Letter from the Director
Happy New Year to all! When you read this issue of our newsletter you will see that MMBNE has been making wonderful progress in many areas in the last few months. Our traveling Medical Director, Dr. Kathleen Marinelli, has been lecturing about the value of breastfeeding and donor milk all over New England, New York and even Spain. She also attended a meeting of the FDA about breastfeeding and donor milk banking. Her comments are available online, as are comments from others.

Our lab construction is finally fully complete and we are setting up and testing our lab equipment in anticipation of beginning to process our own milk. MMBNE has been awarded a Breastfeeding Friendly Employer Award by the Massachusetts Breastfeeding Coalition. Three New England hospitals — Connecticut Childrens' Medical Center, Brigham and Women's Hospital, and Concord Hospital — are now using donor milk as standard of care in their NICUs, and six more are in the process of establishing similar protocols and budgets in their nurseries and NICUs.

We appreciate every generous donation to MMBNE in 2010. Your donations are providing funds that are vital to making donor milk accessible to all babies in need in our region. If you did not have a chance to send your tax-deductible contribution before the end of the year, a donation in the new year will be gratefully accepted.

Thank you to all of you who have given of your time, creativity or professional expertise and to the many new mothers who have called and emailed offering to donate milk. All of our accomplishments and progress over the last four years are due to the dedication and energy of MMBNE supporters and volunteers throughout New England and beyond.

Naomi Bar-Yam Ph.D.
Executive Director

Medical Director attends Surgeon General's Call to Action
Dr. Kathleen Marinelli, MMBNE’s Medical Director, was thrilled to be present at George Washington University for the Surgeon General’s Call to Action on Breastfeeding on January 20. (View the webcast online.) Here is her enthusiastic first-person account:

Wow! I am here in Washington DC, attending the United States Breastfeeding Committee (USBC) meeting as the representative from the Academy of Breastfeeding Medicine. But I was asked to come to town early to be a part of the USBC media response team for the Surgeon General's Call to Action on Breastfeeding, which occurred on Thursday, January 20 at George Washington University. I witnessed history, and it was an absolute thrill to be there and to experience the electricity in the room! It is an amazing document that is truly a gift to the breastfeeding community and to mothers, babies, and families in the US.

The main message of the document is one of improving SUPPORT for breastfeeding; everyone can help make breastfeeding easier. It contains twenty action items with implementation suggestions, that cover virtually everything one could put on their wish list to help support breastfeeding. Of interest to us in particular, Action 12 is "Identify and address obstacles to greater availability of safe banked donor milk for fragile infants.”

I am truly honored to be here, and to be a small part of the changing landscape of breastfeeding in the United States. We have entered a new era in which breastfeeding support has taken on a whole new meaning and importance, and we will all be able to make these changes happen in our lifetime. Our community has cause to celebrate the leadership of Dr. Regina Benjamin!

Kathleen A. Marinelli MD, IBCLC, FABM, FAAP

MMBNE Receives Award from MA Breastfeeding Coalition
In October, the Milk Bank received a 2010 Breastfeeding-Friendly Business and Employer Award from the Massachusetts Breastfeeding Coalition. The Employer Awards are given out in recognition of employers in Massachusetts who actively support the efforts of their employees who want to continue breastfeeding when they return to work after maternity or adoptive leave.

The Awards were showcased at MBC’s Annual Conference “Breastfeeding in the Bay State” held on October 18, 2010 at the Massachusetts Medical Society Headquarters in Waltham and attended by over 150 health care professionals.

Kelli Purchase, MMBNE’s Laboratory Director, explains her nomination of the Milk Bank for the award:

I've been working for the Milk Bank for under a year, but from day one, Naomi [Executive Director Naomi Bar-Yam] and my fellow coworkers have been very supportive of my nursing relationship with my son Henry, who recently turned three. We meet weekly, and often Henry will join us at the table for the staff meeting, where he will perhaps color on some paper, or more often than not, latch on and happily enjoy the meeting with us. No one has ever batted an eye as he climbs on my lap and asks for "ma-ey milk".

It is absolutely lovely to work for an organization that not only values breast milk as a food, but also understands the bond that a mother and child have. I do hope that other employers will look on and learn that it is possible to support a working mother, whether in the form of a private pumping room or by welcoming a “new coworker” like Henry.

Roopesh and Sumitha Mathur live in Lebanon, New Hampshire. Their daughter Diya was born in 2004, and in early 2010, Sumitha was pregnant with their second child. They expected their baby to be born in early May, but in February, their obstetrician suspected something unusual about the baby’s development. In fact, an ultrasound on March 11 revealed that the baby was suffering from intrauterine growth restriction (IUGR), a condition in which the placenta no longer supplies enough nutrition to the baby, which necessitates immediate delivery.

The doctors induced labor and Nikhil was born on March 15 at the Dartmouth-Hitchcock Medical Center. Though he arrived eight weeks early, weighing 2 pounds and one ounce, he was relatively healthy for such a tiny fellow and he took up temporary residence in the NICU. Sumitha began expressing breastmilk for her baby and storing it for his future use. When he was approximately 4 weeks old, he began to be fed her milk through his feeding tube.

In April, Nikhil was given medication for Patent Ductus Arteriosus (PDA), a condition where the ductus arterious that bypasses the lungs in-utero and usually seals itself off soon after birth, is still open. His blood pressure shot up as a result of his underdeveloped kidneys’ inability to clear the medication, but his doctors were able to control this with medications (Propraponol and then Analepril). By early May Nikhil weighed around 4 pounds and the state of his health was steadily improving and stabilizing. He came home at around the time of his original due date in May.

Sadly, on June 19th, Roopesh and Sumitha suffered the death of their beloved daughter Diya, due to an unexpected, acute flare-up of a genetic disorder that had hitherto been under control. At this time, Sumitha stopped expressing breastmilk, and her stored milk ran out at the end of June. Consequently, Nikhil’s doctors suggested replacing it with a special formula designed for premature babies which contains high levels of protein and other nutrients.

Periodic testing of Nikhil’s kidney function determined that the amount of protein in an all-formula diet could not be processed by his growth-restricted kidneys and the protein leakage could cause permanent damage. In August, his pediatrician and his nephrologist (physician specializing in kidney care) prescribed breastmilk and suggested finding a milk bank.

Roopesh contacted Andrea Suh, MMBNE’s Outreach Director, and Nikhil received his first shipment of donor milk from MMBNE in August. His doctors at DHMC, with assistance from MMBNE, tried to convince the family’s private insurance to cover the costs. In fact the hospital even devoted the full-time efforts of a staff member to the assignment of following-up with the insurance company, but with unsatisfactory results.

In the meantime, both Nikhil and his mother Sumitha are demonstrating quiet fortitude in the face of their challenges: Nikhil was introduced to solids in October and is “very interested in food!” says his father; Sumitha is pumping again and, with the aid of galactogogues and determined perseverance, she is producing 4-6 oz. of milk a day!

At nine months old, Nikhil weighs 13 pounds, and he is a healthy, thriving baby. He is still on Analepril to control the protein leakage through the kidneys, which will continue until the testing shows that he has outgrown the problem. In addition to solid food, he consumes two to three 6 oz. bottles of breastmilk a day, a combination of human donor milk from MMBNE and his mother’s milk. Sumitha intends to continue pumping in order to provide him with her own milk at least until he reaches one year of age, when she plans to introduce cow’s milk.

All of our best wishes go out to the Mathur family for peace and health as they continue to delight in Nikhil and our condolences for the untimely death of their precious daughter Diya.