Department of Surgery and Cancer, Imperial College London, London, UK.
Human Milk Foundation, Rothamsted Institute, Hertfordshire, UK.
Matern Child Nutr. 2021 Jul;17(3):e13131. doi: 10.1111/mcn.13131. Epub 2021 Jan 6.
If maternal milk is unavailable, the World Health Organization recommends that the first alternative should be pasteurised donor human milk (DHM). Human milk banks (HMBs) screen and recruit milk donors, and DHM principally feeds very low birth weight babies, reducing the risk of complications and supporting maternal breastfeeding where used alongside optimal lactation support. The COVID-19 pandemic has presented a range of challenges to HMBs worldwide. This study aimed to understand the impacts of the pandemic on HMB services and develop initial guidance regarding risk limitation. A Virtual Collaborative Network (VCN) comprising over 80 HMB leaders from 36 countries was formed in March 2020 and included academics and nongovernmental organisations. Individual milk banks, national networks and regional associations submitted data regarding the number of HMBs, volume of DHM produced and number of recipients in each global region. Estimates were calculated in the context of missing or incomplete data. Through open-ended questioning, the experiences of milk banks from each country in the first 2 months of the pandemic were collected and major themes identified. According to data collected from 446 individual HMBs, more than 800,000 infants receive DHM worldwide each year. Seven pandemic-related specific vulnerabilities to service provision were identified, including sufficient donors, prescreening disruption, DHM availability, logistics, communication, safe handling and contingency planning, which were highly context-dependent. The VCN now plans a formal consensus approach to the optimal response of HMBs to new pathogens using crowdsourced data, enabling the benchmarking of future strategies to support DHM access and neonatal health in future emergencies.
如果无法获得母乳，世界卫生组织建议首选巴氏消毒的捐赠人母乳（DHM）。母乳库（HMB）对母乳捐赠者进行筛查和招募，DHM 主要用于喂养极低出生体重儿，降低并发症风险，并在与最佳母乳喂养支持同时使用时支持产妇母乳喂养。COVID-19 大流行给全球的 HMB 带来了一系列挑战。本研究旨在了解大流行对 HMB 服务的影响，并制定关于风险限制的初步指导。一个由来自 36 个国家的 80 多名 HMB 领导者组成的虚拟协作网络（VCN）于 2020 年 3 月成立，其中包括学者和非政府组织。各个母乳库、国家网络和地区协会提交了有关 HMB 数量、DHM 产量以及每个全球地区受助者数量的数据。在数据缺失或不完整的情况下进行了估计。通过开放式提问，收集了每个国家的母乳库在大流行的头 2 个月的经验，并确定了主要主题。根据从 446 个单独的 HMB 收集的数据，全世界每年有超过 80 万名婴儿接受 DHM。确定了与服务提供相关的 7 个与大流行相关的具体脆弱性，包括充足的捐赠者、预筛查中断、DHM 供应、物流、沟通、安全处理和应急计划，这些都高度依赖于具体情况。VCN 现在计划使用众包数据对 HMB 对新病原体的最佳反应采用正式共识方法，以便为未来的战略提供基准，以支持未来紧急情况下的 DHM 获得和新生儿健康。
