human milk bank processes: your facility and location sertac arslanoglu, md associate professor of...
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Human Milk Bank Processes: YOUR FACILITY AND LOCATION
Sertac Arslanoglu, MDAssociate Professor of Neonatology
Head of the Department of NeonatologyIzmır Dr. Behcet Uz Chıldren’s Hospıtal, Izmır, Turkey
Vıce President, EMBA
Scıentıfıc Dırector, AIBLUD
[email protected]+90 532 155 3002
Background info
Page 2
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 HospitalAnd 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 de-centralized)
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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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ProcessBrief 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
• 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.
ProcessBrief 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
Post pasteurızatıonEvery 10 cycleWhen there is a concern regarding the pasteurization
Quality assurance • HACCP• Auto auditing the compliance yo guıdelınes• Hospıtal’s qualıty control team audit
Equipment/LocationBrief description of process
What is used/how many? • Pasteurizer 1• Freezers (lockable?) lockable yes, 4• Refrigerators 1
Additional HMB equipment requirements?
• Ex. lockable room 2• Computers 1• 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
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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
Organizational Challenges
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Brief description of top 3-5 challenges
Policy • Milk kinship• Creation of a milk bank model adapted to religion and cultural issues
OperationalFunding ıssues
Technology • Pasteurization technique should be optimized (research)