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    In an unassuming room on the second floor of the Philippine Children’s Medical Center (PCMC), two young women of slight frame were seated at the pumping station. In their own special way, these women were saving lives by sharing their milk with babies whose mothers are too sick to feed them. Because, no matter how you look at it, breast milk is still the best food for babies.

    Gloria Ramirez, M.D., director of the Human Milk Bank of PCMC, shares how you can get the most out of breastfeeding, and maybe, even help other moms in the process.


    Breast Milk: The More You Empty It, The More You’ll Have
    According to Dr. Ramirez, one of the factors affecting a mom’s ability to breastfeed is early imprinting. If the baby is able to latch on to the breast within the first few hours after birth, the mom might be able to breastfeed for a longer period of time. That’s why doctors encourage rooming in; this holds true for mothers who gave birth via C-section as well. In such cases, it’s best that daddy holds the baby for the still weak mommy.


    During the first few days, Dr. Ramirez explains that lactation is hormonally governed. Afterwards, when true milk production sets in, it will be under autocrine control based on demand. In other words, the more you empty your breasts of milk, the more you will produce this important mixture. It is of utmost importance to empty your breasts after every feeding. If your baby did not consume all your milk in one feeding, then express and store it for future use. When you start going to work, pump till your breasts are empty, preferably at about the same time your baby usually feeds.


    Milk Production Naturally Decreases with Mixed Feeding
    A mom who worries that she doesn’t have enough milk for her baby will soon learn that she can produce more milk than her own baby needs. She can even donate her excess breast milk. The problem starts when you go the mixed feeding route. When you start alternating breast milk with milk formula, your breast milk production will decrease.

    Breast milk is best for babies because of its nutritional, protective, and neurodevelopmental
    Attributes. Dr. Ramirez says, “It is sad for a mother not to be able to breastfeed. Having to go back to work should not be an obstacle. Ask your company to provide a lactation station. The requirements for one are minimal: a freezer, a comfortable private seat, and a sink where moms can wash hands.”


    The Basics of Expressing Milk at Work
    The less bacteria, the better There are different methods of expressing breast milk: by hand, with a manual pump, or with an electric pump. Breast milk that is not directly suckled from the breast, no matter how it was extracted, is a breeding ground for various organisms. The least bacteria is found in milk expressed by hand. A full-term baby can safely consume pumped milk within four hours with no need for refrigeration. Keep it bacteria-free for 24 hours by refrigerating it. If baby cannot consume it in 24 hours, then the breast milk has to be frozen. Before giving it to baby, thaw it in the refrigerator overnight.

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    Expressing Milk for Premature Infants
    For premature infants or those with weak immune systems, breast milk has to be pasteurized
    for virological and bacterial safety. It is this need that led Dr. Ramirez to design a breast milk
    pasteurizer together with scientists at the Advanced Science and Technology Institute (ASTI) of the Department of Science and Technology (DOST). “A decade ago, pinagtatawanan ako when I was talking about the need to pasteurize breast milk,” Dr. Ramirez recounts. Now, many have realized its importance. Today, PCMC uses the prototype unit of the fourth generation of Dr. Ramirez’ breast milk pasteurizer. It is a table-top model controlled by a microchip to ensure that the accurate temperature is maintained at all times. Mass production of the PCMC-ASTI pasteurizer is in the works.


    Alay Gatas: Hope for the Less Fortunate
    The other brainchild of Dr. Gloria Ramirez is the Alay Gatas Community Program. This local initiative encourages lactating mothers to donate excess breast milk for babies whose mothers are in the Intensive Care Unit (ICU) of Philippine Children’s Medical Center (PCMC), or for babies who are themselves in the ICU and whose mothers cannot breastfeed. In 1997, this program won national recognition as a proactive community project. The first set of donors came from the barangays around the hospital; some of the moms are still donating to this day. These moms are no less than heroines. Though most of them come from urban poor communities, they do not receive any monetary remuneration for their efforts. Potential breast milk donors are screened, interviewed, subjected to medical tests, and taught the proper ways of expressing breast milk. The milk donations are then kept frozen in a refrigerator at the barangay
    health center, before being transported to PCMC. The pasteurizer makes sure that the donated milk is safe for babies.


    Alay Gatas, in essence, is the precursor of the milk banks. There are now similar milk banks in the country. However, only PCMC and Dr. Jose Fabella Memorial Hospital use pasteurizers. Babies in the ICU of other hospitals such as the Makati Medical Center, Polymedic General Hospital, St. Luke’s Medical Center, and others have also been availing of the collected breast milk at the PCMC Milk Bank.

    The ultimate dream is to help more and more babies. But like any other bank, the human milk bank keeps a “balance sheet” where withdrawals must be balanced by deposits. And the human milk banks are entirely dependent on volunteer donor mothers for “deposits.” If you want to help others, this is one way you can intimately share your blessings.


    ● Gloria Ramirez, M.D., director, Human Milk Bank of the Philippine Children’s Medical Center; charter and fellow, Academy of Breastfeeding Medicine


    Want to help? Contact Alay Gatas Headquarters at the Human Milk Bank, 2/F Philippine Children’s Medical Center, Quezon Avenue, Quezon City 1100 Philippines; Tel. 924-083 or 924-6601 local 354; pcmcmilkbank@yahoo.com

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