There is a substantial online trade in breast milk in the US, where women advertise their expressed milk for sale.
New Delhi: Even as the country seeks to scale up human milk banks to save premature and sick babies, the Union health ministry is working on a regulation to ensure that “donors” are not paid so that human milk is “not commercialised” in India. In a new set of guidelines, to be released by the ministry soon, the ministry proposes to make it mandatory that “milk is given out on doctor’s prescription” and the donors are not “paid”.
Boon to fragile infants and mothers with delayed lactation or those who cannot nurse, the easy availability of human milk poses both ethical and public health challenges. In fact, many countries have been critiqued for the sale of breast milk from the poor and vulnerable women for profit and commercial purposes. There is a substantial online trade in breast milk in the US, where women advertise their expressed milk for sale.
Therefore, to regulate the milk banks in the country the way they do blood banks, the health ministry is working on safety standards, which makes screening of donors for various diseases like HIV, VDRL (syphilis test) and Hepatitis B test, compulsory. The guidelines makes “mothers consent” compulsory for donation too. “Human milk banks will be the part of the lactation management centre, where women would be given support for breastfeeding, kangaroo mother care and encouraged to donate milk,” said Ajay Khera, deputy commissioner (incharge), child and adolescent health programme in the ministry.
The proposed guidelines will also focus on hygiene and handling of milk. “Hospital staff will be trained for Hazard Analysis and Critical Care Points (HACCP) systems. This system is usually used for food safety. Pasteurisation techniques and temperature for storage will also be described in the guidelines,” said Ruchika Sachdeva, who heads the nutrition department at the international health NGO, Path, and has worked with the ministry on milk bank guidelines.
Aimed to counter the use of formula feed, the health ministry proposes to establish human milk banks in tertiary care hospitals or well performing Sick New born Care Units (SNCUs) with high load facility and collection centers in smaller hospitals. At present there are 661 SNCU’s in the country. “Government wants to increase access and uptake of human milk to all the SNCUs in the country through human milk banks and collection centres. A Centre of excellence or reference center will be established in each state for monitoring and evaluation and capacity building through training ,”added Dr Khera.