Breast Milk Bank

Breast milk can save lives of premature infants and infants with special medical conditions who do not have access to their mother’s breast milk. For these infants, the milk is not only an optimal source of nutrition but a special medical food that supplies unique nutrients that facilitate the development of the immune system, the brain and optimal growth.

Newborns need active feeds that include, in addition to nutrients, various active maternal components, much like those found in the umbilical cord. Breast milk is the only way for these infants to receive various maternal tissues that are rich in active components that infants cannot obtain from any other source, such as: immune components (antibodies), hormones, growth factors, white blood cells, stem cells, and more. These tissues nourish and help them get stronger and develop.

Despite the processing, even the milk from the milk bank is a recommended feed in the absence of the biological mother's milk because it still contains a variety of active human ingredients and is safe for use.

The need for a breast milk bank

Premature infants or infants who feed exclusively on breast milk develop a unique environment of microorganisms in tissues that is part of their immune defense and helps prevent allergies. If the biological mother is unable to breastfeed her baby, units of milk from a regulated breast milk bank are the feeding option recommended by all health agencies around the world, including the Ministry of Health in Israel. Because of its importance, breast milk is defined as “life saving treatment” for infants who need it.

Who is eligible to receive breast milk from the milk bank

The Ministry of Health determines who is eligible to receive milk from the milk bank, the duration of the donation and the prioritization for breast milk donations.

• The first priority is premature infants born before week 32 or who weigh less than 1.5 kg or who face other unique medical conditions.
• If the infant is hospitalized, check eligibility for milk donation through the milk bank's coordinator in the NICU. If the infant is not hospitalized, the pediatrician can submit an application with the Mother, Child and Adolescent Department in the Ministry of Health.

The Human Milk Bank in Israel

The role of the MDA’s milk bank is to allow infants and premature infants to receive breast milk, which is the best food for them in their first weeks of life. For premature infants - breast milk is a unique collection of tissues that supplements what they are missing and is the only source of nutrition they can receive without harm. Simply put, it is not only the best nutrition for them and the main and important component for their survival, the milk is also a significant source that affects their future well-being. Therefore, when the biological mother cannot feed the baby with her own milk, donated breast milk is critical to the baby's life and health.

There are about 800 milk banks worldwide, approximately half of which are in developed western countries. Most milk banks are non-profit organizations, as is the case in Israel. In all western countries, medical care of premature infants includes a milk supply from a human milk bank when necessary, to maintain a diet based on breast milk in the first weeks of life.

The Magen David Adom’s National Human Milk Bank

The National Human Milk Bank was established by Magen David Adom in 2018 to assure a regulated supply of breast milk for newborns and premature infants as part of the medical service in the country, similar to the Magen David Adom’s National Blood Services.

Since breast milk is human tissue like blood, the National Human Milk Bank is part of the MDA’s National Blood Services.

The milk bank is responsible for collecting milk donations from volunteer mothers who undergo a preliminary screening, for processing the milk and supplying it to premature infants and newborns in the hospitals in Israel. All collected donations are processed and tested by a skilled staff with advanced equipment to ensure that the units to be supplied to the premature infants and newborns are of the highest quality and safe and make sure the units are delivered to every infant or premature infant irrespective of religion and race.

Safe use of donations from the milk bank

The National Human Milk Bank that is operated by the MDA and regulated by the Ministry of Health. It ensures the safety and quality of the tissue that is supplied to premature infants and newborns. Much like the blood bank, which works in accordance with the stringent procedures, the milk bank also screens donors and tracks their health throughout the duration of the donation. The milk donated to the milk bank is not delivered to the recipients in a raw form but undergoes tests that detect food bacteria that are dangerous to infants as well as a nutritional analysis, as a prerequisite to the initial processing. Afterwards, the units of several donors are mixed to optimize the nutritional composition and the active components. At this stage, the milk undergoes monitored pasteurization that guarantees it is sterile, free of pathogens and safe and healthy for use. In addition, due to the nutritional profile of raw milk, the staff calculates the composition of the finished milk to make sure it is balanced.

Pasteurization of breast milk

The milk is pasteurized to prevent the transmission of infections, the majority of which can be attributed to the pumping and storage processes. When processing and pasteurization are properly performed, the harm to the milk components is minimal. Like other tissues, milk cannot be produced in a laboratory or factory, and therefore must be obtained by donation from a mother who produces milk. The fear of pathogens that may potentially enter the milk from the environment, or by maternal infections, makes pasteurization necessary, as it kills these bacteria. Only when the donation process is performed by a regulated milk bank will the donation be considered a safe and optimal feed for even the smallest premature infants.

For full information about eligibility to donate milk, and in case of doubt about the eligibility criteria and other questions, email milkbank@mda.org.il.

Why donating breast milk through the internet can be dangerous

When donating breast milk through the internet or social media, there is no control and regulation of the donor’s background, the donor is not tested and the milk is neither tested or pasteurized, thus the milk is unregulated and may be unsafe for infants and expose them to medical risks for several reasons:

• Lack of familiarity with the donor: when the donor is anonymous or unknown, in many cases it is impossible to verify her identity and personal details (if she provided any) and to know what her lifestyle is like, the state of her health and whether she consumes drugs or dangerous substances. In addition, in the absence of complete medical information about the donor, there is a risk of transmission of infectious diseases that may endanger the infant receiving the donated milk.
• The donation is not screened: at a professional and qualified milk bank, every donation is screened for viruses, infections and toxins, but on the internet, there is no regulation.
• Improper storage and transport: food infections, which are common in every kitchen, can infiltrate pumped breast milk. Without regulation, there is no way of ensuring that milk donated through the internet meets the adequate storage conditions to prevent their development.
• Regulation: in contrast with an official milk bank, websites and the internet are not subject to regulation and standards that protect the health of consumers.

Hence, despite the need and important contribution made by the donor, the recommendation is to rely on professional and transparent milk banks that comply with stringent medical standards.

Breast milk donation in emergencies

The National Human Milk Bank prioritizes donating breast milk to infants under six months of age who need breast milk due to the absence of their mother. The Ministry of Health established criteria for receiving breast milk donations in the current situation:

• The nursing mother was injured or died.
• The infant is unable to consume infant formula due to an allergy or intolerance (and there is signed confirmation by a certified medical professional).
• Infants under the age of one who were injured and who require assistance in their recovery according to medical discretion.
• Infants with any medical condition who require breast milk, such as infants with an oncological condition (with signed confirmation by a qualified medical practitioner who is treating them) - to submit applications, a letter should be sent to the National Human Milk Bank: milkbank@mda.org.il and the Mother and Child Department of the Ministry of Health: emveyeled@moh.gov.il with the relevant medical information for the purpose of approving the provision of milk from the bank.
• When there is no information about the infant’s nutrition- priority should be given to them to receive breast milk.

These criteria may change depending on the security situation and the stock available at the National Human Milk Bank. The Ministry of Health will issue updates when necessary.

Receiving the milk

Families or medical practitioners caring for infants who satisfy the criteria can contact the National Human Milk Bank by email: milkbank@mda.org.il or by WhatsApp: 052-6344101 or by telephone: 073-2630200.