Impact of involvement of NGO in strengthening breast feeding practices and milk donation in a resource limited health care facility

Background:
Early initiation of breastfeeding and exclusive breastfeeding for the first six months of life are crucial for the growth, development, and survival of new-borns. Early breastfeeding significantly reduces infection-related infant morbidity and mortality and is one of the most cost-effective interventions for lowering neonatal mortality rate (NMR) and infant mortality rate (IMR). However, in many healthcare settings, particularly resource-limited centres, establishing successful lactation remains a challenge due to short hospital stays and limited staff availability.

Methods:
This study was conducted at Chhatrapati Shivaji Maharaj Hospital (CSMH), a 500-bedded tertiary care hospital in Kalwa, Thane, attached to the Thane Municipal Corporation. CSMH has established its own human milk bank, which collects milk from lactating mothers and distributes it to neonates in need. As per hospital protocol, women who deliver vaginally are discharged within 48 hours, and those undergoing caesarean section are discharged on the 5th day. This short duration often does not allow adequate time for lactation establishment or confidence building in mothers. To address this gap, a mother-support group was initiated to promote and counsel mothers on the importance of breastfeeding and milk donation. Given the high workload of hospital staff and time constraints, and taking into consideration the comfort level of mother in communicating with elderly women who are non-medicos and themselves being mother have a very good potential in supporting lactating mothers which can definitely avoid unnecessary use of formula feeds because of various misconceptions.

Results:
Over a period of 299 days, counselling sessions were conducted by trained counsellors, motivating lactating mothers to donate excess breast milk. A total of 1,389 human milk donors were registered, and 3,490 mothers were counselled. As a result, 265 newborns received donor human milk, and 123.54 litres of breast milk were collected.

Significant improvements were observed between 2016 and 2018:

·         Human milk collection increased from 31.06 litres annually to 83.25 litres.

·         Donor registrations rose from 472 in 2016 to 1,128 in 2018.

·         Newborn recipients increased from 52 in 2016 to 179 in 2018.

·         A statistically significant reduction in hospital visits for illnesses among children during the first six months of life was noted.

Conclusions:
In resource-limited centers with overburdened hospital staff, community-based self-help groups trained in lactation management can play a vital role in supporting breastfeeding practices and human milk donation. This model not only improves donor participation and milk availability but also enhances neonatal health outcomes by reducing dependence on formula feeds and decreasing infection-related morbidity. The CSMH experience highlights that empowering mothers through peer support and structured counselling is a sustainable strategy to strengthen breastfeeding practices and reduce infant mortality

Dr. Sandhya Khadse is  a Paediatrician specializing in Neonatal Nutrition and Human Milk Banking, she holds a MD degree and she is fellow of Indian academy of Paediatrics she has worked with UNICEF and WHO and is National expert for human milk banking in India and technical expert group committee member for global guidelines she has published 176 papers, she currently the Dean at MGM Medical College, Nerul Navi Mumbai