Latin American breast milk banks catch on worldwide August 3-8 in Mexico City (Feature)

By Veronica Sardon Jul 29, 2008, 5:10 GMT

Buenos Aires/Rio de Janeiro - Brazil has the widest breast milk bank network in the world equipped with the technology to treat milk from HIV-positive mothers, enabling them to safely breastfeed their healthy babies without the risk of infection.

With an impressive national network of 192 banks, Brazil has spurred a trend across Latin America and some AIDS-hit African countries.

Babies who are breastfed are six times more likely to survive during the first two months of life, according to UNICEF, the United Nations Children's Fund.

Breastfeeding also contributes to babies' cognitive development, helps prevent anemia, and reduces the risk of ovarian and breast cancer in mothers.

When AIDS surfaced in the 1980s and scientists discovered that HIV could be transmitted through breast milk, most banks across the world simply shut down.

Brazil took the controversial decision of keeping its banks open, ensuring the safety of the milk through sterilization.

'We had a very great fight to keep the banks at work,' Franz Novak, a human milk researcher at the Rio de Janeiro-based Oswaldo Cruz Foundation (Fiocruz), told Deutsche Presse-Agentur dpa.

'Given that we worked with pasteurization at 62.5 degrees, over 30 minutes, we were sure that it de-activated HIV in human milk.'

Brazil's banks, like those in other parts of world, opened more than half a century back, as a means of feeding children whose mothers had insufficient or no milk at all. This was before the arrival of infant formula.

At the initiative of the Brazilian health ministry and Fiocruz, it grew into a national network by 1998, and is now decentralized with outlets in more than 100 towns.

The banks procure breast milk from thousands of healthy women, who have milk to spare and are willing to take the trouble of drawing and donating it. All the women are clinically screened.

The milk then goes through a process of selection, classification and pasteurization so that its quality is fully certified by the time it reaches the babies.

Novak said the programme's philosophy is 'to recover lactation' in women so they can then go on to breastfeed normally. Brazilian milk banks give priority to 'low-weight babies and sick babies, especially those sick with infections.'

The babies of HIV-positive mothers also benefit from this system, but only while they are still in hospital.

'When they are released, we are not in a position to provide milk for them, because they absorb a great volume,' Novak explained. 'These babies are normally born after a full gestation. They are big.'

Given that appropriate pasteurization 'de-activates' HIV in human milk, the infected mothers can have their own milk processed to feed their babies.

'Mothers that are infected with HIV cannot put their babies to their breasts. If the breasts are not stimulated (in this way), their lactation is rapidly lost. The longest period we have achieved so far with external stimulation is 30 days,' Novak said.

'But then it is very frustrating for them not to produce any more milk,' he said, adding that doctors need to talk frankly to these women about the short-lived lactation period.

'Otherwise, from the emotional point of view it is terrible for their condition, even for their immunological state,' the researcher stressed.

Apart from expanding its own network, Brazil plays a key role in exporting its technology to banks across Latin America.

'This technology can be adapted to all countries in South America because it was developed to deal with the reality of countries with few resources,' Novak said.

In 1997, Venezuelan technicians were trained in Brazil, and the latter's instruction manuals on breast milk banks were translated from Portuguese into Spanish.

Brazil has extended support to Argentina, which now has two milk banks. Uruguay has one bank, and others are planned in Ecuador, the Dominican Republic, Honduras, Colombia and Cuba.

Last year, an Iberian-American network of human milk banks was established at the Iberian-American Summit in Santiago, and is set to provide methods and tools for distance and online training on breastfeeding based on Fiocruz's experience.

Spain has closely followed the Latin American model. Brazil would like to export this technology to the world, but that has proved more challenging.

'We are discussing how to adapt our work to Africa. But there are crucial differences, due to climate conditions, conditions of health and hygiene, important questions for the cold chain,' Novak noted.

'Once collected, milk has to be kept at a low temperature, and this is more complicated in Africa.'

Extra funds would ensure that Brazil's breast milk bans remain open, but it's illegal for banks to pay women for their milk.

As Novak puts it, poorer nations know they have little choice but to encourage breast milk donations. 'For us as a society it is very difficult to buy modified milk for (premature) children. It is very expensive.'