Milk banks have a long tradition of helping premature or ill babies. Claire Roberts takes a look at how another woman's milk can save a life

It all started with the birth of the St Neot's quadruplets, born seven weeks early, at their home in Cambridgeshire. The babies were very small, prompting a forward-thinking woman, Miss Edith Dare, matron at the Queen Charlotte's and Chelsea Hospital in London, to organise the milk of other new mums in her maternity unit to be collected and flown twice daily to the tiny village where the quads lived. Their mother, elated but exhausted, could supplement her own breast milk and ensure each of her tiny babies received adequate nutrition and so the best start in life.

That the quads survived is something of a success story even in our enlightened times; that this took place back in 1935 is even more extraordinary. Miss Dare's compassion inspired Great Ormond Street physician, Dr Donald Peterson, to write to her in person, suggesting there should be a centre at Queen Charlotte's for 'supplying breast milk to premature babies on a large scale.' And so the first human milk bureau, as it was known for many years, was officially opened on March 1st 1939.

Milk banks today
There are now 10 milk banks supplying needy infants UK-wide (see www.ukamb.org for a full list), and plans for expansion are afoot. 'Access to milk banks for all babies who could benefit is under discussion,' says Gillian Weaver, milk bank manager at the Queen Charlotte and Chelsea Hospital. 'Banks that currently exist are supplying more hospitals as demand for donor milk increases. In 2002 this hospital alone supplied 250 premature babies with donated milk.'

In the main, milk banks supply donor breast milk to babies in Neonatal Intensive Care Units. 'Most recipients of donor milk are premature babies,' says Gillian. 'They are usually only on donor milk for a very short period of time whilst their own mother's milk comes in'. Sometimes they have as little as half a millilitre every four hours but it helps to 'prime the gut' - to make sure the stomach is prepared for food.

Beneficial for recipient and donor
'Breast milk is much better tolerated than formula and of course contains the all-important immune components,' adds Gillian. Giving premature babies breast milk increases their chances of survival and helps their long-term development. It also takes the pressure off the mother, who may be unable to breastfeed due to sickness or stress.

'We hear a lot about those mothers unable to produce enough milk, and while, of course, milk banks are a Godsend to these women, they're also invaluable to those who have so much milk it's uncomfortable,' says Sandra Tanner from the Association of Breastfeeding Mothers (ABM). 'It's great that mums with a surplus can put it to good use instead of tipping it down the sink after the frustration of endless expressing.'

Another woman's milk
It's not unusual for some mothers to feel uncomfortable about their baby receiving the breast milk of another woman. 'Reactions range from delight to abject horror,' says Gillian Weaver. 'Some new mums feel so strongly, they'd rather use formula. Part of our job is educating new mums about the health benefits of breast milk for their babies.' 'Psychologically, there's no need to feel uneasy about giving your child the milk of another woman,' says Sandra Tanner of the ABM. 'After all, we're prepared to feed our babies formulas based on cow's milk. You're still physically feeding - the emotional attachment is still there.'

Your questions answered

Q. Who can donate milk?
A. So, can any breastfeeding mother be a milk donor? Yes, providing you don't smoke or use illegal drugs. All potential donors have to be tested for infections that may be passed on through the milk (see below). You don't need to produce a freezer-full, either. 'Every drop counts,' says Gillian Weaver. 'Small or sick babies benefit from even the smallest quantities of breast milk. Premature babies will often start with less than 20ml per day. One ounce of milk will feed a tiny premature baby for a day.'

Most mothers prefer to wait until they and their baby are confidently breastfeeding before they begin to express for the milk bank, although it's fine to start sooner if you have a large surplus of milk in the early weeks. Then you can continue for as long as you wish.

Q. Why is donor milk pooled?
A. There are several advantages. First, milk may not always be provided in the volumes needed. Secondly, because breast milk changes with every feed, and from the beginning to the end of every feed, pooling the milk means that it retains an average consistency of all the nutritional components.

Q. My wife doesn't want to breastfeed but I am keen that our baby gets the best start in life. Can our baby receive donor milk?
A. Milk banks are there to supply babies with a clinical need. At present, UK milk banks simply don't have the resources to supply milk for healthy, full-term babies.

Q. What health checks do donors undergo?
A. Breast milk donors are tested for HIV, hepatitis B and C, HTVL I and II (Human T-cell leukaemia viruses - rare in the UK), and syphilis. Donors are also required not to smoke, drink more than two units of alcohol a day, take drugs or consume excessive caffeine. All donated milk is also heat-treated (pasteurised) for extra safety.

Q. Will I get paid to donate milk?
A. Donors are not paid, primarily so that the banks can trust that the primary motive of the donor is to assist sick babies.

For more details send an SAE to Gillian Weaver, Milk Bank Manager, Queen Charlotte's and Chelsea Hospital, Du Can Road, London W12 0HS.