Human Milk Bank Processes:
YOUR FACILITY AND LOCATION
Sertac Arslanoglu, MD
Associate Professor of
Neonatology
Head of the Department
of Neonatology
Izmır Dr. Behcet Uz
Chıldren’s Hospıtal, Izmır,
Turkey
Vıce President, EMBA
Scıentıfıc Dırector, AIBLUD
asertac@tiscali.it
+90 532 155 3002
Background info
Brief description
How did your human milk bank (HMB) began?
When?
The first human milk bank in Turkey has newly been established in İzmir in September
2012 (Department of Neonatology, Dr. Behcet Uz Children’s Hospital) (by Arslanoglu S
and Chıldren’s Hospıtal team with the support of Turkish Ministry of Health). Soon there
will be an official opening. The second bank is planned in Ankara.
Who provided initial funding? How are
ongoing operations funded? Integrated into
government services?
Mainly by Children’s Hospital
And partly from a charity foundatıon of Hospital (donatıons)
Who regulates /oversees HMB in your
country/region (if any)?
There is a close collaboration with Ministry of Health. Some regulatory measures and
foundation of a human milk bankıng association are planned. National guidelines will be
prepared. In the meantıme ınternational guıdelines are being followed.
How many HMBs are part of your system?
Where are they?
2 planned.
Is there a central HMB that processes milk
and distributes or many HMBs that process
milk and distribute? (Centralized vs decentralized)
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How many NICU/Neonatal wards/community
homes does each bank serve? Are they
collocated?
Our human milk bank is planned to serve to 2 NICUs .
How many babies does your facility/system
serve annually?
3000 babies a year
How many liters/year does your
facility/system process annually?
…..
How many donor mothers initiate donation to
your facility/system annually?
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Process
Brief description of processes
Staffing
•
•
1 responsıble doctor
1 full-time manager (nurse)
Donor recruitment
•
•
•
•
•
•
Information sharıng at admission of the babıes to the hospıtal
Pediatricians in the field
Press ( planned)
Regular courses at the obstetrıc wards (planned)
Distribution of the informatıon materia to the famıly doctor and pediatricians
(planned)
Website (planned)
Donor screening
•
•
•
Face to face interview, detailed health questionnaire
Blood testing (at the hospıtal’s central lab)
Milk microbiology
Recipient eligibility and
selection
•
•
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Planned for all preterm infants below 34 weeks
Preterm ınfants < 1500 g , <32 weeks have priority
Infants recoverıng from NEC or with intestinal problems
Handling and storage of
donor milk (from donation
to feeding)
•
•
At home monitoring of the temperature will be asked
In hospıtal and in the bank temperature is continuously monitored. Raw and
pasteurized milk is being conserved separately. All milk is rigorously labeled and
registered by a computerized system.
Process
Brief description of process
Transport of milk
•
•
By hospıtal’s transport car and Milk Bank Staff
Cold chain is being respected (thick walled containers )
Pasteurization
•
Holder
Tracking and record
keeping
•
•
Computerized system
Paper charts
Assessing milk quality and
safety (ie. microbiology
assays)
Pre pasteurization
Every pool from a singe donor is tested
Quality assurance
•
•
•
Post pasteurızatıon
Every 10 cycle
When there is a concern regarding the pasteurization
HACCP
Auto auditing the compliance yo guıdelınes
Hospıtal’s qualıty control team audit
Equipment/Location
Brief description of process
What is used/how many?
• Pasteurizer 1
• Freezers (lockable?) lockable yes, 4
• Refrigerators 1
Additional HMB equipment • Ex. lockable room 2
• Computers 1
requirements?
• Other Lamınar flow cabin, steriızer, macrocomponent
analyzer
Referral/feeder/depot
facilities?
• How many?
• Equipment requirements?
Neonatal ward equipment
requirements?
• System for tracking usage? Yes, computerized system
• Freezer? 2 more freezer are needed
Other?
Organizational Successes
Brief description of top 3-5 successes
Policy
• A Model of Human Milk Bankıng which takes into consideration «milk
kinship» (religious and cultural aspects)
Operational
• Health outcomes will be monitored after the opening of HMB
Technology
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Organizational Challenges
Brief description of top 3-5 challenges
Policy
Operational
Technology
• Milk kinship
• Creation of a milk bank model adapted to religion and cultural issues
Funding ıssues
• Pasteurization technique should be optimized (research)
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