Associated Press - Sunday October 7, 2001
Connie Mabin, Associated Press Writer

Madeleine entered the world in quite the opposite fashion. She arrived two months early on April 8, weighing just 1 pound, 14 ounces. Her size and weak immune system meant the first months of her life were spent in the neonatal intensive care unit at Seton Hospital, an incubator as her cocoon. Machines recorded her heart rate, pulse, blood pressure and oxygen levels.

With her mom unable to produce enough breast milk to keep up with Madeleine's needs, a doctor recommended Mothers' Milk Bank, an organization in Austin that collects donated breast milk for babies in need.

The milk is delivered first to the most critical premature babies in central Texas, and then beyond.

Durkin-Drga believes the donated milk helped her daughter gain a healthy footing. At 6 months, an age when full-term healthy newborns are expected to double their birth weight, Madeleine weighs 11 pounds, about the size of a healthy, full-term 3-month-old.

"She has no residual effects at this point of being premature other than just being tiny for her age. She's looking like your pretty standard, typical chubby baby. I'm convinced that's because of the breast milk," Durkin-Drga said.

The bank, which serves mostly preemies but also babies who have lost their mothers, was formed in 1998 by a group of Austin neonatologists. It is one of four in the nation; the others are in San Jose, Calif.; Denver; Newark, Del.; and Raleigh, N.C.

Elizabeth Bruns, a mother of two from San Marcos, is one of 400 women in Texas who signed up to donate this year.

"I had tons of milk. I mean, a lot," Bruns said. "I didn't want to throw it away."

Between caring for her own young children, she surrendered multiple hours to the careful and rigorous screening process.

Donors must answer health- and diet-related questions during a short phone interview. If the interview is successful, they are asked to complete an application and get medical release forms from their doctor and their baby's doctor. Their blood is screened for HIV, hepatitis and other diseases.

Only then are they asked to give a minimum of 100 ounces of milk, which is also tested for bacterial growth. If that test is clear, the milk is pasteurized and tested again.

For Bruns, it was all worth it.

"Not everyone can do it, so if you can do it I think it's one of the most rewarding things to know that you are really helping some child who's not going to be able to thrive without it," she said.

Milk banking is not new, but it is uncommon.

Before formula was available, lactating women commonly nursed children of mothers who could not breast-feed. Donors were called "wet nurses."

The first known milk bank was formed in Boston in 1911 by two doctors who were worried about the number of deaths at an orphanage where they worked. The practice grew, mostly in Europe, as technology made it easier and safer to collect, pasteurize and store donated breast milk.

Milk banking declined in the 1950s when formula was mass-produced and marketed. By the 1980s, fear of AIDS contributed to the slowdown.

The founding doctors at the Austin milk bank were inspired to revive banking because of their belief that breast milk is the healthiest nourishment for babies, particularly vulnerable preemies, said Ana Mejia-Dietche, the bank's former executive director.

Formula or cow's milk can build up in the intestines of premature babies and cause an infection called necrotizing enterocolitis. "If they get a mild case they can treat it with antibiotics but it can mean lots of surgeries for lots of babies, or even death," she said.

Dr. Rodolfo Barrera, a pediatrician in Austin, said breast-fed babies are significantly less likely to contract the infection. Whether the milk comes from the biological mother or is donated, health care providers believe antibodies in the milk reduces the babies' risk for respiratory infections as well as meningitis and juvenile diabetes.

A healthy, full-term newborn can consume between 15 and 30 ounces of milk a day, depending on size. The Austin bank pasteurizes up to 7,000 ounces of breast milk a month. The cleansing does not reduce the health benefits of the milk.

"The supply and demand here can change quickly," said Gretchen Flatau, interim director at the Austin bank. "We have received a slight increase in calls and e-mail since Sept. 11 from potential donors and we assume there may be an increased sensitivity to the need for human milk donations."

Officials at the bank also hope to get a boost from a state law that went into effect only last month. It creates state oversight of the bank, similar to the regulation of blood banks, with the goal of allaying fears of doctors and parents about transferring disease through donated milk. Barrera said the intense cleansing and testing of the milk is stricter than testing blood.

Additionally, Mejia-Dietche said, "the combination of doing all that screening, the pasteurization and the deep freezing" is likely to kill any disease.

To Durkin-Drga, the donations are simply selfless acts of kindness. "That's the neat part - helping in a selfless way. You have no idea who's getting it," she said. "It is a wonderful gift. I'd like to thank every woman who's ever donated to a milk bank. I'm really convinced that's why my daughter's doing so well."
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