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DONOR HUMAN MILK BANKING DEVELOPING A FOUNDATION FOR KENYA

Presenter Betty Samburu Deputy Head Nutrition and Dietetics Services-MOH. DONOR HUMAN MILK BANKING DEVELOPING A FOUNDATION FOR KENYA. Global strategy on infant and young child feeding. WHO and UNICEF developed the global strategy for IYCF in 2002

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DONOR HUMAN MILK BANKING DEVELOPING A FOUNDATION FOR KENYA

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  1. Presenter Betty Samburu Deputy Head Nutrition and Dietetics Services-MOH DONOR HUMAN MILK BANKINGDEVELOPING A FOUNDATION FOR KENYA

  2. Global strategy on infant and young child feeding • WHO and UNICEF developed the global strategy for IYCF in 2002 • The AIM of the GS was to revitalize world attention on the impact feeding practices have on: • Nutritional status • Growth and development • Health • Survival of infants and young children

  3. Background BF a pillar for child survival. • Prevents 823,000 deaths annually • Reduce 72% & 57% of all admissions for diarrhea and URTI respectively • Promotes sensory and cognitive development (IQ by 3 points) Long-term • Prevents 20,000 cases of cancer in women annually • Prevents adult onset diabetes WHO recommendation for breastfeeding Immediate initiation of Breastfeeding Exclusive breastfeeding for first six months Sustained breastfeeding for 2+ years alongside appropriate, adequate and safe complementary feeding from6 months • Optimal maternal nutrition, social and community support

  4. Importance of IYCF (BF & CF) in child survival BF & CF = single largest impact on child mortality of all preventive interventions : 19% Source: Lancet Child Survival Series 2003/2013

  5. Malnutrition –single greatest contributor to child mortality. It accounts for more than a half of deaths among under-fives. • None BF infants and children have a 7 fold and 5 fold greater risk of death from diarrhea diseases and RTI respectively.

  6. Premature and LBW infants have nutrition challengesHigh Growth Rate and Nutrient Accretion

  7. Window of opportunity: pregnancy to 2 years Mean anthropometric z-scores by age for 54 studies, based on WHO standards BF+CF Exclusive BF Source: Victora et al. Pediatrics, 2010 Mar;125(3)

  8. Innocent declaration 1990 Declared that: All women should be enabled to practice exclusive breastfeeding for upto 6 months and continued breastfeeding for up to two years or beyond. Recognizing the importance of breastfeeding Convinced of importance of  Exclusive BF for 6 months and extended duration of breastfeeding

  9. WHO AND UNICEF (2002) Global strategy Called upon countries to provide guidance on feeding of infants & young children in exceptionally difficult circumstances (ACTION 8) WHO & UNICEF developed the global strategy with 9 operational targets/Actions which countries were to implement with the aim of improving child survival In cognizance that some children may have difficult accessing their own mothers breast milk

  10. Kenya Adoption of the Global Strategies MIYCN Policy guidelines MIYCN strategy

  11. Strategies in Kenya MIYCN Strategy 2012-2017 Strategic objective 3.5 To ensure appropriate MIYCN practices for infants and children in difficult situations lBW and preterm without access to own mothers milk Hospitalized infants during and after illness Orphaned and children separated from their mothers Infant and young children in emergency situation Term babies without accesss to mothers own milk There is a gap for hospitalized children like the LBW and abandoned infants who cannot access their own mothers breast milk Difficulty in reaching Most infants Most focus has been in the management of malnutrition

  12. Recommendation-Donor Human Milk • For low-birthweight or preterm, infants who do not have access to their mother’s own milk, WHO recommends donor human milk (DHM) from a human milk bank (HMB) as the best alternative2 • Infants who cannot be fed their mother’s own milk. • Infants who cannot be fed or who need to be supplemented, especially low-birthweight infants, including those with very low birth weight and other vulnerable infants, should be fed donor human milk. (WHO 2018)

  13. Developing a foundation-Methodology • The Ministry of Health, with the support of PATH, recognized the need to establish an integrated HMB model with nutrition and newborn programming3 • The Mother Baby Friendly Initiative plus (MBFI+), integrates HMB services with breastfeeding promotion and Kangaroo Mother Care for optimal neonatal outcomes through a phased approach4,5

  14. PHASE 1: Establishing a foundation

  15. Phases II And III: Implement and Evaluate

  16. Conclusion • Human Milk Banks allows access to safe human milk for vulnerable and sick infants who do not have access to their mother’s own milk to reduce early neonatal and postnatal morbidity and mortality for babies who cannot breastfeed • Breastfeeding promotion is paramount as the scale up continues

  17. THANK YOU

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