10 December 2018

Uganda: Donor Breast Milk Timely Help for Premature Babies

It is common among mothers who give birth to premature babies [at fewer than 37 weeks] to find difficulty producing breast milk immediately. In this case, experts require specifically human breast milk to increase the baby's survival chances.

If given the wrong milk, they risk getting complications, being malnourished or even death. This is the reason well-wishers such as Juliet Kemigisa Akiiki, 30, a mother of three, are donating breast milk to premature babies.

Willing donor

In 2015, Kemigisa, a midwife at St Francis Hospital-Nsambya's Intensive Care Unit (ICU), donated breast milk for the first time to a mother as the only thing that would help her baby to survive. "I was breast feeding my first born and doctors recommended that she gets a donor who would give her breast milk. She tried to look for donors and failed. Since I had excess, I saw this as a chance to help," Kemigisa says adding that she had to undergo tests including HIV/Aids, hepatitis and syphilis before she could be allowed to donate her breast milk.

The second time Kemigisa donated breast milk was when she had her second born and another mother had delivered four babies but could not produce enough breast milk to feed all of them.

"What motivates me is I am also a mother. I do not want to see someone's baby die yet I know there is something I have that can help the baby survive. At the end of the day breast milk is the best food for premature babies," she adds. As a midwife, Kemigisa says she is aware that babies, especially those born prematurely if given other milk and formulae [manufactured food designed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid], it affects their stomachs.

Kemigisa says she pumps at least 250 millilitres of breast milk every day to give to the recipient baby on top of feeding her own baby and does this until the mother is able to produce her own breast milk."It does not affect my health in any way and the only challenge I face is that we are currently misunderstood. A number of people think that donors do it for the money which is not the case," Kemigisa says encouraging other mothers to also donate whenever there is need.

Recipient

Tekie Natsnet says breast milk donation is a miracle while raising a premature. Last year, Natsnet delivered a premature baby at 26 weeks [six months and one week] weighing 650 grammes and she had no breast milk. "I delivered on October 14, 2017 but afterwards I was very weak and I had no milk to feed him. A donor gave her breast milk which she used to feed the baby who is now 11 months old and meeting all the major milestones of babies his age.

"As a mother who knows how powerful breast milk is to our babies, I cannot fail to support the breast milk bank. I thank all mothers who supported me with breast milk while I was admitted," she says.

The mothers were giving their testimonies during the commemoration of World Prematurity Day and the launch of the fundraising drive to raise money for the first breast milk bank drive at St. Francis Hospital, Nsambya in Kampala on November 24.

The bank

Dr Victoria Nakibuuka, the head of the peadiatric department at the hospital, said the more than 10-litre human breast milk bank expected to cost between Shs50m and Shs80m is expected to start working next year. "It is basically a fridge that will store human breast milk such that it can stay fresh for a long time. The ordinary fridges cannot keep the milk for all that time," Dr Nakibuuka explains. At a particular time, one can give up to 500 mililitres of breast milk depending on the person's ability but any quantity would be acceptable, according to Dr Nakibuuka. Currently, the hospital is calling upon well-wishers to contribute towards the more than Shs300m needed to procure the bank and build the infrastructure where it will be housed, train health workers, buy pumps and a milk pasturiser.

Statistics

In Uganda, newborn deaths contribute to 42 per cent of death in children under five and prematurity is the leading cause of newborn deaths, according to statistics from the Ministry of Health.

The ministry also reports that 108,000 children are born prematurely every year out of which 11,700 newborns die due to complications of prematurity. Up to 75 per cent of these deaths in newborns are preventable with affordable solutions, according to observations by the same ministry.

Dr Sabrina Kitaka, a senior lecturer in the department of Paediatrics at Makerere University School of Medicine, explains that most mothers who cannot produce enough milk in the first days are those who give birth to premature babies because their bodies do not undergo the normal gestation period of 40 weeks or 280 days.

"Unless you give a particular type of formulae milk [manufactured] that looks like breast milk, the other types can cause diarrhoea to the little one since they are delicate which reduces their survival chances," Dr Kitaka explains.

Babies who are produced normally are able to survive on glucose until the mother is able to produce milk in the first two to three days when colostrum; the yellowish sticky breast milk produced at the end of pregnancy before the real milk comes on the fourth day starts coming.

Many hospitals and health facilities in Uganda are currently doing breast milk donation at a small scale where mothers look for donors at the ward to give them breast milk after undergoing the required tests to prevent transmission of diseases to the recipient baby. Health workers also use ordinary fridges to store the donated milk although these cannot store it for a very long time.

Mother of quintuplets relies on donors

After suffering breast cancer and losing one of her breasts, on September 9, Honoranta Nakato, 44, gave birth to normal quintuplets; three girls and two boys by C-section. Her twin sister Babirye also has five children but not through the IVF. Nakato's right breast that remained can still produce some breast milk but it is not enough considering the number of her babies. She now has about three breast milk donors one of whom is her sister with a three months old baby.

"My sister expresses the milk every morning and evening. She is the only reliable donor that I have for now. The other people still have little milk and it may not be enough for all the five babies. I still need more breast milk donors," she pleads.

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