Donor breast milk program expands to include hypoglycemic infants
Seven-month-old Killian has big brown eyes and an even bigger smile. One gaze can make all of Briana McGaha’s problems melt away. “It doesn’t matter how rough my day has been, he always makes me feel like I am doing something right,” said the first-time mother.
Killian captured Briana’s heart the moment he was placed in her arms. “It was so surreal. I kept having to tell myself that he was my son, and that he came out of me,” McGaha said.
Killian weighed 10 pounds, 12 ounces when he was born, making him large for his gestational age. Infants like Killian have birth weights greater than 90 percent of all babies born during the same number of pregnancy weeks.
The average baby weighs around 7 pounds at birth, and about 9 percent of all babies weigh more than 8 pounds, 13 ounces. Rarely do babies weigh more than 10 pounds. “Killian was a breech baby. It was because of this and his large size that doctors performed a cesarean section,” McGaha said.
Infants who are large for their gestational age, small for their gestational age or are born to diabetic mothers all run the risk of having hypoglycemia, or low blood sugar. Killian was hypoglycemic, and Briana was unable to produce enough milk at the time to stabilize his levels.
“This is very common when you have a larger infant and especially if the mother underwent a C-section,” said Jenny VanRavestein, division director of clinical services for Nursing Services Administration. “These mothers are often very tired from surgery. They may also have a delay in increased milk production.”
Serving up good health to more than just preemies
Previously, donor breast milk was exclusively given to premature or severely ill babies recovering in the NICU. The nursery at UF Health Jacksonville now offers donor breast milk to hypoglycemic babies like Killian, whose mothers can’t produce enough to meet their infant’s needs.
“This has increased the number of exclusively breastfed babies at discharge and decreased the number of babies who have to enter the NICU because of irregular blood sugar levels,” said Mandy Schumacher, a lactation counselor at UF Health Jacksonville.
UF Health Jacksonville uses donor milk provided by the Human Milk Banking Association of North America. The company screens its donors for diseases and viruses and tests the milk for contaminants. The milk is then pasteurized and frozen until it is ready for use. The donated milk remains good for one year, but milk delivered to UF Health Jacksonville is often used long before it expires.
“Babies who are exclusively breastfed are less likely to become obese, and they have a lower chance of developing respiratory infections, diabetes and digestive infections,” Schumacher said.
Saving premature babies one drop at a time
Breast milk is the recommended food source for all babies, but it becomes lifesaving for babies who are born prematurely or are in the NICU. Many preterm infants are often given a fortifier with the donor milk because they need more nutrition than is naturally available in breast milk. In May 2015, UF Health Jacksonville became the first hospital in the region to provide a human-based breast milk fortifier for infants in the NICU.
“Traditionally what has been used is a bovine or cow-based fortifier. Instead, we use a human-based fortifier,” said Sandy Inman, a lactation consultant at UF Health Jacksonville. “This lowers the risk of infections in our underdeveloped infants in the NICU.”
One in eight infants in Florida is born premature. Necrotizing enterocolitis, or NEC, is an acquired gastrointestinal disorder mostly developing among preterm infants. Breast milk has been shown to decrease the risk of NEC, which causes the bowel to die and leads to short gut syndrome. The disease extends the time infants spend in the NICU and is very costly to treat.
“Human milk is very important because it contains qualities that we cannot replicate in any formula. It contains antibodies and antibacterial properties that are all beneficial,” said Josef Cortez, MD, a neonatologist at UF Health Jacksonville.
More mom and baby bonding
More full-term, hypoglycemic infants are also spending less time in the hospital and more time with mom since the donor breast milk program has been expanded to include them. Briana and Killian spent two days at UF Health Jacksonville, and he did not have to go to the NICU despite his low blood sugar.
“I am very thankful that he was able to stay in the room with me. After nine months, you get pretty close to your baby. I want to spend as much time with him as possible,” McGaha said.
Being discharged together was also important to Briana because her husband was set to deploy six days after Killian was born. Kent McGaha serves as a firefighter for the Air National Guard and just completed a six-month deployment in Qatar. “Bringing a healthy baby home was extremely important because I knew my husband wasn’t physically going to be there to help me with any complications,” she said.
The brain depends on glucose as its main source of fuel. “ Too little glucose can impair the brain’s ability to function. Severe or prolonged hypoglycemia may result in seizures and serious brain injury,” Cortez said.
Briana says Killian is developing extremely well and has reached or surpassed all of his growth benchmarks. “Killian can now sit up briefly without support. He is army crawling, cooing, giggling and putting everything in his mouth.”
Killian is also teething and uses his favorite toy, a lion named Taggy, to soothe his discomfort. They are all milestones Briana and thousands of mothers like her are able to experience thanks to donors who shared their breast milk.
“This is no different than being a blood or organ donor. You have mothers out there who have plenty of milk and are able to help others because they understand just how valuable of a resource breast milk is,” VanRavestein said.
Their generosity gave Killian the health boost he needed to become the active and happy baby he is today — keeping Briana a very joyful mother.
Medical Director, Neonatal Intensive Care Unit