The initial stage of the PREMB will be the development of a conventional human milk bank. The PREMB will screen donors, then collect and store milk which will be pasteurised and made available to pre-term and ill very low birth weight (VLBW) infants in the NICU at King Edward Memorial Hospital. This represents an Australian first. As such, the PREMB at KEMH will be developed as a model that can be applied nationally.
Following the establishment of a conventional human milk bank, we aim to develop new technology (Ultra-filtration) for the concentration of human milk protein. This will allow the fortification of human milk, with human milk derived protein, to meet he higher nutritional demands of pre-term babies. The application of this technology to infant feeding in a clinical setting by the PREMB represents an international first.
PREMB will commit to the development and implementation of a Quality Management System to ensure safe production standards are maintained and regularly reviewed. The Quality Management System will be based on the relevant clauses of ISO 9000:2001. The management board of the milk bank will determine whether certification to the Standard will be sought. Lack of certification will not diminish the quality of the product and service provided by the PREMB.
Stage One
Stage one of the PREMB will involve the development of a ‘conventional’ human milk bank where milk donated by thoroughly screened donor mothers is pasteurised and made available to pre-term infants at KEMH whose mothers are unable to provide enough milk for their nutrition. At this stage of development of the PREMB, if fortification of the donor milk is required, this will be achieved by the addition of artificial Human Milk Fortifier (cows milk based).
Stage Two
Stage two of the PREMB will see the development of an international first in human milk banking. Ultra-filtration techniques developed for the dairy industry will be used to concentrate the protein from mother’s own breastmilk to allow fortification of milk for pre-term infants with human milk proteins. This will allow mothers of pre-term infants who are producing enough milk the option of milk fortification with protein concentrated from their own milk.
Stage Three
Stage three of the milk bank will see the Ultra-filtration of human milk applied to donor milk for use by all pre-term or ill infants in need in the NICU at KEMH.
Following these three development phases donor human milk may also be made available to term babies whose mothers are unable to produce enough milk for them. An additional service may be offered to mothers whose babies are at risk of infection. Breastfeeding of an infant is contraindicated in certain instances, for example if the mother is HIV+. Pasteurisation is an effective method of removal of many viruses and bacteria that may potentially be present in breastmilk. Expressed breastmilk from mothers who are at risk of transmitting an infection to their infant may be pasteurised by the PREMB.
The PREMB will produce either human milk or human milk products to provide an alternative to artificial formula and human milk fortifiers that are based on either cow’s milk protein or soy protein. It should be noted that the composition of human milk is very complex and it is unlikely that it will be duplicated artificially in the foreseeable future. Thus there will be a long-term need for the PREMB in Western Australia.
The immediate goal will be to provide the option of breastmilk for all pre-term and ill term babies in Western Australia. Approximately 7% of babies in Western Australia are born prematurely (before 37 weeks) and KEMH is the only tertiary care maternity hospital in Western Australia with the facilities to care for mothers with high-risk pregnancies. Indeed, approximately 95% of all mothers in Western Australia with high-risk pregnancies give birth at KEMH.
