Arkansas’ first human milk bank benefiting neonatal intensive care units in the state opened Sept. 6 as a partnership with Arkansas Children’s and the University of Arkansas for Medical Sciences.

Human milk banks are a separate entity from a hospital. It receives breastmilk (mother's expressed milk, also known as human milk) from donor mothers in the community and distributes it to babies in NICUs. Sometimes, milk banks distribute donor milk to families out in the community.

There are 32 milk banks in North America and Arkansas’ UAMS Milk Bank is the 33rd. The milk bank will distribute donated milk to the roughly 20 level two and three NICUs in the state and some term nurseries in hospitals. Term nurseries use donor milk to help moms who want to breastfeed exclusively but do not have enough milk to feed their babies at birth. In the future, the bank may distribute donor milk to the community. Arkansas Children’s Hospital (ACH) has the only level 4 NICU in the state.

Misty Virmani, M.D., is a neonatologist at ACH and associate professor at the University of Arkansas for Medical Sciences (UAMS), who works at both hospital’s NICUs. Virmani will be the director of the milk bank on the UAMS campus.

"There's an extensive donor screening process to ensure the milk is safe, that mom and baby are healthy, and that their milk is good for premature babies," Virmani said. "We put it through a process called pasteurization. It's pooled together to ensure calories and proteins are provided in the right amounts and so babies are exposed to the widest variety of an important immune factor called human milk oligosaccharides (HMOs). We freeze and distribute the donor milk to NICUs throughout the state."

Currently, the Arkansas Children's NICU gets its supply of donor milk from Texas or Oklahoma. States prioritize their residents first, so they will not donate to Arkansas if their supplies are low.

NICU babies need donor milk when the parent cannot express or produce enough or if a mother's milk is not safe for the baby because of a medical condition or medications. A milk bank differs from a milk lab that prepares donor milk for feeding. Milk labs do not directly accept donor milk.

Any baby less than 34 weeks at delivery qualifies for human donor milk. The Arkansas Children's NICU prioritizes feeding parental milk (mother's milk) if available. Still, roughly 50% of babies at the NICU receive donor milk at some point during their hospital stay.

A state law passed in 2021 provided funding for the milk bank, which was remodeled in the UAMS Monroe Building. Funds for phase one, totaling $1.7 million, will make the lab operational. Virmani said they are advocating for $1.2 million phase-two funds to create a breastfeeding support center for educational outreach, support and training for both health care providers and for mothers/families. It will also be open to students interested in a medical career, medical students, nurses, clinicians, etc.

According to 2017 Centers for Disease Control and Prevention Statistics, Arkansas is ranked second highest in the nation for infant mortality, or babies who die before they turn 1. That equates to 8.2 deaths per 1,000 live births or more than 300 infants per year.

For premature infants globally, having parental or donated human milk for their primary feedings reduces the risk of developing necrotizing enterocolitis (NEC), inflammation of the intestinal tissue, which can cause some of the intestine to die or create a hole that can cause bacteria and intestinal contents to leak into the abdomen or the bloodstream. Human milk is genetically derived and developed by a mother's body specifically to enhance her baby's immune system development. Human milk, particularly a mother's own milk, reduces the risk of several health conditions, including sepsis, chronic lung disease, sudden infant death syndrome (SIDS) and blindness.

Lactation after pregnancy, or breastfeeding, also lowers maternal mortality. To help a baby grow in the womb, a pregnant woman's body stores extra fats and sugars in her body and delivers it to her growing baby by the bloodstream. Breastfeeding helps reset their metabolism by pulling out those sugars and fats and using them to make milk. Women who choose not to breastfeed are at a higher risk for heart attack, heart disease, ischemic stroke, breast and ovarian cancer, early death and other conditions.

According to Arkansas Children's neonatologists, the milk bank and creating a center for breastfeeding support and education in the state will save lives. Human milk globally reduces infant mortality by 21 percent.

"It is a massive decrease. When you think about Arkansas being one of the highest infant mortality rates in the U.S., it can have a huge impact on better supporting the mothers and babies in our state. It will reduce infant mortality in Arkansas," Virmani said.

Learn more about the UAMS Milk Bank and its requirements for donors.

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