Exclusive: Standards for operation of mother's milk donations unenforceable.
By JUDY SIEGEL-ITZKOVICHjp.services1(photo credit: )
Almost two years ago - in honor of Breast-feeding Encouragement Week - then-health minister Dan Naveh declared that the ministry would "help establish" a mother's milk bank to feed the 700 premature babies born with gastrological conditions that deteriorate with commercial milk formula and whose mothers could not breast-feed.
But on Monday, with Naveh long out of the ministry, the Health Ministry announced that it had set down "standards for the operation of mother's milk banks" if anyone cared to go into the business.
When questioned, the ministry admitted it had no budget to fund such a project and would leave the field open to private enterprise.
In addition, The Jerusalem Post learned that the standards determined by the ministry committee, set up in 2005 and chaired by head of the ministry's department of maternal, child and adolescent health, Prof. Yona Amitai, are so impractical and unenforceable that they will undoubtedly be ignored completely by the sole source of mother's milk donations - haredi women volunteers.
Until the discovery of the HIV virus 26 years ago, a few groups of haredi women who had recently given birth would supply extra milk to premature infants of other women who could not breast-feed and/or those who suffered from necrotizing enterocolitis (NEC). NEC, which occurs in between one percent and 5% of neonatal intensive care unit patients, is the most common and serious gastrointestinal disorder among hospitalized premature infants. The babies, whose immature bowels are sensitive to changes in blood flow and prone to infection, may develop NEC. In severe cases, a hole may develop in the intestine, allowing bacteria to leak into the abdomen and cause life-threatening infection.
Experts note that there can be serious complications even if the condition is treated quickly. NEC is more common among infants who are fed formula at birth than those who are breast-fed, and the condition generally improves with human milk.
In Naveh's 2005 statement, the ministry "recognized the fact that giving mother's milk to such babies who can't get it from their own mothers can save a great deal of money in treating various diseases much more prevalent among infants that do not get breast milk. It has been found that the cost of operating a mother's milk bank is significantly lower than the cost of treating these conditions."
But when HIV was discovered and doctors realized that the virus could be transmitted via breast milk, health authorities began to worry that it could be spread via mother's milk banks.
In Israel, while the risk of HIV and other viral infections is close to zero among observant religious women, the possibility of infants being infected through donated mother's milk caused worry nevertheless. A professional committee recommended to the ministry's senior echelon that a state-sponsored mother's milk bank be established, along with operating standards.
"This will be an important milestone for the health of many babies," Naveh declared.
Yet with the recent decline in government funding for public health projects and the growing privatization of remaining services, the ministry has abandoned the idea. After almost two years of sessions, Amitai's committee issued on Monday a 100-word press release, which stated that "mother's milk is the ideal food for babies, and the ministry recommends six months of exclusive breast-feeding for babies. Sometimes, when breast-feeding is not possible, a mother's milk bank can be a suitable and vital solution, especially for premature babies and those with certain conditions."
No details of the standards for mother's milk banks were provided. The ministry merely said that they determined eligibility for receiving and donating bank milk, and covered preventing infecting, testing and control of donated milk supplies.
Amitai, a toxicologist and a pediatrician by profession - not a gynecologist - told the Post that the cost of collecting, processing, testing and storing a single liter of breast milk in accordance with the new standards would be about $150. The ministry, he said, did not have the requisite funds and thus would not establish a mother's milk bank.
Amitai suggested that entrepreneurs interested in the mother's milk business could collect donated milk and handle it according to the ministry's standards. They would not be allowed to pay women for their milk. Supplementary health insurance policies could cover the cost for members whose babies needed donated milk, Amitai said.
However, Amitai conceded that the committee had not sought out any groups of haredi women who are currently supplying mother's milk to needy babies, and therefore the ministry would not be able to regulate their donations.
"We will inform hospital neonatology departments of our new standards, and they will send out the message, but we are not going to do active surveillance [of donated milk]," he said.
Asked to comment, Health Ministry associate director-general Dr. Boaz Lev told the Post, "If anybody thinks they can make money from establishing a mother's milk bank, he is welcome to do so, but he must meet ministry standards. We can't afford to do it ourselves, but it is our duty to set standards."
Asked whether he realized that haredi women would continue to do what they have been doing for the mitzva of saving lives, and whether the ministry would enforce these regulations among these informal networks of mother's milk donors, Lev said, "We will not hire milk detectives."
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