk.  Milk is the only donated human tissue that can be pasteurised and still be useful, unlike blood and sperm.  Hospitals in Norway do not pasteurise their donor milk, and cover themselves by stringently screening the mothers.

The new pasteuriser cost trillions more than the old method but I didn’t pay for it.

Hot water bath on left, cold water bath and mixer on right

The basic outline in any pasteurising process is that we heat the milk for long enough to kill all the potential bacteria (and viruses) in the milk, trying to make the balance between sterility and cooking the good things out of the milk.  We can do this by heating the milk either very fast to a high temp for a few seconds, or  more of a gentle sweat for a long time.

The new machine uses Holder pasteurisation (Low Temp Long Time pasteurising), ie 62.5^C for 30 minutes, and is the current gold standard for milk banking.  I have the entry-level pasteuriser, which means that I have to push the buttons and move the milk from hot to cold water by hand.   I think the better version provides a slave to do for you.

I also have a new bottle-sealer which MAGnetICALLY seals a plastic/foil tab inside the bottle without frying the bottle cap.  It was a surprise to feel the sealed jar getting warmer from the inside.  Sealed like the juice bottles, this is yet another protection for the milk during pasteurisation, cooling and later thawing.

And here is the precious potion about to go into the pasteuriser:

One day I will have my label printer and computer all connected and have a professional retail product fit for somewhere like Woolworths…. if only.   We exist to serve babies desperately in need, and we will never have enough milk.  As always, if you know someone who is willing and able to send milk or money, please put them in touch!  Our banking information or contact numbers are on the “Our details” page.

Thanks to the donors

On the Saturday before Mothers’ Day, the milk bank’s doctors and I hosted a tea for the donor mothers.  I enjoyed it thoroughly, as it was good to meet the mothers and hear them share their different breastfeeding and donating experiences.

Sandra and Dunelle – sharing their milk for 9 months

Sandra, our first donor (and still going strong) has agreed to share her story.  Sandra discovered that she was pregnant again when her youngest child was 24 years old.  In the meantime, breastfeeding support has got very much better in South Africa, and for the first time Sandra tried breastfeeding – and loved it.  She had so much milk, even when Dunelle was 15 months old, that she was thrilled to be able to donate it to premature babies at Drops4Life.  She can’t speak highly enough about breastfeeding, and says she can see a distinct difference in Dunelle’s development compared to her other children.

Sandra has donated steadily for the past 9 months, and has given us nearly 16 litres of milk.  Nearly 40 babies have received Sandra’s milk.

16 litres sounds like a LOT of milk, perhaps quite intimidating to a new donor.   It was expressed drop by drop, just that the donations were consistent over time.  We welcome smaller donations too, and some donors send jars with 2o mls at a time.  20 mls can be enough to feed a premature baby for a day – a day when he could get so much stronger, or when his mother could start producing her own milk supply. 20 mls a day for a week could save a baby’s life.

Please contact Drops4Life if you can help our little milk bank.  You can add a comment in the comments section, or write to jacquie@milkmatters.org  .  To receive notifications of our irregular posts, click the “Follow” button.

Breastfeeding is good for the mother’s heart

William and his mother: photo used with permission

Donating milk is heartwarming, but there are apparently other benefits.  In May, a new study published in the American Journal of Obstetrics and Gynecology showed that having breastfed has a positive impact on a mother’s blood pressure.  The effects last even several years after weaning – in fact till well after menopause.  An important finding was,  “The longer a woman breastfeeds, the lower her likelihood of having high blood pressure later in life.” (Translation: the shorter the breastfeeding period, the greater one’s risk of high blood pressure later).

How much healthier will milk donors be, since they have provided milk for more than one baby at a time?

The study was carried out in Australia on huge group of nearly 75000 women, so the results are, shall we say, fairly conclusive.  For further details, see  http://sciencealert.com.au/news/20132605-24416.html

The scientific abstract is on                                                                                                             http://www.ajog.org/article/S0002-9378(13)00155-5/abstract

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This past week, our little milk bank was feeding four babies at once, and full feedings too.  We had only fed one or two babies at a time previously, usually with a fair amount supplied by their own mothers.  However for one reason or another, each of these four mothers was unable to provide milk at times during the week.

Finally we were down to two babies on full donor milk – one whose mother was too ill to provide her own milk, and one baby from a set of twins.   The photos below are used with permission, to show donors where their precious milk went this week.

Logan

Sarah

Feeding four babies fully put us under some pressure, and it was hard to keep up with the collection of raw milk, and the pasteurising.  My huge gratitude goes to our current donors for helping us keep up.

Unluckily, in the end, the hard decision was made to move the two biggest and healthiest of babies on to formula, so as to to keep a stock of milk for the little ones and for any emergency situation.  Things are so relative – sometimes a baby of 1.6 kgs can seem “nicely chubby” or “very strong” when compared with the fragile 900g baby next to her,  but in reality she is acutely vulnerable too.

How I wish we had donor milk for ALL our high-care babies in need, for as long as they needed it.  That would make my heart feel great.

The Pink Teddy

What a momentous week!  Thanks to everyone who responded to the appeal for Milk for Angelina.  I was overwhelmed with the kindness from all sides.    We are working on logistics, and have managed to get depots in Stellenbosch and possibly Somerset West to add to the Paarl/Wellington coverage.

Firstly, Angelina is doing well, and we currently have enough milk for her for 2.5 weeks, so she will not starve for the time being!

Here is a picture of Angelina’s guardian, The Pink Teddy.

When I looked at the photos, I was disappointed that I hadn’t captured the bear full face, however I hadn’t wanted to wake Angelina while I was photographing him.   Now I realise that it’s great that Teddy wasn’t posing for me, but he continued to look after Angie, paying no attention to his fans.

Weird thing, I’ve just been given a new freezer.  Good timing!

Angelina needs breast milk

This week (1 – 8 March) is National Milk Banking Week in South Africa.

The Paarl Breastmilk Bank started operating at the end of August 2012, so is just over 6 months old.  What a learning curve!  It’s felt very rewarding being the volunteer coordinator, working with dedicated and supportive doctors and nursing staff .

Babies below 900g  have little chance without human milk for immune protection and organ growth.  Paarl mothers have kept 25 babies supplied with donor milk for varying periods during the past 6 months.   Most times it’s a matter of providing a top up for a mother who is struggling to bring in her own supply, a few mls per feed.   Almost all mothers can provide all the milk their babies need if breastfeeding (or expressing) is managed well from birth, but mothers of Very Low Birth Weight (VLBW) prematures will miss out on several weeks of breast development when their pregnancy ends early, and may need extra time to get going.  Of course sometimes mothers give birth early because they themselves are ill, and that also means a delay in breast milk production.

Our current treasure is a minute but perfect little girl, and I’ll call her Angelina.  Angelina lies in her incubator all alone, but someone has given her a pink teddy to keep her company.  The pink teddy does not comfort her when she cries.  The main thing going for Angelina is her fighting spirit – and  that she was started on donor milk from birth.

She has grown to 1490g, (still less than half the weight of my own babies at birth!) and is now drinking four times as much milk as comes into our milk bank each week.  In two weeks, she will have finished every drop we have, but we must keep a good reserve in case we get some really small sick babies, and so the doctors are reluctantly talking about putting Angelina on formula in a week’s time.

What’s the big deal?   Well, premature babies have no immune system yet and need the germ-fighting cells of breast milk to fight off even ordinary bacteria that the rest of us shrug off.  There are no immune factors in formula, plus formula causes inflammation in a premature gut, which may lead to a horrifying disease called NEC (necrotising enterocolitis – a kind of rotting of the intestines).

For this reason, formula is almost never used in our premature unit – except in the past for orphans and adoptive babies.

I am fairly sure that someone reading this will know of  a breastfeeding mother in Paarl or the surrounding areas who is willing to become another donor for Angelina.  Donors complete a lifestyle questionnaire regarding medications, alcohol and tobacco use, undertake a blood test and are shown how to collect and store milk for a sick baby.   They are provided with sterile sealed jars for their donations, but a freezer stash in the donor’s own jars would also be welcome (I guarantee to get their bottles back to them).

If you need further information, or are willing to donate right now, please email jacquie@milkmatters.org with your phone number, and I’ll contact you.

Thank you, from the Paarl team, and from Angelina