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In Nepal, although Neonatal and child health has been improved from the decades but the declining rate of mortality and morbidity rate has not been improved. Every year, around 15 million babies are born preterm around the globe. In lower-middle-income countries like Nepal, an estimated 81,000 babies are born preterm. Children face the highest risk of dying in their first month of life and preterm and low birth weight babies are at even higher risk. According to the Nepal Multiple Indicator Cluster Survey (NMICS) 2019, the neonatal mortality rate (number of deaths per 1000 live births during the first 28 days of life) in Nepal is 16. Similarly, the infant mortality rate (number of deaths per 1000 live births, which are under 1 year of age) is 25 and the under-five mortality rate is 28 per 1000 live births.
Exclusive breastfeeding has the potential to prevent 13 per cent of under-five deaths globally each year. Early initiation of breastfeeding within the first hour of birth in addition to exclusive breastfeeding can cut down 22 per cent of all newborn deaths worldwide. In Nepal, only 42 per cent of children under 2 years of age are breastfed within one hour of birth and 62 per cent of children under six months are exclusively breastfed, according to NMICS 2019.
Objectives
•To ensure that every baby born or admitted to the hospital receives mother's milk.
•To avoid bottle, animal & formula milk.
•To heighten breastfeeding awareness.
•Ancillary support to breastfeeding practices.
•To promote Baby Friendly Hospital care.
Why Breast milk Bank in Dhulikhel Hospital?
•The first priority for infant feeding is to encourage the use of infant's mother's breast milk, but when this is not possible, donated breast milk is the second best option.
•Human milk protects premature infants, low birth weight infants from necrotizing entero colitis and from sepsis.
•Human milk Bank provides mothers with an alternative to infant feeding such as lactogen, cow's milk, and buffalo milk.
•Establishing breast milk bank is necessary as breast milk cannot be substituted and wet nurses are not easily available and it would not be possible to produce breast milk in large quantity from wet nurses
•The lactating mothers discard the excess breast milk and if breast milk banks were established, the interested mothers would have a chance to provide surplus amount without compromising on her own baby's requirements
•Since Dhulikhel Hospital covers wide range of area with numbers of outreach centres.
Therefore, it is our forth and effort to establish the human milk bank in Kathmandu University Dhulikhel Hospital, Dhulikhel, Kavre inside the premises of the postnatal ward. It will help to ensure that every baby born or admitted receives mother's milk. It will help to promote Baby friendly Hospital care by avoiding formula and bottle milk. It will help in provide ancillary support to breastfeeding practices and heighten breastfeeding awareness.
Recipients
•Absent or insufficient lactation
•For babies of non-lactating mothers, who adoptneonates and if induced lactation is not possible.
•Abandoned neonates and sick neonates.
•Temporary interruption of breastfeeding.
•Infant at health risk from breastmilk of the biologicalmother.
•Babies whose mother died in the immediatepostpartum period.
Infrastructure
•partitioned room of 250 square feet for lodging equipment, work area for technical, area for counselling
•Provision of music/television:1
•Pasteurizer/Shaker-water bath (1): it should be double walled and made of steel, with tray capacity of 9-24 containers of 200-400 ml
•Deep freezer (2): Digital display of temperature inside it with an alarms setting.
•Refrigerators
•Breastmilk pumps
•Containers: For collection and storing the milk, singleuse hard plastic containers of polycarbonates, Pyrexor propylene are used worldwide
•Generator for continuous supply of electricity
•Cooler Boxes (for transportation)
•laboratory system for screening of serology
•computer and IT services
•Staffing requirement and training
•personal protective barriers (Sterile gloves, gown, mask, cap)
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