Milk Banks and Moms: How Your Extra Breastmilk Can Save Lives with @ucmilkbank Alison Wolf, CPNP, IBCLC

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<v SPEAKER_1>Something that I did not anticipate that I would not love as a parent of school-age kids is making my kids' school lunches.

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<v SPEAKER_1>September is baby safety month and my favorite baby feeding gear brand, Easy Peasy, is having a major sale.

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<v SPEAKER_1>Sale ends September 29th.

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<v SPEAKER_2>We say about one pump bag of milk, so that 4-6 oz, 2-6 oz of milk can feed a micro-preemie for an entire day.

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<v SPEAKER_2>That you're able to provide that nutrition and protect them against necrotizing and tericlytis.

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<v SPEAKER_2>Even if it's one bag a day, it makes a huge difference in these babies' life.

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<v SPEAKER_1>Hey there, I'm Katie Ferraro, Registered Dietitian, College Nutrition Professor and Mom of 7, specializing in Baby-Led Weaning.

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<v SPEAKER_1>Here on the Baby-Led Weaning with Katie Ferraro podcast, I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using Baby-Led Weaning.

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<v SPEAKER_1>If you are a breastfeeding, chestfeeding parent, this episode is for you.

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<v SPEAKER_1>I'm currently in the process of working on obtaining my Ibclc lactation credential, and with one of the projects, last month I had the opportunity to tour the University of California Health Milk Bank.

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<v SPEAKER_1>So the UC Health Milk Bank is a non-profit organization.

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<v SPEAKER_1>It's based in San Diego, where I live, provides access to safe, high-quality donor milk for infants in need.

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<v SPEAKER_1>And you're probably aware of all the different benefits of breast milk, but human milk is especially important for premature infants, as it helps dramatically decrease the risk of necrotizing enterochalitis, abbreviated NEC, which is a life-threatening intestinal disease that primarily affects premature babies.

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<v SPEAKER_1>So when my quadruplets were born prematurely, even though I was pumping like crazy, I never made enough breast milk for them, and I was so grateful that we were able to receive donor milk for free in the NICU.

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<v SPEAKER_1>So I was really interested to learn how the process of screening and analyzing and pooling the donor milk all works in order to benefit these premature babies.

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<v SPEAKER_1>And what does it look like behind the scenes at really the nation's leading milk bank?

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<v SPEAKER_1>Because UC Health's milk bank is just revolutionizing the process for ensuring the safe provision of donor milk for infants in need.

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<v SPEAKER_1>They're the only milk bank owned by a health care system.

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<v SPEAKER_1>They're the only physician led bank in North America.

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<v SPEAKER_1>And my tour guide, who is also my guest today, was Alison Wolf.

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<v SPEAKER_1>She's a pediatric nurse practitioner.

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<v SPEAKER_1>She's also an Ibclc.

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<v SPEAKER_1>She serves as the executive director of the University of California Health Milk Bank.

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<v SPEAKER_1>And their operation is very, very different from the informal milk sharing situations and operations that many of you may be a part of.

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<v SPEAKER_1>Some of you may be donating to or have received donor milk from an accredited milk bank.

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<v SPEAKER_1>Some of you may be doing informal milk sharing.

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<v SPEAKER_1>Regardless, this episode is all about donor milk and how it works.

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<v SPEAKER_1>And in particular, how the milk bank works.

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<v SPEAKER_1>So the UC Health Milk Bank works in conjunction with the Human Milk Institute at the University of California San Diego.

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<v SPEAKER_1>They have a lot of researchers that are also analyzing human milk and some of the benefits that it has especially for premature babies.

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<v SPEAKER_1>So in this interview, Alison, the executive director, is going to take you behind the scenes of the milk bank to explain how just one bag of your pumped breast milk, four to six ounces, can feed a premature baby for a whole day.

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<v SPEAKER_1>She'll talk about why donor milk is essential for premature babies and preventing neck, which is that devastating bowel disease.

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<v SPEAKER_1>And then what you can do to become a breast milk donor, even if you don't live near a milk bank.

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<v SPEAKER_1>Another thing I really enjoyed about this conversation was the very compassionate way that Alison talked about the UC Health Milk Bank's Cherry Blossom Program for bereaved and grieving mothers.

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<v SPEAKER_1>Nationwide, it's thought that about 5% of milk donors are bereaved mothers.

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<v SPEAKER_1>So content warning here that this episode does contain mention of infant loss, which may be difficult for some listeners.

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<v SPEAKER_1>Alison provides information and resources for bereaved mothers who may be considering donating their milk as they grieve.

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<v SPEAKER_1>If that's too much and you need to X out at this point, please do.

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<v SPEAKER_1>But if you can stick around, I really hope you enjoy this interview with Alison Wolf.

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<v SPEAKER_1>She's the executive director of the University of California Health Milk Bank, and we'll be talking about milk banks and moms, how your extra breast milk can save lives.

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<v SPEAKER_2>A family comes in unexpectedly, has premature delivery.

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<v SPEAKER_2>So let's say a 25-week gestation, 800-gram baby, mama's most likely sick.

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<v SPEAKER_2>She may have preeclampsia, high blood pressure on magnesium, needed a C-section.

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<v SPEAKER_2>Baby goes to NICU, mom and baby are separated.

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<v SPEAKER_2>She's not able to pump right away because of what's going on medical issues that are going on with her.

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<v SPEAKER_2>Then in the NICU, the neonatologist explains the importance of mother's own milk, of donor milk, of optimal nutrition, and wanting to start early feeds to get the intestines working, normal flora, all those things.

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<v SPEAKER_2>But unfortunately, mama's milk supply is delayed because of all these things that are going on.

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<v SPEAKER_2>They bring up the benefits of donor milk, if mother's own milk is not available.

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<v SPEAKER_2>That baby being able to get that tiny little drops of donor milk, that first couple of days, those first couple of weeks until mother's milk comes in and she's able to supply that for her baby.

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<v SPEAKER_2>The baby goes home from the NICU a couple of months later, able to get all of mama's own milk.

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<v SPEAKER_2>Either she has an excess supply stored up in the NICU, or she's been pumping a lot and she ends up with an excess supply and she wants to donate.

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<v SPEAKER_2>Because she knows how important those first couple of days were, and what it meant to her to have that donor milk available, and what it meant for the health of her baby, and wanting to give that back, to invest that back, to pay it forward.

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<v SPEAKER_2>It sends this message of the importance of this breast milk feeding community.

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<v SPEAKER_2>Being able to access donor milk if you need it, and then also being able to donate if you have extra.

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<v SPEAKER_2>It just creates, again, this breast milk feeding community.

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<v SPEAKER_1>Alison, can you give us a brief overview of what the UC Milk Bank does and then the services that you provide to families in need?

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<v SPEAKER_2>Absolutely.

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<v SPEAKER_2>I'm going to go back a little bit farther in history.

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<v SPEAKER_2>In the 1990s, UC San Diego Health was actually part of the beginning of the baby-friendly movement, of the 10 steps to baby-friendly.

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<v SPEAKER_2>In the early 2000s, we established the SPIN program in the NICU, or the Supporting Premature Infant Nutrition Program.

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<v SPEAKER_2>Again, implementing the best practices around optimal nutrition and breast milk feeding.

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<v SPEAKER_2>It was during that time that we really realized the significance of donor milk in reducing neck, neck rotizing and tericollitis, and the importance of the availability and equitable access.

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<v SPEAKER_2>That's when we decided, okay, we need to open a non-profit milk bank in Southern California, to be able to serve these families, serve the community.

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<v SPEAKER_2>Then we opened in 2020, and we are able to take milk donations.

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<v SPEAKER_2>We are part of Habana, which is the Human Milk Banking Association of North America.

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<v SPEAKER_2>It accredits non-profit milk banks.

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<v SPEAKER_2>So we are able to accept breast milk donations, screen, test, process the milk, and distribute it back into NICU's hospitals and the community as it's needed.

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<v SPEAKER_1>Can you just briefly explain what the Baby-Friendly Movement is if people are not familiar with that?

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<v SPEAKER_2>It is a movement to optimize breast milk access or feeding for infants.

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<v SPEAKER_2>And so it's based on the 10 steps.

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<v SPEAKER_2>And they recently expanded it to into the NICU and how hospitals can support families in their breastfeeding journey.

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<v SPEAKER_2>And it's just best practices.

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<v SPEAKER_1>And I remember I work from the San Diego area.

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<v SPEAKER_1>So, you know, we've worked in the same hospitals.

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<v SPEAKER_1>And I had my first child at one of the hospitals when it was not baby friendly.

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<v SPEAKER_1>And then when I had my quadruplets, it had been designated baby friendly in the interim.

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<v SPEAKER_1>And I can tell you, like, just the world of difference that you would experience as a patient was like so amazing.

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<v SPEAKER_1>It was, they were so helpful and encouraging to keep me motivated to be pumping when my quads were in the NICU.

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<v SPEAKER_1>And I think that the program was amazing because the staff was just so committed.

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<v SPEAKER_2>And it's really about education of every single staff member in that hospital who's going to have contact with that mother, with that baby, with that family, and really being able to send that consistent message around breast milk feeding.

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<v SPEAKER_1>Why is donor breast milk so critical for certain infants?

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<v SPEAKER_1>Like what types of situations or conditions make donor milk essential?

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<v SPEAKER_2>Our whole goal at the UC Health Milk Bank is optimal growth, nutrition, and what we call neck prevention or neck reticent and tericollitis.

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<v SPEAKER_2>So neck is a devastating bowel disease that at-risk infants can develop.

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<v SPEAKER_2>And so being at-risk infant is usually less than 32 weeks, gestation less than 1500 grams, some other bowel issues, cardiac issues, growth restriction, whatnot.

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<v SPEAKER_2>And it puts them at risk.

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<v SPEAKER_2>So this neck is not something that your full term baby at home is at risk for, anything like that.

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<v SPEAKER_2>This is specifically for premature infants.

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<v SPEAKER_2>And neck is a multifactorial disease.

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<v SPEAKER_2>We don't know exactly what causes it and we don't know 100 percent how to prevent it.

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<v SPEAKER_2>But the one thing we do know protects against neck is mother's breast milk.

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<v SPEAKER_2>So mother's own milk if it's available and if it's not available or not sufficient using donor milk, we know is protective against neck.

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<v SPEAKER_2>It's not 100 percent risk reduction, but we know that it does help.

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<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

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<v SPEAKER_4>George Clooney and Brad Pitt's new movie, Wolfs is on Apple TV+ September 27th.

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<v SPEAKER_5>That's where I want you to be now.

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<v SPEAKER_4>Or if you want to see Brad Pitt and George Clooney, go to Apple TV+.

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<v SPEAKER_4>I am enjoying the show.

00:12:07.200 --> 00:12:08.780

<v SPEAKER_4>And if you want to see their new movie, Wolfs.

00:12:08.780 --> 00:12:10.060

<v SPEAKER_4>You can't do it, I'm going to help you out.

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<v SPEAKER_4>Okay, fine, it was very cool.

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<v SPEAKER_4>Wolfs, streaming September 27th on Apple TV+.

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<v SPEAKER_4>Rated R.

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<v SPEAKER_1>Can you walk us through the process of testing and ensuring that the donor breast milk is safe?

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<v SPEAKER_1>What sort of measures are in place to ensure the safety of the milk for the recipients?

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<v SPEAKER_2>Absolutely, because this is a question that we get a lot.

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<v SPEAKER_2>And it's one of our key quality steps is really to make sure that this milk that's going to these teeny tiniest little micro-premies is 100% safe.

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<v SPEAKER_2>And so we do abide by Habana standards.

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<v SPEAKER_2>So they have very strict specific standards on how to screen, how to test, how to process the milk.

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<v SPEAKER_2>But kind of starting from the very beginning, we have a screening process.

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<v SPEAKER_2>It's very similar to blood donation.

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<v SPEAKER_2>We ask a lot of the same questions about medical history, medications, social history, those type of things.

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<v SPEAKER_2>We get a consent from the prenatal provider saying, yes, that this mother is safe to donate her milk.

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<v SPEAKER_2>We verify this in some interview questions.

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<v SPEAKER_2>And then the donor comes in either remotely or locally, in the area or out of area, gets a blood test.

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<v SPEAKER_2>It is very similar to the screening test for blood donation, screening for any communicable diseases that could potentially pass through the breast milk.

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<v SPEAKER_2>We then get the milk and we do a nutritional analysis, checking for calories and fat and protein.

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<v SPEAKER_2>And then we're able to pool about five to seven donors together to get adequate calorie and protein count.

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<v SPEAKER_2>We want to make sure these babies are going to be growing well off the milk.

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<v SPEAKER_2>We send a pre-pasteurization culture, checking for bacillus.

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<v SPEAKER_2>We then heat pasteurize the milk using the holder pasteurization to kill any potential viruses or bacteria.

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<v SPEAKER_2>And then after pasteurization, we send a second culture to make sure that there's nothing growing in the milk.

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<v SPEAKER_2>A lot of these, there's two person verifications along to the way to make sure all these safety steps are met.

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<v SPEAKER_2>And only after all of this is done, the screening, the testing, the pasteurizing, are we able to approve the milk for distribution.

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<v SPEAKER_1>I have to say the whole operation was so impressive just watching the milk techs at work.

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<v SPEAKER_1>I can actually see them in the background of where you're doing this interview from, which is really cool.

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<v SPEAKER_1>But it does really, I think, I think it's important for the average person in the public to know, because I think historically, you know, breast milk banking, and we can talk about this a little bit, it was much more loosey goosey, you know, for lack of a better word.

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<v SPEAKER_1>And you guys really have elevated the bar with regards to the science and the testing and ensuring, you know, just give us some ideas of, you know, if you were to just use some randos breast milk, like obviously you hope people have the best intentions at heart, but what would be some of the side effects of not doing all of these standards for testing and safety?

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<v SPEAKER_2>Absolutely.

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<v SPEAKER_2>And I just, just because you did mention them, you can see them behind me.

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<v SPEAKER_2>They are in full PPE.

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<v SPEAKER_2>I mean, this is, that is a lab.

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<v SPEAKER_2>They scrub in, they will full PPE.

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<v SPEAKER_2>We're very, you know, very careful with what's getting into touching the milk, who's handling the milk.

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<v SPEAKER_2>They're all diet technicians who are trained specifically.

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<v SPEAKER_2>So they're amazing and they're meticulous and they know exactly where this milk is going and how important all those safety steps are.

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<v SPEAKER_2>And so that goes back to this informal milk sharing.

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<v SPEAKER_2>The issue is when it comes to that you're getting it off Facebook or the internet, and it's different if it's your sister or your best friend and you know them very well.

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<v SPEAKER_2>You know their medication history, their social history, all those other things.

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<v SPEAKER_2>But the problem is, even though people are very well intentioned that they want to share their milk, they want to help their neighbor, they want to help their friend, whatever it may be, they may not know what is in the milk, or they may not know all the safe handling or storage or medications or risk factors or communicable diseases and all these other things that go into it.

00:16:08.880 --> 00:16:19.140

<v SPEAKER_2>The other part of informal milk sharing, although you're helping your friend and your neighbor, you know, somebody in the community, that milk isn't able to go to these teeny tiny little preemies who really, really need it.

00:16:19.260 --> 00:16:29.260

<v SPEAKER_2>That it is the difference between potentially saving, and the milk is medicine and could be saving their life, is such an important, when you're thinking about donating.

00:16:29.260 --> 00:16:30.800

<v SPEAKER_2>Not that you can't donate to both.

00:16:30.800 --> 00:16:38.640

<v SPEAKER_2>I mean, you can donate to a friend or to a neighbor, but also donate to these micro preemies who really have the medical necessity for that breast milk.

00:16:38.640 --> 00:16:46.660

<v SPEAKER_1>I think it's so amazing that even just one day of you pumping milk can extend the life of a preemie for a couple of days.

00:16:46.660 --> 00:16:47.500

<v SPEAKER_1>Is that correct?

00:16:47.500 --> 00:16:48.980

<v SPEAKER_1>Because they're taking so little.

00:16:49.660 --> 00:17:01.800

<v SPEAKER_2>So, this is a general approximation, but we say about one pump bag of milk, so that four to six ounces, two to six ounces of milk can feed a micro preemie for an entire day.

00:17:01.800 --> 00:17:08.280

<v SPEAKER_2>And so, that you're able to provide that nutrition and protect them against necrotizing and teraclitus.

00:17:08.280 --> 00:17:13.000

<v SPEAKER_2>So, even if it's one bag a day, it makes a huge difference in these babies' life.

00:17:13.000 --> 00:17:16.320

<v SPEAKER_1>I know that there are moms listening who are like, wait a minute, I can do this.

00:17:16.320 --> 00:17:20.300

<v SPEAKER_1>I have some extra breast milk or I would like to help these super-premie babies.

00:17:20.300 --> 00:17:24.020

<v SPEAKER_1>What criteria do potential milk donors need to meet?

00:17:24.020 --> 00:17:27.500

<v SPEAKER_1>And then, how do you determine if someone's eligible to donate their human milk?

00:17:27.500 --> 00:17:31.640

<v SPEAKER_2>You know, a healthy mom who has an extra supply of breast milk.

00:17:31.640 --> 00:17:34.000

<v SPEAKER_2>And so, we use Habana guidelines.

00:17:34.000 --> 00:17:37.380

<v SPEAKER_2>That's who, where, they have specific standards of who could donate.

00:17:37.380 --> 00:17:44.020

<v SPEAKER_2>There's some medication deferrals, some health deferrals, communicable diseases, those type of things, some social risk factors.

00:17:44.720 --> 00:17:51.400

<v SPEAKER_2>But, what we do is we, potential donors answer some questionnaires, and then we have a phone interview to clarify any questions.

00:17:51.400 --> 00:17:56.020

<v SPEAKER_2>But really, a healthy woman with an excess supply of breast milk, for whatever reason.

00:17:56.020 --> 00:18:01.440

<v SPEAKER_2>And some, I know you didn't ask this question, but like sometimes it's just a freezer clean out.

00:18:01.440 --> 00:18:06.660

<v SPEAKER_2>Let's say somebody's getting ready to move, and they have a huge freezer full that they can't take with them.

00:18:06.660 --> 00:18:16.220

<v SPEAKER_2>Sometimes it's a freezer full, and baby doesn't like the frozen milk because of the high light pace, or they developed a dairy allergy and can't use that milk.

00:18:16.220 --> 00:18:20.480

<v SPEAKER_2>Or it's sometimes just families who have an excess supply of breast milk.

00:18:20.480 --> 00:18:28.500

<v SPEAKER_2>They're pumping, maybe their baby didn't feed well initially, and they started pumping and now have this big excess supply, and they have this extra breast milk that they can share.

00:18:28.500 --> 00:18:29.920

<v SPEAKER_1>What's the exclusion criteria?

00:18:29.920 --> 00:18:31.760

<v SPEAKER_1>Like you mentioned some of the social factors.

00:18:31.760 --> 00:18:34.020

<v SPEAKER_1>Is it like illicit drug use, alcohol?

00:18:34.020 --> 00:18:36.240

<v SPEAKER_1>What makes you ineligible to be a donor?

00:18:36.240 --> 00:18:39.840

<v SPEAKER_2>So illicit drug use, excess alcohol use.

00:18:40.080 --> 00:18:45.300

<v SPEAKER_2>There are some criteria of pumping and length after alcohol use and whatnot.

00:18:45.300 --> 00:18:46.840

<v SPEAKER_2>Nicotine.

00:18:46.840 --> 00:18:50.900

<v SPEAKER_2>Some medications, but usually they are a deferral period.

00:18:50.900 --> 00:18:55.620

<v SPEAKER_2>So maybe mother had to go on antibiotics because of mastitis.

00:18:55.620 --> 00:19:00.120

<v SPEAKER_2>We would have to exclude milk from that time period, but not overall.

00:19:00.120 --> 00:19:05.880

<v SPEAKER_2>There are some medications for chronic diseases that we aren't able to accept the milk.

00:19:05.880 --> 00:19:07.760

<v SPEAKER_2>But again, that's part of the screening process.

00:19:08.580 --> 00:19:20.600

<v SPEAKER_2>And then any high-risk social risk factors, multiple sex partners, IV drugs, anything like that, that you would think of, any risk for blood-borne pathogens or blood-borne diseases.

00:19:20.600 --> 00:19:26.140

<v SPEAKER_1>So if a potential donor says, okay, yes, I meet the criteria to donate, what does the screening process look like for them?

00:19:26.140 --> 00:19:34.020

<v SPEAKER_1>And then what steps do they have to go through in order to collect and store milk so that it's in alignment with your guidelines at the milk bank?

00:19:34.020 --> 00:19:34.200

<v SPEAKER_2>Right.

00:19:34.200 --> 00:19:49.620

<v SPEAKER_2>And we'd like to say our screening process is vigorous but we try to make it as simple as possible because we know how much time it takes to pump, to freeze, to label, to go through all these steps on top of being a mom of maybe a newborn or multiple kids.

00:19:49.620 --> 00:19:52.720

<v SPEAKER_2>And so we really try to simplify the process as much as we can.

00:19:52.720 --> 00:20:01.180

<v SPEAKER_2>So the first step is to go to our website that has a link to our what we call our donor portal where people can get a log in and sign in.

00:20:01.640 --> 00:20:08.500

<v SPEAKER_2>They sign some consents and answer two brief questionnaires, one about the baby and one about themselves.

00:20:08.500 --> 00:20:13.440

<v SPEAKER_2>Again, going over medical history, medication, social history, those types of things.

00:20:13.440 --> 00:20:16.500

<v SPEAKER_2>And then all the communication is done through this online portal.

00:20:16.500 --> 00:20:18.480

<v SPEAKER_2>Again, trying to make it as easy as possible.

00:20:18.480 --> 00:20:23.520

<v SPEAKER_2>It could be done from a mobile device, from a laptop, those types of things.

00:20:23.520 --> 00:20:36.760

<v SPEAKER_2>And then we set up a brief 10 to 15 minute phone interview to again, just clarify any questions, going over the questionnaires, any concerns, talk about steps, next steps and safety type things.

00:20:36.760 --> 00:20:44.080

<v SPEAKER_2>We then ask for consent from the prenatal provider, just saying yes, as far as they know, mother's in good health, no concerns.

00:20:44.080 --> 00:20:48.160

<v SPEAKER_2>And then if they're local, they come to the blood bank.

00:20:48.160 --> 00:20:51.360

<v SPEAKER_2>The milk bank is located inside the San Diego blood bank.

00:20:51.360 --> 00:20:55.340

<v SPEAKER_2>Again, because we get a lot of this best practices from the blood banking community.

00:20:55.340 --> 00:20:56.980

<v SPEAKER_2>So they come, they drop off their milk.

00:20:57.840 --> 00:21:00.480

<v SPEAKER_2>For local donors, it's a hundred ounce minimum.

00:21:00.480 --> 00:21:03.320

<v SPEAKER_2>They get their blood drawn at the same time, they get their blood test.

00:21:03.320 --> 00:21:07.220

<v SPEAKER_2>And then once we get those results back, we can approve them.

00:21:07.220 --> 00:21:09.900

<v SPEAKER_2>For out of area donors, it's a very similar process.

00:21:09.900 --> 00:21:17.920

<v SPEAKER_2>Those first steps are exactly the same, except for we send a requisition for a lab drawn, any Quest lab near them, no cost.

00:21:17.920 --> 00:21:23.720

<v SPEAKER_2>And then we send boxes and prepaid FedEx shipping labels and FedEx picks the milk up at their home.

00:21:23.720 --> 00:21:26.300

<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

00:21:30.760 --> 00:21:32.940

<v SPEAKER_6>My dad works in B2B marketing.

00:21:32.940 --> 00:21:37.320

<v SPEAKER_6>He came by my school for career day and said he was a big ROAS man.

00:21:37.320 --> 00:21:42.320

<v SPEAKER_6>Then he told everyone how much he loved calculating his return on ad spend.

00:21:42.320 --> 00:21:44.880

<v SPEAKER_6>My friends still laughing me to this day.

00:21:44.880 --> 00:21:49.420

<v SPEAKER_5>Not everyone gets B2B, but with LinkedIn, you'll be able to reach people who do.

00:21:49.420 --> 00:21:51.840

<v SPEAKER_5>Get $100 credit on your next ad campaign.

00:21:51.840 --> 00:21:54.660

<v SPEAKER_5>Go to linkedin.com/results to claim your credit.

00:21:54.920 --> 00:21:57.100

<v SPEAKER_5>That's linkedin.com/results.

00:21:57.100 --> 00:21:58.480

<v SPEAKER_5>Terms and conditions apply.

00:21:58.480 --> 00:22:01.300

<v SPEAKER_5>LinkedIn, the place to be, to be.

00:22:05.040 --> 00:22:08.000

<v SPEAKER_1>Can I ask you about the prenatal provider consent?

00:22:08.000 --> 00:22:08.880

<v SPEAKER_1>Is that a barrier?

00:22:08.880 --> 00:22:11.000

<v SPEAKER_1>Because what if it was a long time ago that you had a baby?

00:22:11.000 --> 00:22:15.460

<v SPEAKER_1>You have to go make an appointment with your doctor to have them say, yes, you had a baby?

00:22:15.460 --> 00:22:16.740

<v SPEAKER_2>That's a really good question.

00:22:16.740 --> 00:22:20.640

<v SPEAKER_2>Yes, I would say that is our biggest rate limiting step.

00:22:20.640 --> 00:22:22.840

<v SPEAKER_2>That's the step that sometimes takes the longest.

00:22:23.380 --> 00:22:32.820

<v SPEAKER_2>So what we have, we do have some workarounds, but really what we do is when people sign up, we let them know, reach out to your provider.

00:22:32.820 --> 00:22:34.660

<v SPEAKER_2>We can fax them, we can reach out to them.

00:22:34.660 --> 00:22:38.320

<v SPEAKER_2>That takes usually a bit longer to get a response.

00:22:38.320 --> 00:22:45.720

<v SPEAKER_2>But now with everything, the Electronical Medical Record, you go on to MyChart, you can put in or, you know, send them the consent letter.

00:22:45.720 --> 00:22:47.300

<v SPEAKER_2>They send it back electronically.

00:22:47.300 --> 00:22:49.820

<v SPEAKER_2>You know, really we're getting like a 24 hour turnaround.

00:22:50.460 --> 00:22:53.740

<v SPEAKER_2>And most donors are within Baby's first year.

00:22:53.740 --> 00:22:57.400

<v SPEAKER_2>So they're going back to either their midwife or their OB and they're seeing them.

00:22:57.400 --> 00:23:02.880

<v SPEAKER_2>So they have a relationship with a bigger health system, maybe with Kaiser or something like that.

00:23:02.900 --> 00:23:10.440

<v SPEAKER_2>Using that Electronical Medical Record and sending it electronically, getting it back electronically is much easier than trying to make that appointment.

00:23:10.440 --> 00:23:14.180

<v SPEAKER_1>I love that you mentioned faxes, like doctors are literally the only people on the planet still using faxes.

00:23:14.180 --> 00:23:16.760

<v SPEAKER_1>Like they're keeping the fax machine industry alive.

00:23:16.760 --> 00:23:24.740

<v SPEAKER_1>So you had already mentioned some of the benefits, obviously the helping the super teeny tiny preemies and the prevention of neck is huge.

00:23:24.740 --> 00:23:30.260

<v SPEAKER_1>But what are the other incentives or benefits for moms who are maybe on the fence about doing this?

00:23:30.260 --> 00:23:35.320

<v SPEAKER_1>What are some things you hear about why moms choose to donate human milk?

00:23:35.320 --> 00:23:42.700

<v SPEAKER_2>So definitely the benefit of knowing they're impacting another baby's life, a family's life, really that paying it forward.

00:23:42.700 --> 00:23:48.300

<v SPEAKER_2>And our donor coordinators are amazing at really educating families about where your milk is going.

00:23:48.700 --> 00:23:50.600

<v SPEAKER_2>It's not just nutrition, it's medicine.

00:23:50.600 --> 00:23:54.160

<v SPEAKER_2>It's going to help other families and other babies.

00:23:54.160 --> 00:23:58.380

<v SPEAKER_2>The other thing is every donor gets a nutritional analysis of her milk.

00:23:58.380 --> 00:24:07.960

<v SPEAKER_2>So that includes calories, fat, protein, carbohydrates, and we send them a little nutritional card with all their information on it, about it.

00:24:07.960 --> 00:24:12.580

<v SPEAKER_2>But it also reinforces like, wow, that's my breast milk.

00:24:12.580 --> 00:24:15.760

<v SPEAKER_2>And maybe they have a high-cal, high-protein breast milk.

00:24:15.760 --> 00:24:18.420

<v SPEAKER_2>And we let them know that's going to the little tiniest babies.

00:24:18.420 --> 00:24:26.640

<v SPEAKER_2>And it really incentivizes women to be like, you know what, I'm going to pump an extra time a day because I know where this milk is going and who it's helping.

00:24:26.640 --> 00:24:29.320

<v SPEAKER_2>And it really, our donors are amazing.

00:24:29.560 --> 00:24:31.680

<v SPEAKER_2>They're doing it from the goodness of their heart.

00:24:31.680 --> 00:24:35.480

<v SPEAKER_2>And they are so grateful to be able to give back.

00:24:35.480 --> 00:24:37.120

<v SPEAKER_2>And it involves the entire families.

00:24:37.120 --> 00:24:42.800

<v SPEAKER_2>When they come for drop-offs, grandma and auntie and dad and the kids are all coming.

00:24:42.800 --> 00:24:44.140

<v SPEAKER_2>And they were all part of this.

00:24:44.140 --> 00:24:48.440

<v SPEAKER_2>They were all part of, you know, helping make this milk and make this donation.

00:24:48.440 --> 00:24:54.680

<v SPEAKER_2>So it just, it's amazing what they do and what they, how they contribute to helping.

00:24:54.680 --> 00:25:00.680

<v SPEAKER_1>I thought the most fascinating part of the tour was watching the Milk Tech do the nutrition analysis and seeing the pooled milk.

00:25:00.680 --> 00:25:03.840

<v SPEAKER_1>Like, okay, your milk is perfect for your baby, but you're donating it to someone else.

00:25:03.840 --> 00:25:05.700

<v SPEAKER_1>So they, you don't add anything else.

00:25:05.700 --> 00:25:10.600

<v SPEAKER_1>It's just the pooled breast milk, but you mix it to get the certain protein and calorie content.

00:25:10.600 --> 00:25:14.080

<v SPEAKER_1>And just that nutrition facts panel was so cool.

00:25:14.440 --> 00:25:24.880

<v SPEAKER_1>Like, this is your individual breast milk, and it would be such a cool thing to put in your baby's baby book and then be able to say, you know, the milk that I made for you also went to help these other really needy children.

00:25:24.880 --> 00:25:28.920

<v SPEAKER_1>So just curious about misconceptions about donating breast milk.

00:25:28.920 --> 00:25:31.860

<v SPEAKER_1>Like, what are the fallacies or the falsehoods that you hear?

00:25:31.860 --> 00:25:34.780

<v SPEAKER_1>And how do you address these concerns with potential donors?

00:25:34.780 --> 00:25:39.560

<v SPEAKER_2>I think what we hear the most is, oh, donating to a milk bank is really hard.

00:25:39.560 --> 00:25:40.820

<v SPEAKER_2>It's really difficult.

00:25:41.040 --> 00:25:43.300

<v SPEAKER_2>It's the process is just too much to do.

00:25:44.280 --> 00:25:51.080

<v SPEAKER_2>So again, we need it to be rigorous, because we need to make sure that the milk that's going to these babies is safe.

00:25:51.080 --> 00:25:53.880

<v SPEAKER_2>But we really do try to make it as simple as possible.

00:25:53.880 --> 00:26:00.440

<v SPEAKER_2>So the online portal, helping people manage that prenatal consent, because that is kind of a stumbling block.

00:26:00.440 --> 00:26:02.580

<v SPEAKER_2>We have different ways we can help with that.

00:26:02.580 --> 00:26:11.880

<v SPEAKER_2>And just accommodating family, out-of-area donors or in-area donors, just so making that process as simple as possible for very busy people.

00:26:12.840 --> 00:26:21.480

<v SPEAKER_2>The other part of it, I think what I hear is kind of a myth is like, well, you can either do informal milk sharing or donate to a milk bank.

00:26:21.480 --> 00:26:23.500

<v SPEAKER_2>And I think you can do both.

00:26:23.500 --> 00:26:29.920

<v SPEAKER_2>I think you could donate to your neighbor or to your friend, but you could also donate to a milk bank and help these preemies.

00:26:30.080 --> 00:26:31.720

<v SPEAKER_2>It's not an all or nothing thing.

00:26:31.720 --> 00:26:38.980

<v SPEAKER_2>And some amazing women make extraordinary amounts of milk, and they're able to share that in multiple different ways.

00:26:39.640 --> 00:26:45.940

<v SPEAKER_1>I think the takeaway message when I saw your whole operation was like, yes, this is rigorous, but it's totally worth it and doable.

00:26:45.940 --> 00:26:55.780

<v SPEAKER_1>Like, this is a lot of expense and time that your staff is going to, to ensure that it's safe because it's going into the teeniest, tiny, premature babies.

00:26:55.780 --> 00:27:02.800

<v SPEAKER_1>But wow, like, you know, hard things are worth doing, and feeding your own child and pumping, like, it is a lot.

00:27:02.800 --> 00:27:06.020

<v SPEAKER_1>But wow, you're literally extending the life of a premature baby.

00:27:06.020 --> 00:27:07.580

<v SPEAKER_1>You know, when else will you get that opportunity?

00:27:08.200 --> 00:27:12.560

<v SPEAKER_1>I was really touched by the Cherry Blossom program that you explained and showed me on our tour.

00:27:12.560 --> 00:27:17.140

<v SPEAKER_1>Could you explain how that works, how it came to fruition, who can participate?

00:27:17.140 --> 00:27:21.260

<v SPEAKER_2>Nationally, about 5% of milk donors are bereaved donors.

00:27:21.260 --> 00:27:27.700

<v SPEAKER_2>And so that could be a neonatal loss, a fetal loss, or even a SIDS death.

00:27:27.700 --> 00:27:37.200

<v SPEAKER_2>And donation is a way for families to grieve and process and work through this, their whole grieving process.

00:27:37.500 --> 00:27:40.880

<v SPEAKER_2>And so we created the Cherry Blossom Program.

00:27:40.880 --> 00:27:45.320

<v SPEAKER_2>We chose the cherry blossom because it is the most beautiful but shortest lasting blossom.

00:27:45.320 --> 00:27:54.860

<v SPEAKER_2>And we actually have a big cherry blossom tree mural on our front wall, where we have little ceramic cherry blossoms with the baby's names that families are able to put on there.

00:27:54.860 --> 00:28:01.720

<v SPEAKER_2>And when we started this, we were initially gearing it towards the NICU and being able to support families in the NICU.

00:28:02.660 --> 00:28:07.800

<v SPEAKER_2>And I worked 20-plus years for the newborn service at Jacobs Medical Center.

00:28:07.800 --> 00:28:16.660

<v SPEAKER_2>And working with lactation and working with all this, we really found this big gap in care, actually with the intrauterine fetal demise.

00:28:16.660 --> 00:28:24.620

<v SPEAKER_2>And so these families come in with a fetal loss, they deliver the baby and normally go home within about 12 hours.

00:28:24.620 --> 00:28:30.900

<v SPEAKER_2>They don't have a pediatrician, they don't have a lactation consultant, they don't have a pump and they don't have a baby.

00:28:31.580 --> 00:28:39.600

<v SPEAKER_2>And on day two or three, when they get engorged, a lot of times they haven't even gotten any lactation education and they have no idea what to do.

00:28:39.600 --> 00:28:52.000

<v SPEAKER_2>And so we created this program to really help these families, number one, have access to education, to know, again, you're not going to be able to really give them much in the hospital, except maybe a flyer.

00:28:52.000 --> 00:29:03.020

<v SPEAKER_2>And we have cherry blossom bags that they go home with that has a double electric pump or a hand pump of information on suppression, pumping for comfort and donation, if that's something they want to do.

00:29:03.020 --> 00:29:04.900

<v SPEAKER_2>And a little memory stone and some other things.

00:29:04.900 --> 00:29:13.540

<v SPEAKER_2>And so these families at a couple of local hospitals and out-of-area hospitals, they get this flyer and they get this bag if they choose and they go home with it.

00:29:13.540 --> 00:29:18.060

<v SPEAKER_2>So again, just a quick touch base with lactation before they go home.

00:29:18.060 --> 00:29:23.480

<v SPEAKER_2>And so then on that day two or three or when they get engorged, they have something to reference to.

00:29:23.480 --> 00:29:32.380

<v SPEAKER_2>They did not have any control over this situation and we want them to have education and control over their decision of what they do when their milk comes in.

00:29:32.380 --> 00:29:34.320

<v SPEAKER_2>And donation is not for everybody.

00:29:34.320 --> 00:29:36.320

<v SPEAKER_2>That isn't the point of the program.

00:29:36.320 --> 00:29:40.300

<v SPEAKER_2>But for the people who donate, they really say that it saved their lives.

00:29:40.300 --> 00:29:41.480

<v SPEAKER_2>It gave them something to do.

00:29:41.480 --> 00:29:44.260

<v SPEAKER_2>It gave them meaning out of something that was terrible.

00:29:44.260 --> 00:29:50.060

<v SPEAKER_2>Very similar to organ donation, that this is something that made, that they only they made with their baby.

00:29:50.060 --> 00:29:59.680

<v SPEAKER_2>And we really like to acknowledge that these women are mothers, that their baby is a baby and has a name and really just help them and their family walk through the process.

00:29:59.680 --> 00:30:04.920

<v SPEAKER_2>So our goal would be that any family would have access to this information.

00:30:04.920 --> 00:30:13.300

<v SPEAKER_2>And we do, like I said, we are in some hospitals, but even for, it's not UC San Diego Health limited.

00:30:13.300 --> 00:30:15.320

<v SPEAKER_2>It could be any family, anywhere.

00:30:15.320 --> 00:30:19.800

<v SPEAKER_2>We can overnight ship them a bag of information and just be here to help support them.

00:30:19.800 --> 00:30:23.760

<v SPEAKER_1>The cherry blossom mural at your facility is just, it stops your heart.

00:30:23.760 --> 00:30:24.360

<v SPEAKER_1>It's so beautiful.

00:30:24.360 --> 00:30:28.540

<v SPEAKER_1>Once you realize that every name there, the names on there, it's the mom and the baby.

00:30:28.540 --> 00:30:29.600

<v SPEAKER_1>Is that how it works?

00:30:29.600 --> 00:30:30.760

<v SPEAKER_2>It's the baby's name.

00:30:30.760 --> 00:30:33.660

<v SPEAKER_2>And so it's just honoring their baby.

00:30:34.900 --> 00:30:43.420

<v SPEAKER_2>And it's just a lot of times these are kind of, again, the fetal demise more so, are kind of forgotten.

00:30:43.420 --> 00:30:45.740

<v SPEAKER_2>People are uncomfortable talking to them.

00:30:45.860 --> 00:30:47.560

<v SPEAKER_2>They don't know what to say.

00:30:48.700 --> 00:30:49.660

<v SPEAKER_2>They lost a pregnancy.

00:30:49.660 --> 00:30:51.640

<v SPEAKER_2>It could even be third trimester.

00:30:51.640 --> 00:30:54.500

<v SPEAKER_2>Co-workers, friends, family, they don't know what to say.

00:30:54.740 --> 00:30:56.560

<v SPEAKER_2>So they just don't say anything.

00:30:56.560 --> 00:31:01.880

<v SPEAKER_2>And they aren't acknowledged that they're a mother and a father and, you know, are the siblings.

00:31:01.880 --> 00:31:03.180

<v SPEAKER_2>They're still siblings.

00:31:03.180 --> 00:31:07.380

<v SPEAKER_2>And there is a baby who, you know, who there was a life.

00:31:07.380 --> 00:31:15.480

<v SPEAKER_2>And so I think it's just really important to kind of say it out loud and acknowledge like that, yes, this is something that happens.

00:31:15.480 --> 00:31:20.120

<v SPEAKER_2>And being able to put that blossom and be able to say, yes, that my baby was here.

00:31:20.580 --> 00:31:27.480

<v SPEAKER_1>I want to ask for parents who are listening, caregivers, mothers who are pumping, especially if they don't live in San Diego.

00:31:27.480 --> 00:31:30.580

<v SPEAKER_1>If you're in San Diego, you see Milk Bank and I'll link to it.

00:31:30.580 --> 00:31:35.700

<v SPEAKER_1>But how do you get involved if you're outside of the Southern California region?

00:31:35.700 --> 00:31:40.280

<v SPEAKER_1>Are there local milk banks or can your, like you said, FedEx boxes be shipped?

00:31:40.360 --> 00:31:43.660

<v SPEAKER_1>What can a mom in Massachusetts do if she wants to give donor milk?

00:31:43.660 --> 00:31:46.060

<v SPEAKER_2>Yes, we can accommodate anybody anywhere.

00:31:46.060 --> 00:31:47.920

<v SPEAKER_2>You know, again, the Quest Labs are everywhere.

00:31:48.520 --> 00:31:50.380

<v SPEAKER_2>The FedEx boxes can go anywhere.

00:31:50.380 --> 00:31:53.400

<v SPEAKER_2>We are happy to help support anybody.

00:31:53.400 --> 00:32:08.480

<v SPEAKER_2>But if you go to the Habana, so if you just, it's H-M-B-A-N-A website, there is a find a local milk bank, little kind of you click on it, you put in your zip code or there is a map and it shows you exactly a local milk bank closest to you.

00:32:08.480 --> 00:32:17.380

<v SPEAKER_2>And the majority of these milk banks do have some sort of shipping mechanism, so it doesn't have to be that you're within a couple miles of it or you know what not.

00:32:17.480 --> 00:32:21.800

<v SPEAKER_2>There's mechanism to help support people in every area of the US and North America.

00:32:21.800 --> 00:32:24.360

<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

00:32:28.880 --> 00:32:35.220

<v SPEAKER_4>This episode is supported by FX's Grotesquery, a new series from executive producer Ryan Murphy.

00:32:35.220 --> 00:32:46.660

<v SPEAKER_4>Heinous crimes unsettle a small community, and the local detective feels these atrocities are eerily personal, as if someone or something is taunting her.

00:32:46.660 --> 00:32:48.800

<v SPEAKER_4>Starring Nisi Nashpets, Courtney B.

00:32:48.800 --> 00:32:52.140

<v SPEAKER_4>Vance, Leslie Manville, and Travis Kelce.

00:32:52.180 --> 00:32:56.460

<v SPEAKER_4>FX's Grotesquery premieres September 25th on FX.

00:32:56.460 --> 00:32:57.580

<v SPEAKER_4>Stream on Hulu.

00:33:03.100 --> 00:33:12.160

<v SPEAKER_1>Well, Alison, I just want to close out by asking, you are the perfect spokesperson, you are such an advocate for the work that your team is doing at the UC Milk Bank.

00:33:12.160 --> 00:33:17.300

<v SPEAKER_1>I know you guys are really on the cutting edge, so what are your hopes or your plans for the future of Milk Bank?

00:33:17.300 --> 00:33:24.520

<v SPEAKER_1>How do you see the role of Milk Banks evolving, and is that gonna be based on the work that you guys are doing at the UC Milk Bank?

00:33:24.520 --> 00:33:26.640

<v SPEAKER_2>Yes, I believe that it will be.

00:33:26.640 --> 00:33:32.700

<v SPEAKER_2>We are in this amazing position of, the Milk Bank was founded by Dr.

00:33:32.700 --> 00:33:34.380

<v SPEAKER_2>Lisa Stowagin, a pediatrician.

00:33:34.380 --> 00:33:37.620

<v SPEAKER_2>I'm a pediatric nurse practitioner at Ibclc.

00:33:37.620 --> 00:33:41.840

<v SPEAKER_2>We are part of the UC San Diego Health System.

00:33:41.840 --> 00:33:45.100

<v SPEAKER_2>We have the University of California Health name.

00:33:45.100 --> 00:33:49.760

<v SPEAKER_2>We are associated with the UC San Diego Human Milk Institute.

00:33:49.760 --> 00:33:57.440

<v SPEAKER_2>We have not only the backing and resources of the health system, but also the whole academic campus side.

00:33:58.340 --> 00:34:09.540

<v SPEAKER_2>We're very active in research, really finding out what is the optimal pooling practices to make sure that we have the best quality milk to help these babies grow.

00:34:09.540 --> 00:34:15.020

<v SPEAKER_2>In the NICU, what is the difference between giving them a higher protein donor milk versus a lower protein milk?

00:34:15.020 --> 00:34:17.020

<v SPEAKER_2>What's their growth velocity?

00:34:17.020 --> 00:34:40.800

<v SPEAKER_2>Really advocating for evidence-based practice, highest level of technology possible, and how do we continue to grow this and work with neonatologists, work with nutritionists, work with specialists in the area to really optimize what we're doing, how we're growing these babies, how are we protecting them, and then bringing that back to the milk banking community to help them grow.

00:34:40.800 --> 00:34:46.940

<v SPEAKER_2>Because that's where it's going and babies are only being born more and more prematurely.

00:34:46.940 --> 00:34:53.080

<v SPEAKER_2>Viability-wise, we're able to save younger and smaller babies, but that's only going to make this even more important.

00:34:53.540 --> 00:35:00.320

<v SPEAKER_1>I have to tell you, in preparing for this interview, my niece was over helping watch some of my kids and she's starting high school.

00:35:00.320 --> 00:35:04.180

<v SPEAKER_1>And so I have two babysitters at any given time, one, her brother's there too.

00:35:04.180 --> 00:35:13.660

<v SPEAKER_1>She was a 25-weeker and he was a 24-weeker, and she's going into ninth grade, he's going into eighth grade, and they're only like, they're not a full year apart.

00:35:13.660 --> 00:35:15.420

<v SPEAKER_1>My sister was in the NICU for like almost a year.

00:35:15.420 --> 00:35:16.660

<v SPEAKER_1>It was just awful.

00:35:16.660 --> 00:35:18.160

<v SPEAKER_1>But they're in regular school.

00:35:18.160 --> 00:35:19.220

<v SPEAKER_1>They are thriving.

00:35:19.840 --> 00:35:32.260

<v SPEAKER_1>They both have some cerebral palsy and they've worked with a lot of therapists, but like they were there watching my kids, and we were talking about donor milk, and then they were, they got donor milk when they were in the NICU, and they were like, oh my gosh, that helped save our lives.

00:35:32.260 --> 00:35:42.200

<v SPEAKER_1>I was like, yes, I'm talking to the lady today who runs the whole milk bank, like literally the person that helped you get that donor milk so that you can thrive and become the amazing teenager that you are today.

00:35:42.200 --> 00:35:43.900

<v SPEAKER_1>So I'm crying now as I say that.

00:35:43.900 --> 00:35:46.280

<v SPEAKER_1>But thank you for all of the work that you do.

00:35:46.280 --> 00:35:51.140

<v SPEAKER_1>If I want to share all of the resources, it will all be in the show notes in the description where you guys are listening.

00:35:51.220 --> 00:35:57.720

<v SPEAKER_1>But what's the UC Milk Bank website again, for those who want to go on right now and click that button to become a donor?

00:35:57.720 --> 00:35:58.980

<v SPEAKER_2>So ucmilkbank.ucsd.edu.

00:36:04.120 --> 00:36:18.000

<v SPEAKER_2>I did love that last thing you said, just because I think that really that's the whole point, is creating this community and sending that message is that you can really, really impact another person's life and look at your niece and your nephew and your quads.

00:36:18.900 --> 00:36:28.180

<v SPEAKER_2>One of our donor coordinators had a one-pounder in the NICU, and that it really does affect these families and these babies' lives.

00:36:28.180 --> 00:36:30.440

<v SPEAKER_1>Well, I hope you enjoyed that interview with Alison Wolf.

00:36:30.440 --> 00:36:37.120

<v SPEAKER_1>Again, she's the Executive Director of the University of California Health Milk Bank, located here in San Diego, but they service nationwide.

00:36:37.120 --> 00:36:41.380

<v SPEAKER_1>You can also look up their information online to learn how to become a donor.

00:36:41.380 --> 00:36:50.400

<v SPEAKER_1>I'll link the resources she mentioned from today's episode in the description where you're listening to this episode, but also in the show notes, which you can find online at blwpodcast.com.

00:36:50.400 --> 00:36:53.880

<v SPEAKER_1>I want to say a special thank you to our partners at Airwave Media.

00:36:53.880 --> 00:37:00.360

<v SPEAKER_1>If you guys like podcasts that feature food and science and using your brain, check out some of the resources and the podcasts from Airwave Media.

00:37:00.360 --> 00:37:02.800

<v SPEAKER_1>We're online at blwpodcast.com.

00:37:02.800 --> 00:37:03.920

<v SPEAKER_1>Thank you so much for listening.

00:37:03.920 --> 00:37:04.640

<v SPEAKER_1>I'll see you next time.

00:37:13.528 --> 00:37:17.468

<v SPEAKER_3>Ever dreamed of traveling the world with your children without leaving your home?

00:37:17.468 --> 00:37:23.328

<v SPEAKER_3>Tune in to Culture Kids Podcast to embark on an incredible adventure right where you are.

00:37:23.328 --> 00:37:37.188

<v SPEAKER_3>At Culture Kids, we collaborate with cultural organizations, authors and educators from all over the world to expand our children's horizons, inspiring them to embrace our differences while bridging communities worldwide.

00:37:37.188 --> 00:37:39.348

<v SPEAKER_3>And that's Culture Kids Podcast.

00:37:39.348 --> 00:37:40.788

<v SPEAKER_3>Here's your passport, let's go.