Human milk is a lifesaving food and medicine for premature and critically ill infants, and is recommended as the first and exclusive food of all babies through 6 months of age. If 90% of infants are exclusively breastfed through the first 6 months of life, which is the optimal rate of exclusive breastfeeding, the US could annually save $13 billion and 1000 infant lives. Just this year the Hawaii Breastfeeding Report showed that Hawaii pays approximately $45 million annually in combined medical, non-medical, and death related costs by not achieving the optimal exclusive breastfeeding rate. Hawaii is in a prime position to achieve optimal breastfeeding rates and be a leader for our country with over 90% of moms initiating breastfeeding after birth! Hawaii starts out strong; this project seeks to provide supports to the community in maintaining optimal breastfeeding rates. Donor human milk in NICUs has shown to have better health outcomes in infants and reduce preterm infant mortality, and donor human milk available for term babies requiring supplementation in community hospitals demonstrates an improved exclusive breastfeeding rate upon discharge. Donor human milk can help families and the state achieve optimal breastfeeding rates for the health of Hawaii’s community. This project is Phase 1 of our pathway to establishing a Human Milk Banking Association of North America non-profit member milk bank in Hawaii. The project is also part of The Maternal-Child Health Nurse Leadership Academy (MCHNLA), presented by Sigma Theta Tau International Honor Society of Nursing (Sigma) in partnership with Johnson & Johnson.
Purpose:
The purpose of the project was to develop a strategic plan for opening donor human milk depots in Hawaii.
Methods:
Under the Sigma-Johnson & Johnson Maternal-Child Health Nurse Leadership Academy Fellow’s guidance, Breastfeeding Hawaii board members implemented a strategic plan to open milk depots and local donor milk shipping supply sites across Hawaii over an 18-month period. The first step was to identify barriers to hosting a freezer to collect donor human milk among potential customers. Within this acknowledgement, Breastfeeding Hawaii created alternate plans such as hosting local shipping supply sites rather than a business having a freezer, and also became more detailed in management of interested parties, such as coordinating shipping days and times based on how long donor milk would be in transit from a site to the donor human milk bank in California. Applications for milk depot sites were launched on the Breastfeeding Hawaii’s website. Identified sites received a site visit for activation of the milk depot. Breastfeeding Hawaii also sought and received grant funding for the initial investment for the project. Lastly, an online educational video was administered to all interested parties to determine change in knowledge regarding breast milk and donor human milk pre/post-the video.
Results:
The number of milk depots and shipping supply sites to be opened in Hawaii will be reported through September 1, 2019. The results from our pre/post-test are pending.
Conclusions:
Approximately 90% of mothers initiate breastfeeding in Hawaii and if we can maintain this level of exclusive breastfeeding throughout an infant’s first 6 months, this creates optimal health for the infant and our future. Optimal breastfeeding rates in Hawaii models breastfeeding as the norm to siblings, family members and the community, which impacts generations to come as they incorporate breastfeeding as the norm. Building a donor human milk bank can support breast milk needs for the future as a supplement for a child’s own mother’s milk.
Future work should focus on if the establishment of donor human milk depots in a community increases lactation support in the community, exclusive breastfeeding rates, and acceptance of breastmilk as the First Food. Additionally, future studies should look at long term outcomes of generational health improvements when communities achieve milestones of increased exclusive breastfeeding rates on the pathway to an optimal exclusive breastfeeding rate. Breastfeeding Hawaii’s last recommendation is to monitor how a state becoming a champion in modeling optimal exclusive breastfeeding rates influences other states to stretch to achieve the same goals.