When Elizabeth Schmid gave birth to triplets, she was able to give them everything except the one thing they needed most — breast milk.
Born three months prematurely, Bridget, Caroline and Jamie weighed no more than 2 pounds each. Very little and very sick, the three girls needed expert care and the best nutrition to survive.
Luckily, they got both.
Doctors provided the care, and nursing mothers with too much milk for their own children provided the lifesaving nutrition.
Seven months later, Bridget, Caroline and Jamie are happy, healthy little girls. And their mom is thankful for both the good care they received early in life and for the breast milk selflessly donated by other mothers — even though they didn't know Schmid and had no connection to Schmid.
"This was a wonderful gift that these women gave to our sick babies," said Schmid.
The donated milk came from Mother's Milk Bank of Iowa in Iowa City, about two hours away from Schmid's home in Dubuque. The milk bank — one of six in the United States — collects, pasteurizes, stores and distributes human breast milk to babies in need.
Pediatrician Ekhard Ziegler, medical director and co-founder of the bank, says he started it because he wanted all babies — and especially ones born prematurely — to have the benefits of breast milk.
"I knew that many mothers of premature babies either couldn't provide breast milk at all or tried and couldn't provide enough," said Ziegler. "In our hospital, premature babies have the benefit of getting mother's breast milk when the mom cannot give milk themselves."
There are many reasons why breast milk is ideal for infants: It's easy to digest, it strengthens a baby's immunity against infection and disease, and it promotes the growth of developing bones and tissue.
Babies in Need
Schmid is just one of many mothers who rely on donated breast milk for their babies' nutrition.
Most often, recipient mothers are those whose milk hasn't come in after having a preterm baby or who have given birth to multiple preterm babies and don't have enough milk.
Some recipient moms may be too ill to breast-feed themselves because they are undergoing chemotherapy or have life-threatening infections.
But all moms whose babies receive donated breast milk are grateful.
Teresa Wrieden's son was born 14 weeks early and received donor milk from the Iowa bank. At birth he only weighed 1 pound 10 ounces. In the first three weeks on donated breast milk, the baby boy gained over 2 pounds.
"I really wanted to keep him on breast milk and I couldn't provide it," said Wrieden. "It's helping him a lot and he's growing and he's doing really good. He's my sunshine every day and it's good to know that he's getting the best nutrition."
Who Are the Donor Moms?
Women who donate breast milk do so because they want to help other moms and babies, especially those in need.
The donors are both stay-at-home moms and working moms. Sometimes they have extra milk and sometimes they donate milk after suffering a late-term miscarriage or losing a newborn. They are not paid for their time or compensated in any way. Many feel that donating their extra milk is a way to give back to their communities and a way to help their peers.
Five years ago, Cindy Bys, a working mother of three from North Liberty, Iowa, had identical twin girls who were born prematurely. Bys spent a lot of time in the neonatal intensive care unit, and although she was able to pump her own milk for her babies, she saw lots of other babies in need.
So when she gave birth to a baby boy 10 months ago, Bys decided to donate her extra milk to the Mother's Milk Bank of Iowa.
"With this baby I have extra breast milk, so donation is a great way to help other babies get a good start," said Bys.
Gretchen Flatau, executive director of the Mother's Milk Bank in Austin, Texas, believes women who give to milk banks are true altruists.
"When you look at the donor moms who make it happen, what the moms are providing, the gifts that they are giving, and the benefits for the babies who are getting it, this is an inspiring story," she said.
Schmid, the triplets' mother, says not knowing the identity of the donor moms makes the milk even more special.
"Without knowing me or meeting me it makes that gift more meaningful," she said. "It's something that is voluntary and it takes time and it's just very generous of these women who help those of us who can't nurse their children or elect not to for various reasons."
Mothers who are willing to share their extra milk must be nursing and in good health. They cannot smoke, take any medications or consume alcohol.
All Mother's Milk Banks follow strict guidelines put in place by the Human Milk Banking Association of America. Much like a blood bank, milk banks carefully screen donor moms for infections and viruses, including HIV and hepatitis B and C.
"We have a verbal screen, a written screen and we contact the donor's physician and her baby's physician," said Jean Drulis, director of the Mother's Milk Bank of Iowa.
The donated milk is pasteurized and tested for bacteria before being dispensed to babies in need.
There are currently six human milk banks in the United States, with four more opening their doors within the next 12 months. All are either run by nonprofit organizations or associated with a medical center. The milk banks are run as nonprofit, so they charge no more than the cost of collecting, pasteurizing, storing and shipping the milk. Whether the patient, a hospital or an insurer picks up the tab varies. Some of the banks ship milk to different locations.
Human milk banks date back to the turn of the last century. Then, the breast milk banks replaced the role of wet nurses — women who breast-fed the babies of family, friends and neighbors — by creating a store of donated breast milk for use in hospitals.
The banks all but disappeared in the mid-1980s with the arrival of HIV/AIDS and concerns over its transmission. But in 1985, the Human Milk Banking Association of America was established to provide safe standards for milk banks, and Mother's Milk Banks are again on the rise.
Flatau says one of the reasons there are not more human milk banks in the United States is what she calls the "yuck factor," a natural aversion to sharing breast milk.
"As Americans, we seem to trust these formula products that come in sealed containers, but not breast milk," she said. "There has never been a documented case of a baby getting sick from getting donor human milk."
Why Not Use Formula?
The American Academy of Pediatrics recommends human milk as the preferred nutrition for all infants.
For some special-needs babies, including premature infants, babies who are allergic or have intolerance to formula, or babies who cannot drink their own mother's milk because of the risk of passing infections like HIV, banked donor milk is not only required for their health, but for their survival.
According to Ziegler, premature babies thrive better on breast milk than on formula. They are even able to leave the hospital earlier than formula-fed babies.
"Babies who receive mother's milk have fewer infections and fewer problems with their bowel, specifically necrotizing entercolitis," says Zeigler.
Necrotizing entercolitis, or NE, is an intestinal infection that kills more than one-third of the infants who get it. And premature infants, especially those under 3 pounds in weight, are more at risk for the infection.
Craig Anderson, director of newborn medicine at Grant Medical Center in Columbus, Ohio, says studies have shown the risk of this intestinal infection is reduced when premature babies receive breast milk.
"Our first choice is mother's own milk, but there are situations when a mother can't supply her own," says Anderson. "The order of preference for newborn nutrition is one, mom's own milk; two, donor breast milk, and three, formulas."
Anderson believes human milk banks serve a very important purpose and will become more common. Moms like Elizabeth Schmid certainly agree.