CARY, N.C. (AP) - Learning to breast-feed her newborn son Max brought Amy Hambright to tears - and they weren’t happy tears.
The experience was frustrating and painful for both mother and child. Max had a shallow latch in which the nipple didn’t get to the back of his palate, and Hambright would grit her teeth when it was time to feed him.
“I didn’t think I could go on another day,” said Hambright, who lives in Cary. “I was at the end of my rope.”
Hambright joined a support group, and breast-feeding became rewarding but still challenging. When she had her second son last year, Hambright began donating her extra breast milk to the WakeMed Mother’s Milk Bank in Cary to help moms struggling to breast-feed.
“It’s really important to be able to give back, especially to babies who really need it,” Hambright said.
One of only 23 nonprofit milk banks in the United States, the WakeMed project depends on mothers to donate breast milk. It sends about 200,000 ounces of breast milk each year to neonatal intensive care units at up to 50 hospitals along the East Coast. The milk is fed to babies born prematurely and infants with severe illnesses.
In the past, milk that wasn’t sent to hospitals was sold to families who had a prescription from a pediatrician, including couples who recently adopted a baby. But the hospital had to stop the service last year because it didn’t have enough milk from donors.
WakeMed’s milk bank has about 150 active donors, and it’s looking for more. Donations have declined in the past year, said manager Montana Wagner-Gillespie.
“People don’t realize this stuff is liquid gold,” she said.
Many parents in the Triangle likely don’t know about the Mother’s Milk Bank, Wagner-Gillespie said. Some moms might worry that if they donate their milk, they won’t have enough for their child.
But babies born prematurely have a higher risk of some health issues, and breast milk can be life-saving. The milk is filled with antibodies, vitamins and proteins that protect against infection and disease.
Giving birth prematurely can be stressful for mothers, and stress can affect the hormones involved in producing breast milk, Wagner-Gillespie said. So some mothers of premature babies have trouble producing enough milk.
More than 200 babies are born prematurely, or before the 37th week of pregnancy, in an average week in North Carolina, according to the March of Dimes.
The cost
Access to breast milk is also important for families with prescriptions.
Hospitals that receive donations from milk banks can provide it free to babies who need it. But that’s not the case when the baby leaves the hospital, or when a family adopts a baby.
Most private insurance companies and Medicaid do not cover breast milk in North Carolina, leaving families to foot the bill.
When WakeMed sold breast milk, it cost $5 per ounce. Feeding a 1-month-old baby two to four ounces six to eight times a day, as recommended by Johns Hopkins Medicine, would cost $60 to $160 every day.
The American Academy of Pediatrics and World Health Organization recommend that babies be exclusively breast-fed for the first six months.
Some families supplement formula feedings with breast milk, but few can afford a regular supply, Wagner-Gillespie said.
“Any amount of human milk is better than none,” she said.
To avoid hefty costs, some mothers turn to milk-sharing, where other moms give away their breast milk for free. Many ask friends or family members or find other mothers on social media who are willing to share, said Dr. Aunchalee Palmquist, a professor at Elon University who has spent much of her career researching milk-sharing and the practice of selling breast milk.
Some may sell their milk to companies like Prolacta Bioscience, which uses it to make fortifier products. Others use unregulated milk-sharing websites like Eats on Feets to find milk mothers want to donate or Only the Breast to buy or sell milk.
More than 2,700 people have liked North Carolina’s Eats on Feets Facebook page, which shares requests for milk from mothers across the state.
While the milk can be beneficial to mothers and infants, it raises ethical questions: Should mothers freely donate or be paid for their milk? What if they are depriving their own infants? Should there be more safeguards in place to ensure that the milk is safe for babies?
“There’s definitely a debate,” Palmquist said.
Rates rise
Breast-feeding rates in the United States are on the rise, but some advocates say there’s still a long way to go.
The percentage of infants in the U.S. who were breast-fed at some point rose from 70 percent in 2000 to 81 percent in 2013, according to the CDC. In North Carolina, the rate rose by 8 percent during that time.
The HIV/AIDS epidemic that began in the 1970s posed risks for mothers breast-feeding their children, contributing to a decline in breast-feeding rates before widespread testing became available.
At WakeMed, mothers who donate their milk must be screened and undergo a blood test, and their milk goes through a lengthy process to ensure it is safe for infants.
At its facility in Cary, the bank pasteurizes, homogenizes, tests and re-freezes the milk, which is labeled and tracked in case of a recall. About 20,000 ounces of processed milk from donors and 40,000 ounces of raw milk can be stored at the facility.
Wagner-Gillespie said breast-feeding is becoming more accepted by society, but there’s room for improvement.
“There’s also the sexualization of breasts, which needs to stop,” she said. “As breast-feeding becomes more common, I’m hopeful that all this will change.”
Hambright plans to continue donating breast milk as long as she’s able.
“I want to do anything I can to help,” she said.
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