Vietnam Country Program

All babies should have access to lifesaving human milk: establishing the first human milk bank in Vietnam

Donated milk is screened and pasteurized before being properly stored, ready for distribution to infants in need. Photo: Cheshire and North Wales Human Milk Bank

In human milk banks, donated milk is screened and pasteurized before being properly stored, ready for distribution to infants in need. Photo: Cheshire and North Wales Human Milk Bank

Despite global gains in child health, 4.6 million babies still die in their first year of life—nearly 3 million in the first 28 days.[1] Known approaches could prevent a staggering 71 percent of these deaths, yet strategies to effectively implement and scale these crucial interventions are lacking.

Of all the known approaches, human milk has the greatest potential impact on child survival.[2] Scaling up breastfeeding to a near-universal level could prevent an estimated 823,000 deaths in children under the age of five years worldwide every year. However, social, political, and structural barriers still hinder the number of babies who receive human milk. According to Vietnam’s Ministry of Health, the rate of children exclusively breastfed during the first six months of their lives in Vietnam is only 19.6 percent, lower than 40 percent in Asia overall and the lowest in South East Asia.

Protecting Every Baby

Human milk is especially critical for the estimated 32.4 million babies in low- and middle-income countries—27 percent of live births—who are born sick, with low-birthweight, premature, or otherwise vulnerable.[3] Between 15 and 40 percent of vulnerable babies in neonatal units around the world lack access to their own mother’s milk, often because of maternal illness, death, or abandonment.

For these babies, human milk banks (HMBs) offer a lifesaving alternative to ensure timely access to human milk. HMBs collect, pasteurize, test, and store safe, donated milk from lactating mothers and provide it to infants in need, ensuring that even if babies cannot breastfeed, they still receive human milk as soon as possible. Importantly, HMBs are also key to protecting, promoting, and supporting breastfeeding, ideally positioned to provide lactation support for mothers. More than 37 countries have now developed HMB systems with robust quality control systems to ensure safe donor milk.

Compared with formula, donated human milk reduces the risk of sepsis, necrotizing enterocolitis, diarrhea, and feeding intolerance, as well as the time hospitalized infants remain in care. Recognizing these benefits, the World Health Organization and other health leaders have recommended the scale-up of HMBs as a proven intervention to improve infant health and survival.

Vietnam’s First Human Milk Bank (HMB)

PATH is now working with FHI 360’s Alive & Thrive platform to develop Vietnam’s first HMB, in partnership with the Maternal and Child Health Department, Ministry of Health, Danang Department of Health, and Danang Women and Children Hospital in central Vietnam. It receives donations of breast milk, screening and pasteurizing the milk before storing and distributing it to infants in need. With support from PATH and Alive & Thrive in sourcing high-quality equipment, developing HMB operational guidelines, standardizing operating procedures, and training staff, the HMB became operational in February 2017. The HMB in Danang has the potential to improve access to 3,000 to 4,000 at-risk infants every year.

Watch this video to see how the human milk bank works! 

Video: Alive & Thrive

The HMB in Vietnam follows PATH’s Mother-Baby Friendly Initiative Plus model (MBFI+), serving as a welcoming hub for all mothers (see below). This includes (1) mobilizing health care workers and communities to support and encourage breastfeeding, (2) providing safe, pasteurized donated milk from HMBs when mother’s milk isn’t available, and (3) enabling women and families to practice Kangaroo Mother Care (KMC), an effective method for infant survival that involves providing skin-to-skin contact to low-birthweight infants in addition to exclusive breastfeeding.

Following the MBFI+ model,
the HMBs should not only collect, process, and store human milk but also provide lactation and KMC support and engage local communities with regards to the importance of breastfeeding and milk donation. Implemented this way, HMBs have a greater impact: beginning a cycle in which outreach, promotion, and banking help more babies survive and thrive.

Throughout the development of the HMB, PATH and Alive & Thrive have worked closely with local partners to ensure local ownership of the initiative and develop country-specific strategies for promoting the use of human milk. PATH and Alive & Thrive are now working to support the HMB’s operations, and to gather evidence from this important intervention, in order to support the government of Vietnam to scale-up integrated HMB programs nationally.

Available materials

Fact sheets

Resources

 For more information, contact Dr. Nguyen Tuyet Nga, Vietnam Program Team Leader, at ntnguyen@path.org.

[1] Infant Mortality: situation and trends page. World Health Organization (WHO) website. Available at http://www.who.int/gho/child_health/mortality/neonatal_infant_text/en/. Accessed May 5, 2016.
[2] UNICEF. Adopting optimal feeding practices is fundamental to a child’s survival, growth and development, but too few children benefit. http://data.unicef.org/nutrition/iycf.html#. Accessed June 28, 2016.
[3] Lee A, Katz J, Blencowe H, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet. 2013;1:e26–36. doi: http://dx.doi.org/10.1016/S2214-109X(13)70006-8.