Breast milk is the best nutrition for babies and can be life-saving for premature babies. Unlike the rest of the world, Israel still doesn’t have a breast milk bank
Breast milk is known to be the best diet for babies. In many cases, such as nutrition for premature babies, it is a life-saving treatment. The wisdom of our ancestors emphasizes the importance of saving all souls: “Whoever saves a life, it is considered as if he saved an entire world.” (Mishnah, Sanhedrin 4:5). Israel invests in expensive emergency and routine medical care. Is saving lives limited just to the wounded and sick, or is it just as important to use preventative medicine for sickness and life-threatening situations?
The composition of breast milk adapts to the age of the newborn. Early milk (colostrum) is rich in specific vital proteins and sugars as well as important anti-inflammatory immune constituents. Later on the milk is rich in fat and insoluble protein milk (casein). Breast milk contains some 200 sugar types which are made up of mostly (60%) of lactose, which a baby can breakdown with the enzyme lactase, produced in the first 2-3 years of life, and also feeds the probiotics. The milk is adapted according to the type of mammal. For example, milk of marine mammals living in cold areas is richer in fat, and milk of mammals who do not require very tight treatment is richer in protein. This is beyond the specificity of the immune components according to species.
World Health Organization
The World Health Organization recommends exclusive breastfeeding for babies until the age of six months with the integration of extras later on. Yet, according to the organization, only 38% of babies receive breast milk for their first six months of life. The organization claims that not enough has been done to encourage breastfeeding and has set a target to increase the number of breastfed infants within a decade by 50%. The recommendation is designed to save lives; protect against infectious diseases, gastrointestinal diseases, respiratory diseases (asthma) and metabolic diseases (such as obesity). According to statistics over 20 million babies are born each year at a low weight (below 2.5 kg) and these are at higher risk for developmental delays and diseases. In these cases, the organization recommends that if you cannot breastfeed, the optimal nutrition is breast milk from a donor, provided that a milk bank service is available and safe. At a very low birth weight (less than 1.5 kg), the recommendation is a supplement based on breast milk with added minerals and vitamins.
The International Science Community
The medical journal The Lancet recently published a series of articles and recommendations on breastfeeding. Professor Cesar Victora, an officeholder at the universities of Oxford, Harvard and Johns Hopkins University, led an international team of 50 scientists for a comparative analysis (meta-analysis) of all the studies in the field. The team found that if a baby is not exclusively fed on breast milk in the first six months of life, the risk of death in childhood increases significantly. Breast milk not only protects from infectious diseases and digestive problems but also protects against leukemia, a cancer that is often caused by infectious diseases.
The benefit of breastfeeding is not only medical. Comparative analysis concluded that breastfeeding reduces hospitalization during childhood, increases intelligence, and increases productivity and income for the baby’s in adulthood. Therefore, the transfer of all babies to full breastfeeding for the first six months of life is expected to add more than $300 billion to world revenue.
In an interview with Victora regarding the series of articles he notes that it is the Western world where fewer mothers are breastfeeding due to the job market requirements. Therefore, the onus to breastfeed is not only on the mother but rather by the society, which needs to extend maternity leave, create a nursery at the workplace, limit the aggressive marketing of infant formula and provide lactation consultation.
Breastfeeding also has many advantages for the mother. For example, for every additional year of breastfeeding, there is a six percent decrease in the chance of the mother developing breast cancer. Epidemiologists calculated that an increase in breastfeeding will reduce breast cancer mortality rates, saving approximately twenty thousand women’s lives per year.
American Academy of Pediatrics
Professor (Emeritus) Arthur Eidelman, one of the founders of neonatology in Israel, led a team from the American Academy of Pediatrics to publish a policy paper in the field of breastfeeding confirming the findings of previous reports on the subject: breastfeeding reduces the incidence of diabetes, obesity, ear infections, respiratory infections, asthma, digestive tract diseases, neural-developmental delay, cardiovascular disease, retinal disease (retinopathy), hospitalizations, leukemia and others.
The Academy recommends that the diet for premature babies be based exclusively on breast milk. Such a diet heavily reduces the risk of necrotizing enterocolitis (NEC), which appears in a tenth of premature babies (especially those born weighing less than 1.5 kg) and can result in lifelong ailments. Premature infants that are fed breast milk have almost no NEC, unlike premature babies who receive formula supplements. The policy paper emphasizes that if there is a reason a premature baby cannot receive its mother's milk, a donor can supply the required breast milk but it is important for it to undergo pasteurization and testing through a breast milk bank. The European Society of Pediatrics and Nutrition issued similar recommendations.
The situation in Israel
Following the unequivocal medical recommendations, there currently exists over 500 breast milk banks worldwide that receive donor milk that undergoes pasteurization and testing. In Israel each year over twelve thousand premature babies are born with approximately 1600 weighing less than 1.5 kg.
In light of the clear advantages, earlier this year the Ministry of Health issued extensive guidelines towards establishing a human milk bank. Moreover, the guidelines emphasize that the construction cost of a human milk bank is significantly lower than the cost of the direct treatment for phenomena associated with of lack of breast milk nutrition; for example the costs of surgery for NEC.
The Ministry of Health stresses that a human breast milk bank will primarily be designed for small premature infants, babies with birth defects or deficiencies in the digestive tract and other health problems. A second priority will be given to larger premature infants, orphaned babies, adopted babies or those born via the surrogacy process and every baby where their mother's milk is not available.
For the bank, an “association for donations of breast milk” has been established. Among others, association members include: Professor Eidelman and Dr. Sharron Bransburg-Zabari, a scientist specializing in breast milk and the development of the immune system of newborns. Bransburg-Zabari cited the report on the state of premature babies in Israel, jointly published by the Israeli Neonatology Association, the Association for Premature Babies in Israel, and the Israel Forum for Premature Babies. According to the report, the mortality rate of premature babies (weighing less than 1.5 kg) is significantly higher in Israel compared to developed countries where breast milk banks exist and premature babies are solely fed on breast milk. For example, if premature mortality rates in Israel were the same as Japan, every year 138 lives of premature babies would have been saved, and the percentage of morbidity rates would be lower.
In light of the ongoing bureaucratic procedures of government offices, a human milk bank is still yet to be opened in Israel and there is as of yet no guarantee as to a budget. This article was not written to support a specific human breast milk bank, but rather to accelerate the government to complete the certifications on the issue and make sure there is an allocation of several millions as is needed for its operation. This is not only for economic factors, but will help save those most vulnerable and defenseless that are born into a society that belongs to us all.