I am pleased to feature a guest blog from For Food’s Sake Eat. They are joining hands with the team at ATTA to raise awareness in this Breast Feeding Month. Read on and help. Thank you.
August is breast feeding awareness month and just as we need food to survive, new borns need milk that they do not always have in abundance to grow and thrive. Tracy Ahumuza at Atta breastmilk community shares how new mothers can share and donate milk to new borns who do not have enough and how you can be part of this effort, whether you are a mother or not.
1. What is the ATTA breast milk community?
It is an organization that creates a community of mothers who are ready to donate milk to babies who cannot access it.
The name ATTA is made up of the combined initials of my daughter, Alyssa Marie Taha and her mother Tracy Ahumuza. Alyssa was born full-term in week 39 requiring an operation at birth. Prior to this, I had not been told that post-operative nutrition could only be breast milk, preferably colostrum, the first milk. In the three days of my daughter’s life, I struggled to produce the breast milk the doctors were asking for and eventually settled for a donor as advised by the nurses. My sister-in-law, who had a one-month old baby at the time, came to the hospital, got tested at my cost and expressed milk right there in my room.
At the time of my daughter’s death, I had only managed to express about 40ml in total. My milk started to come in earnest a few days after my daughter’s death and I wanted something good to come of this tragedy. I wanted to donate the milk.
I looked up the only milk bank I knew but found out that it was not operational and that if I wanted to donate, I would have to drive to the hospital on the other side of town. On top of that, I was distraught and recovering from my C-section. In the end, I was encouraged to swallow a pill, Bromocriptine, for two weeks at least, to suppress the milk production.
That is how the idea for the breast milk community was born.
2. Why does the ATTA breast community exist?
The World Health Organisation (WHO) and UNICEF recommend that babies initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water.
Globally, 3 in 5 babies are not breast fed in the first hour of life, the golden hour. In some cases, the mother may not hold her child for a long while, a situation that may delay the production of milk. However, in some situations, even with enhanced lactation support, a mother can be unable to produce sufficient breast milk. WHO recommends safely donated human milk.
Human milk donation has been going on in Uganda for the longest time, sometimes under unsafe conditions. It is hard to know the value of breastmilk until your new-born baby is strapped to machines and you’re being told to produce milk your body cannot. ATTA exists to ease this burden on mothers and support them and their babies.
At the time of its creation, there is no operational milk bank in Uganda. This bank is expensive to set up and will need a community of educated mothers to donate milk to it. However, babies continue to need milk and human milk banks all over the world have to prioritise sick and premature babies. This milk from banks is in many cases sold and many mothers may be unable to afford it so informal and safe milk sharing is the way forward.
Donation of breast milk when a baby dies has been known to help mothers process their grief faster. Many Angel moms have reached out to me saying they wish this initiative existed at the time when their child died.
3. How can mothers and angel mothers donate milk?
Today, if you sign up to be a donor (by calling or texting), you get tested for Hepatitis, HIV and Syphillis. We arrange for testing. This may be done at home or your most recent results may be requested. If any of these are positive you do not qualify.
You are asked about your social habits such as smoking and drinking and required to consent to remuneration-free donation. So far we are mostly matching families as storage facilities for milk are scarce. The donor is educated on how to safely handle milk and the recipient family is also educated on administering the milk if the baby is at home. So far most babies are in the neonatal intensive care units.
4. There must be mounting expenses in storage, transportation and more…
Right now we are depending on donors to use their sanitary equipment and many are using their own bags but we hope that ATTA will be able to supply this equipment in the future. A regular freezer will work to store the milk but we check the temperature to be sure. Any milk that thaws cannot be used.
At the moment I have been using a hospital cooler to pick up and drop the milk myself from the mothers who decide to donate, where necessary I have provided milk bags from the stash I had set aside for my own daughter. I use my own car (I work in the health sector and have been able to move to and from work), fuel and time. The ATTA team includes a lactation consultant, pediatrician, physician pharmacologist and neonatologist all offering their services for free.
In time we will need small deep freezers to store and transport this milk. There is a lot to understand about milk donation. After testing the mothers, milk is pasteurized in a simple non-expensive way and administered to babies. We hope to make this process safer and more rigorous.
Human milk for these tiny babies is like medicine. One of the commonest causes of death in babies in Uganda is Necrotising enterocolitis (NEC). NEC happens when sections of the bowel tissue die. NEC is the most common gastrointestinal (GI) emergency in neonates and can present late in tiny babies. Early or suspected NEC is difficult to diagnose. It typically happens within the first 2 weeks of life in babies who are fed formula instead of breast milk. So you see, the only option for these babies is breast milk and all we can do is make it as safe as possible. Formula is a death sentence at this stage.
Breastfeeding is rarely discussed because of culture and while we stay quiet, neonatal mortality has barely changed in the last two decades. Babies are dying when they shouldn’t. Breastfeeding is one of the only activities that supports all the Sustainable Development goals.
5. How can other people donate or be part of the community?
Many mothers have reached out to donate milk and right now storage and resources to train and ensure safety are none existent. I am encouraging donors to be on standby to donate fresh raw milk when called upon directly to families in need. It is amazing how many wonderful women are out there doing this entirely out of the goodness of their hearts. To answer the question of giving too much milk, a mother knows when her baby is not getting enough milk. Only express for donation right after feeding your own baby.