The tree trunk is painted on the wall, and the dozens of shiny gold metal leaves have been attached one by one by a careful, caring hand.
It’s pretty from afar, but a closer look reveals the tree’s true beauty. Each leaf is engraved with a name — the name of a baby who died, but a baby whose mother selflessly chose to give life to other babies still struggling to thrive.
For grieving mothers who have lost their babies due to miscarriage, stillbirth, preterm labor, complications, birth defects, disease or any other reason, it’s not possible to describe in words what they go through. But the numbers can shine some light on just how many women are dealing with this kind of grief.
According to the American College of Obstetricians and Gynecologists, 10 to 25 percent of clinically recognized pregnancies end in miscarriage. The Centers for Disease Control and Prevention (CDC) reports about 24,000 babies are stillborn each year in the U.S. For babies who do make it to birth, one in nine come early, and six out of every 1,000 will die during their first year, the CDC says.
One thing grieving mothers can do that might ease their pain — and to help keep other mothers from having to experience it themselves — is donate their breast milk to babies who need it.
Carissa Hawkins, communications coordinator at The Milk Bank in Indianapolis — the only human milk bank in Indiana — said many mothers who participate in the organization’s bereavement donation program find it helpful.
“A lot of times what happens when a NICU (neonatal intensive care unit) baby is born and dies, the parents don’t know what to do with the milk,” Hawkins said. “Many of our (bereavement donor) moms have indicated that being able to donate milk after the loss of a baby allows them to feel like something good, something impactful has happened, even though they don’t have a baby to parent.”
Hawkins mentioned specifically one donor who had a miscarriage at 17 weeks pregnant, and her breast milk still came in.
“She pumped (and donated her milk) for a couple of months, because it gave her something to do, something to look forward to,” Hawkins said. “It gave her a reason to get out of bed, is what she told me.”
Hawkins said premature birth is the most common cause of death of the babies whose moms later decide to donate to The Milk Bank, perhaps because those mothers have a keen understanding of the need.
“(That) mom’s been in the NICU with her baby, sees what other families are going through, knows what it’s like to pump in a hospital, knows what it’s like to sleep in a room with monitors and beepers, and many times feel like if they can just provide that extra comfort to another mom who’s going through it, that’s amazing for them,” Hawkins said.
LIQUID LIFE SUPPORT
Sarah Long, the Milk Bank’s clinical coordinator, said she cannot say enough about the benefits of breast milk to a developing infant, describing the fluid as “white blood,” life support, a stepping stone and an extension of mother’s womb.
“It’s not just food. It’s much more than food,” Long said. “It’s the medication, the immunity that the mother can provide, and that’s very important initially for any newborn, regardless of gestation.”
Milk Bank Executive Director Janice O’Rourke said research shows the milk from a donor can be beneficial.
“Studies have shown that babies who get either mom’s milk or donor milk have a shorter hospital stay,” O’Rourke said. “And that the incidence of necrotizing enterocolitis — which is the biggest threat to pre-term babies — is decreased in babies that get human milk.”
Pre-term babies (born before 37 weeks of pregnancy) are particularly at risk of respiratory and digestive problems, Long said. But even full-term infants can use a breast milk boost.
“When any infant’s born, even a term baby, all of their systems are still very immature — respiratory, digestive, everything is immature,” Long said.
There are many reasons why a mother’s own milk might need to be supplemented or replaced by donor milk, including inadequate supply, medication, illness, death of the mother, drug withdrawal, and if the mother’s just not around, such as in an adoption situation. That’s where the Milk Bank comes in.
“Our focus is on providing pasteurized donor human milk to infants in neo-natal intensive care units,” O’Rourke said. “Moms who are breastfeeding who have extra milk will donate it to us, we process it, and then we test it to make sure it’s sterile, and then the hospitals that want to use it for their infants in the NICU will order it from us.”
The fragile NICU infants are the Milk Bank’s priority, but they do provide “outpatient” donor milk to some babies, with a prescription or medical order.
“(Outpatient babies are) not necessarily in dire straits, but they would still benefit from milk,” Long said.
HELP WANTED
The Milk Bank is always looking for more donors, and mothers don’t have to be grieving a loss to qualify.
In recent years, a Texas physician determined the national donor milk need to be 9 million ounces per year. O’Rourke said there’s a gap between how much milk is needed, and how much is donated, though overall the needs in her service area are met. But Hawkins said an influx of premature births could wipe out the Milk Bank’s supply quickly.
“It could be gone in two days. It’s happened before,” O’Rourke said, supporting Hawkins’ point.
Even when the Milk Bank’s supply is flush, they’re always looking for new donors.
“Donors age out for us; you can only donate until your baby’s two years old, so we’re constantly on the lookout for more donors to make sure we have a stable supply,” Hawkins said.
The screening process to become a donor is similar to blood donation. The first step is to call the Milk Bank for a prescreen — questions about what medications the mother’s taking, pumping habits, etc. Next is a donor form, which asks more specific questions. The Milk Bank will also talk to the mother’s OB/GYN and the baby’s pediatrician to make sure the baby is growing well, indicating the mother’s milk is high quality. Finally, the potential donor has a blood draw, which the Milk Bank pays for.
“Donating is not hard. Becoming approved, although it takes a little bit of time, it’s not difficult,” Hawkins said. “And we’re here to usher donors through that process, and we very much need their support and their milk.”
Hawkins said bereavement donors won’t be turned away, even if they don’t “pass” all of the screenings.
“A bereavement parent can donate no matter what, and we’ll save their milk for a research project or use it in some other capacity,” she said.
Once a donor is approved, they can begin giving, either by dropping off their frozen milk at a milk depot site or shipping it to the Milk Bank in a cooler with dry ice.
At the Milk Bank, the raw milk is separated by month and donor and stored in a freezer until it can be put through the pasteurization process.
Pasteurization is done on site by staff trained in sterilization and foodservice cleanliness guidelines. The frozen milk is defrosted, put into large beakers and put through a “pooling” process, which involves homogenizing and mixing the milk so it has a consistent nutrient level.
The milk is then bottled by hand, run through an automatic pasteurizer and sent to a third-party lab for testing to ensure safety.
Long said the idea of breast milk donation, and a baby using a stranger’s milk, is off-putting, but she likens it to receiving donor blood.
“A blood transfusion … for the most part, it will save your life. And this should not be seen as anything different. It’s an absolute necessity. It’s a no-brainer,” she said.
Long said there are strides to be made in awareness of the importance of breast milk, and Indiana’s awareness — especially among racial minorities — is below the national average. Hawkins said she looks forward to the day when it all becomes “normal.”
“I want my two girls, when they’re having children, I want this not to be an issue. I want them to just be able to breastfeed and to have access to donor milk, because it’s normal,” Hawkins said.
For more information about the Milk Bank, visit themilkbank.org or call (317) 536-1670.
Why do you work at the Milk Bank?
“For me, because I know how blessed I am … It was never lost on me how lucky I was to have a healthy, full-term baby.” — Carissa Hawkins, communications coordinator.
“It should be every baby’s right to have human milk.” — Sarah Long, clinical coordinator.
“It’s really important to me to see these pre-mature babies get the best start they can, because they’ve got a lot going against them. … If we can save one baby, I feel like we’ve done a great job.” — Janice O’Rourke, executive director.
