Buenos Aires/Rio de Janeiro - Brazil has the widest breast
milk bank network in the world equipped with the technology to treat
milk from HIV-positive mothers, enabling them to safely breastfeed
their healthy babies without the risk of infection.
With an impressive national network of 192 banks, Brazil has
spurred a trend across Latin America and some AIDS-hit African
countries.
Babies who are breastfed are six times more likely to survive
during the first two months of life, according to UNICEF, the United
Nations Children's Fund.
Breastfeeding also contributes to babies' cognitive development,
helps prevent anemia, and reduces the risk of ovarian and breast
cancer in mothers.
When AIDS surfaced in the 1980s and scientists discovered that HIV
could be transmitted through breast milk, most banks across the world
simply shut down.
Brazil took the controversial decision of keeping its banks open,
ensuring the safety of the milk through sterilization.
'We had a very great fight to keep the banks at work,' Franz
Novak, a human milk researcher at the Rio de Janeiro-based Oswaldo
Cruz Foundation (Fiocruz), told Deutsche Presse-Agentur dpa.
'Given that we worked with pasteurization at 62.5 degrees, over 30
minutes, we were sure that it de-activated HIV in human milk.'
Brazil's banks, like those in other parts of world, opened more
than half a century back, as a means of feeding children whose
mothers had insufficient or no milk at all. This was before the
arrival of infant formula.
At the initiative of the Brazilian health ministry and Fiocruz, it
grew into a national network by 1998, and is now decentralized with
outlets in more than 100 towns.
The banks procure breast milk from thousands of healthy women, who
have milk to spare and are willing to take the trouble of drawing and
donating it. All the women are clinically screened.
The milk then goes through a process of selection, classification
and pasteurization so that its quality is fully certified by the time
it reaches the babies.
Novak said the programme's philosophy is 'to recover lactation' in
women so they can then go on to breastfeed normally. Brazilian milk
banks give priority to 'low-weight babies and sick babies, especially
those sick with infections.'
The babies of HIV-positive mothers also benefit from this system,
but only while they are still in hospital.
'When they are released, we are not in a position to provide milk
for them, because they absorb a great volume,' Novak explained.
'These babies are normally born after a full gestation. They are
big.'
Given that appropriate pasteurization 'de-activates' HIV in human
milk, the infected mothers can have their own milk processed to feed
their babies.
'Mothers that are infected with HIV cannot put their babies to
their breasts. If the breasts are not stimulated (in this way), their
lactation is rapidly lost. The longest period we have achieved so far
with external stimulation is 30 days,' Novak said.
'But then it is very frustrating for them not to produce any more
milk,' he said, adding that doctors need to talk frankly to these
women about the short-lived lactation period.
'Otherwise, from the emotional point of view it is terrible for
their condition, even for their immunological state,' the researcher
stressed.
Apart from expanding its own network, Brazil plays a key role in
exporting its technology to banks across Latin America.
'This technology can be adapted to all countries in South America
because it was developed to deal with the reality of countries with
few resources,' Novak said.
In 1997, Venezuelan technicians were trained in Brazil, and the
latter's instruction manuals on breast milk banks were translated
from Portuguese into Spanish.
Brazil has extended support to Argentina, which now has two milk
banks. Uruguay has one bank, and others are planned in Ecuador, the
Dominican Republic, Honduras, Colombia and Cuba.
Last year, an Iberian-American network of human milk banks was
established at the Iberian-American Summit in Santiago, and is set to
provide methods and tools for distance and online training on
breastfeeding based on Fiocruz's experience.
Spain has closely followed the Latin American model. Brazil would
like to export this technology to the world, but that has proved more
challenging.
'We are discussing how to adapt our work to Africa. But there are
crucial differences, due to climate conditions, conditions of health
and hygiene, important questions for the cold chain,' Novak noted.
'Once collected, milk has to be kept at a low temperature, and
this is more complicated in Africa.'
Extra funds would ensure that Brazil's breast milk bans remain
open, but it's illegal for banks to pay women for their milk.
As Novak puts it, poorer nations know they have little choice but
to encourage breast milk donations. 'For us as a society it is very
difficult to buy modified milk for (premature) children. It is very
expensive.'
USA
Your Talkback on this Story