Guidelines for the establishment and operation of human milk banks in the UK.

Correspondence to: Dr J H Baumer, Derriford Hospital, Plymouth, UK; harry. [email protected] _________________________ H uman milk banks provide an alternative to formula feeds for preterm babies when the mother’s breast milk is unavailable. The first human milk bank in the United Kingdom opened at Queen Charlotte’s Hospital, London in 1939. The emergence of the human immunodeficiency virus resulted in the disappearance of many human milk banks in the 1980s. However, there are currently at least 16 operating in the UK, with others being developed. Most are attached to neonatal units (the one in Northern Ireland is based at a health centre and managed by a health visitor). The UK Association of Milk Banks, a registered charity, provides guidelines for their operation, and the third edition these guidelines were updated using a more rigorous evidence based methodology. There are few studies specifically using pasteurised donor breast milk in preterm infants, and therefore much of the evidence has to be extrapolated from studies including babies fed at the breast and those fed their mother’s own unpasteurised breast milk. The guidelines discuss what is known about the consequences of pasteurisation of breast milk for feeding to unrelated preterm infants. They cover the selection of donors, and the collection, preparation, storage and treatment of donor breast milk. They include information leaflets both for potential donors (with instructions) and mothers of recipient babies. There are good practice points on record keeping, staffing a milk bank, and archiving donor samples in case of a subsequent problem. They do not cover the management of mothers’ milk fed to their own babies, nor the indications for using donor breast milk.