Human Milk Bank - Harvard University

Harvard-Brazil Collaborative Course
January 2013
Human Milk Bank
Ana Márcia Bustamante de Morais
Lúcia Virgínia Reis Aragão
Harvard School of Public Health
Federal University of Ceara (UFC)
Institute for the Promotion of Nutrition and Human Development (IPREDE)
Brazil Studies Program, DRCLAS, Harvard University
HUMAN MILK BANK: DEFINITION (1)
It is a unit necessarily
linked to motherhood.
It supports, protects,
promotes, and
encourages the
maintenance of
breastfeeding.
ANVISA, 2008
HUMAN MILK BANK: DEFINITION (2)
It performs the
collection, selection,
classification,
processing, quality
control, storage and
distribution of human
milk, according to
prescription and / or
nutritionist’s
recommendation.
ANVISA, 2008
1/1/2013
1

HUMAN MILK BANK NATIONAL REFERENCE
• Milk Banks are coordinated by Fernandes
Figueira/Fiocruz‐ Institute, a national reference
bank milk located in Rio de Janeiro.
ANVISA, 2008
HUMAN MILK BANK OF REFERENCE IN CEARÁ
• Each state has a reference Human Milk Bank (HMB).
– It conducts activities common to any HMB, but also
provides training for professional development, conducts
research, and provides technical assistance for other
affiliated HMBs.
• The reference HMB in Ceará is the General Hospital
Dr. Cesar Calls.
ANVISA, 2008
POST COLLECTION OF HUMAN MILK (PCHM)
• It is a unit linked to a HMB, whose function is to
promote, protect and support breastfeeding, as well
as locate milk donors and collect human milk
• It makes pasteurization ‐ The milk is sent to a HMB,
where it is pasteurized and then sent back to PCLH
for distribution
• After pasteurized, human milk is distributed to
newborns admitted to the Neonatal Intensive Care
Units
ANVISA, 2008
1/1/2013
2

HUMAN MILK BANKS IN BRASIL
• Currently, there are 212 Human Milk Banks and 113
collection centers distributed in Brazil.
13
50
29
91
29
8 HMB e 4
PCHM
Fonte: http://www.redeblh.fiocruz.br
TRANSPORTATION OF HUMAN MILK
• Should be done under refrigeration for freezing;
• Maximum transport time = 6 hours;
• Need a thermometer to control temperature.
STAFF MEMBERS
ANVISA, 2008
• The staff of HMB and PCHM consist of: physicians,
nutritionists, nurses, pharmacists, food engineers,
biologists, biomedical scientists, physicians,
veterinarians, psychologists, social workers, speech
therapists, and occupational and technical assistants
(nursing , laboratory and nutrition), among others.
ANVISA, 2008
1/1/2013
3

ACTIVITIES: PROVIDING ASSISTANCE
• Provide advice on the benefits of breastfeeding
• Prevention and treatment of mammary infections
• Provide information on how to breastfeed
• Conduct individual and group visits
• Advise on milk collection and storage at home
• Perform screening of donors
ANVISA, 2008
ACTIVITIES: PROCESSING HUMAN MILK
• Reception
• Pre‐stocking
• Pasteurization
• Quality Control
• Storage
• Distribution
IDENTIFYING DONORS
• Lectures
• Groups of pregnant women
• Phone calls
• Visits to hospitals
• Media campaigns (TV, radio,
Newspapers)
ANVISA, 2008
ANVISA, 2008
1/1/2013
4

CRITERIA FOR A DONOR REGISTER
• Currently breastfeeding her newborn
• Be healthy
• Have surplus of milk
ANVISA, 2008
PHYSICAL INFRASTRUCTURE OF A HMB
Screening of donors
(reception)
Room for receiving human
milk
ANVISA, 2008
PHYSICAL INFRASTRUCTURE OF A HMB
Room cleaning Room milking
ANVISA, 2008
1/1/2013
5

PHYSICAL INFRASTRUCTURE OF A HMB
Room for processing:
• Defrost, selection,
classification, pasteurization,
storage and distribution.
PACKAGING
Laboratory quality control
microbiology:
• May be on the premises of a
milk bank or sector where
HMB is located.
ANVISA, 2008
• Glass with plastic cap
• Screw cap
• Sterilized, if the
donation is in the
hospital
ANVISA, 2008
RECEPTION AND COLLECTION OF HUMAN MILK
ANVISA, 2008
• Identify the bottle with the
name of the mother
• Date of collection
• Store in freezer
1/1/2013
6

DEFROST
COOLING
PROCESSING OF HUMAN MILK
SELECTION
PASTEURISERS
PROCESSING OF HUMAN MILK
MICROBIAL CONTROL STORAGE
DISTRIBUTION
RATING:
creamatocrit
REPOT
ANVISA, 2008
ANVISA, 2008
ANVISA, 2008
1/1/2013
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HMB HOSPITAL GERAL DE FORTALEZA
• Started as a breastfeeding center in 2000, focused on
the promotion, protection and support of
breastfeeding
• PCLH linked to BLH General Hospital Dr. Cesar Cals.
HMB HOSPITAL GERAL DE FORTALEZA
2005:
• HGF is recognized by
UNICEF as Baby‐Friendly
Hospital
• Starts to develop
activities within the
hospital
HMB HOSPITAL GERAL DE FORTALEZA
• 2007 ‐ moved to the
Regis Jucá newly
opened building.
1/1/2013
8

HMB HOSPITAL GERAL DE FORTALEZA
• 2009 ‐ HMB begins to
take shape with the
acquisition of
equipment donated by
FIOCRUZ / MS.
HMB HOSPITAL GERAL DE FORTALEZA
• 2011 –Renovations are performed to meet
the requirements of ANVISA
• 2012 ‐ Project is approved by the Government
of Ceará with release of funds for equipment
acquisition
HMB HOSPITAL GERAL DE FORTALEZA
2012 (August 20):
• Opening with the
presence of
professionals, the
hospital's director,
secretary, members of
the Ibero‐american
Network of Human Milk
Banks, and the Ministry
of Health
1/1/2013
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