Listen to This Article Enhance your reading experience by listening to this article.

Auma Odongo forces a weak smile as she latches her two month baby on her breast. The infant bundled in a bright fleece blanket, tries so hard to breastfeed, before letting out a frustrated cry. “She is tired of suckling air. She is getting little milk. But I have to keep breastfeeding her,” she says.

It has been a week since Auma, a resident of Dandora was reunited with her baby at Pumwani Maternity Hospital.

Her second born child was born prematurely (seven months) at a clinic in Dandora in May this year before being transferred to Pumwani Hospital where the baby was put in an incubator.

Two weeks after mother and child were admitted at Pumwani, Auma had difficulties producing milk for the baby, experienced fatigued, had a consistent cough and a fever. 

Mother away

On testing her, doctors realised Auma had tuberculosis — a highly infectious disease. “They said I had to be separated with my baby to avoid transmitting it to her,” she says.

For two months, Auma was at Mbagathi Hospital receiving treatment leaving her baby at Pumwani. In her absence, the baby was fed with breast milk sourced from the human breast milk bank at the hospital. 

When she returned to be with her baby after completing TB treatment, Auma says she was pleasantly surprised to see that the infant was doing well.

“While I was away, I was so worried about what would happen to my baby. Would she survive?” she kept asking herself. Since birth, the baby has added weight from 1.5 kilogrammes to 1.8 kilogrammes. Auma says the baby continues to feed on the milk from the bank.

“I also breastfeed her though my milk is not enough for her. Doctors have encouraged me to continue breastfeeding even though she gets little from me. They say the more I breastfeed the more I will have milk,” she says.

Auma’s baby is one of the 59 babies who have received milk from the human breast milk bank since it was opened four months ago.

The first of its kind in Kenya and Sub-Saharan Africa, the facility recruits donors, collects, pasteurises, tests, stores and dispenses donated breast milk to vulnerable infants. The facility that aims to provide safe and high quality breast milk to babies follows several operational processes. 

“To recruit donors, we offer education to women attending antenatal clinics, in maternity ward and newborn unit. The idea is to get the information out there that we have the bank, inform them why we need the milk and urge mothers to donate.

Donating is voluntary,” says Faith Njeru, Nurse in Charge, Human Breast Milk, Pumwani Hospital. 

Legible donors are breastfeeding mothers who have surplus milk beyond the needs of their child’s. At the breast milk bank, willing donors first meet a counsellor who explains to them what the process entails.

Donors are required to be screened for Hepatitis B, C, syphilis and HIV/Aids to avoid transmission of these diseases to children. Only after testing negative for all tests can a mother go ahead to donate. 

The process

After delivering her second child at Pumwani, a week ago, Flavia Mbigura remembers how touched she was after hearing there are babies who were not breastfeeding because their mothers were ill or had passed on.

“I thought to myself, what if that was my baby? That sympathy and motherly instincts motivated me to donate my milk,” says the 23 yearold who lives at Saika. 

Donors express milk under hygienic conditions either by hand or via a breast pump. The facility has four expressing rooms, each with a comfortable chair and a breast pump.

Once expressed, the milk is stored in sterile bottles and put in a freezer. Donor mothers are free to donate the milk at any time of the day after they have fed their babies.

Milk from every individual donor is aggregated in one container after which a sample is collected and taken to the laboratory. 

“We test for any bacteria or microorganism that may have contaminated the milk during the process of expressing,” says Njeru.

The milk is then pasteurised—heating the milk at high temperatures of 62.5 degrees for 30 minutes and then rapidly cooling it to four degrees with an automated machine.

The process kills bacteria and viruses in the milk. To ensure the highest standard of safety, another sample of the milk is collected post pasteurisation for testing.

If the milk test negative for bacteria and viruses it’s stored in a freezer at temperatures of -20 degrees.  

When needed, the milk is thawed and stored in a refrigerator for a maximum of 24 hours before being dispensed. The milk is only issued as a prescription given by a clinician. The whole process of collecting milk and dispensing it takes an average of two days. 

“That’s ideally the amount of time mothers spend in the hospital after delivery before being discharged. We maximise on this period to ensure we get as many donors to keep the bank running,” says Njeru. So far, the bank has had 181 donors. 

High demand

World Health Organisation (WHO) recommends babies be exclusively breastfed for the first six months of their life.

But where breastfeeding is not an option for the new mum for whatever reason, WHO recommends human milk as an alternative. Since the demand for the milk is higher than the supply, certain categories of babies receive priority in getting the donated milk.

They are premature, severely ill, and orphaned babies. Babies whose mothers experience delayed lactation or are using drugs that affect breastfeeding are also considered.

At Pumwani, the milk  has been reported to assist in the steady weight gain for preterm babies and improving immunity, thus leading to shorter hospital stays. “The milk is also better tolerated by babies as compared to formula milk,” says Njeru. 

There were high expectations pegged on the breast bank when it was opened with some proving difficult to achieve.

For one, it was hoped the bank would supply milk to other hospitals around the city. But that has proven a challenge since it requires other hospitals to invest in storage and cooling facilities .

“If  hospitals that need the milk don’t have freezers and fridges, then it means we will give good milk only for it to get bad before reaching the recipient,” says Njeru. For now, the milk donated only benefits infants within the hospital.