Transcript Document

Human Milk Bank
DR.SANDHYA KHADSE
PROFESSOR AND HOD
DEPARTMENT OF PAEDIATRICS
BJMC AND SASSOON GENERAL
HOSPITAL
PUNE
Dr. Sandhya Khadse
Introduction as Speaker
Recipient of :
•Six Gold Medals in University Examination (1986)
•James Flett Endowment Award (1995)
•Bibi Sunder Kaur IAP Fellowship (1996)
•First Prize for Best Poster PEDICON (1997)
•Gold Medal for Best Paper Presentation ACODD 2001
•Patented Pediatrician Award Maha Pedicon 2003
•FIAP Award 2005 for Outstanding Contribution in Paediatrics
•Maha Pedicon 2006 Best Research Paper Award
•Chief Officer Child Health Monitoring Committee, Maharashtra State.
•Delivered around 150 guest lecturers in various National & International
Conferences
•50 publications in various National & International journals
•Visiting professor at John Hopkins School of medicines
•Nutrition Expert & Board of study member at Footprints Academy Preschool
daycare Center at Florida USA.
•Academy advisor to the U.S. Fulbright programme & resource person for United
States India Educational Foundation. (USIEF)
•Executive Committee member of CANCL Group & IACP.
•Technical Expert for Human Milk Bank Project.
Background info
Brief description
How did your human milk bank (HMB) began?
When?
It was started on 18th feb 2006 at Grant medical college and JJ group of hospitals, Mumbai
Who provided initial funding? How are
ongoing operations funded? Integrated into
government services?
Rotary club of Nariman point , Mumbai and ongoing operations funded by government.
Who regulates /oversees HMB in your
country/region (if any)?
Individual hospitals where they are operational.
How many HMBs are part of your system?
Where are they?
5 in Mumbai- JJ hospital , CAMA hospital , SION hospital , KEM hospital and RGMC Thane
and chatrapati shivaji hospital , Talwa
-1 in Surat
-1 in Hyderabad
-1 in Goa
Is there a central HMB that processes milk
and distributes or many HMBs that process
milk and distribute? (Centralized vs decentralized)
NO
How many NICU/Neonatal wards/community
homes does each bank serve? Are they
collocated?
Each milk bank serves individual NICU and neonatal wards of the respective institute.
How many babies does your facility/system
serve annually?
Approximately 600-700 babies.
How many liters/year does your
facility/system process annually?
12000-15000 ml.
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How many donor mothers initiate donation to
1200-1500 mothers per year are recruited.
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Process
Brief description of processes
Staffing
-staff sister of NICU
-3 resident doctors by rotation.
-2 technicians by rotation.
-1 senior pediatrician.
Donor recruitment
-PNC ward mothers
-Mothers coming to follow up in neonatal clinics.
Donor screening
-Routine screening for - HbSAg
- HIV
-VDRL
Recipient eligibility and
selection
-Physically fit mothers with BMI around 18.5
-Hb more than 10gm%
-Negative for HbSAg , HIV , VDRL.
-CONSENT OF THE MOTHER.
Handling and storage of
donor milk (from donation
to feeding)
-Collected by manual expression or using electronic milk pumps.
-The milk is stored in the container , tightly sealed & refrigerated according to its date of
collection.
Breast Milk is safe for four to six hrs at room temperature i.e.- 15 to 25 deg centigrade.
Fresh milk can be stored in the refrigerator for five to seven days and in the deep freezer at
-20 deg centigrade for six months.
Thawed refrigerated milk is safe for 24 hours.
Heat treatment & microwaving is NOT recommended.
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Process
Brief description of process
Transport of milk
-Done using vaccine carriers
Pasteurization
Pasteurization done at 60 degrees.
Tracking and record
keeping
Separate registers for the same and also for feedback from mothers are maintained.
Assessing milk quality and
safety (ie. microbiology
assays)
Regular cultures are done of each and every sample collected.
Quality assurance
Accredited microbiology laboratory and ISO-Certified NICU present.
Equipment/Location
Brief description of process
What is used/how many?
• Pasteurizer-1
• Freezers (lockable?)-1
• Refrigerators-1
Additional HMB equipment • Ex. lockable room-yes
• Computers-yes
requirements?
• Other
Referral/feeder/depot
facilities?
• How many?
• Equipment requirements? No
Neonatal ward equipment
requirements?
• System for tracking usage? - Record maintained in
registers and computers.
• Freezer?-yes
Other?
• Breast milk pumps
-electronic-4
-manual-20
Milk collection stainless steel containers.
Organizational Successes
Brief description of top 3-5 successes
Policy
Helped in promotion of exclusive breast feeding.
Operational
-satisfied mother
-weight gain of the baby.
-increased confidence and morale of HIV positive women who like to feed
their babies on human breast milk.
-Baby victim of 26/11 bomb blast was fed on milk from HMB for 3 months.
Technology
-To screen mothers for HCV infection.
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Organizational Challenges
Brief description of top 3-5 challenges
Policy
No administrative or central government support.
Lack of funding
Not included in PIP of NRHM inspite of giving the proposal.
HMB not in the priority list in public health domain or MCH progamme.
Operational
A ll staff work with motivation and personal interest and passion
No designated staff separately for the purpose.
Technology
Absolutely no wastage
On day today basis almost 100 percent usage is present.
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Attendants and sweepers of PNC,
NICU & Pediatric wards being trained
•Mothers to be motivated for
milk donation
- Extensive Training, motivation, commitment…
Regular Parents Meeting
Milk bank in
every first
referral hospital
where
department of
Paediatrics and
Microbiology
works…
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THANK YOU