Bursary · human milk

A neonatologist’s thoughts on the value of human milk

The Canadian Premature Babies Foundation recently held an event at Queen’s Park to raise awareness about the needs of premature and sick newborns; more specifically, we talked about the importance of exclusive human milk diets for these babies.  We were honoured to have the Hon. Minister Tracy MacCharles speak, along with MPP Mike Colle who has been doing incredible work for bereaved families.  One of our Bursary Award recipients was there, and Health Minister Dr. Eric Hoskins also dropped by and talked with many of our family representatives and NICU graduates.

Because of his deep understanding of the importance of human milk for these vulnerable babies, we had invited Dr. Salhab el Helou from the NICU at McMaster to share his thoughts at our event. His speech was incredible, and many guests commented after that it helped them understand the importance of this issue. He has graciously shared his comments with us so that we can share them with you. Thank you, Dr. el Helou, for your wisdom and your support – and of course for your wonderful work with babies and families!


Dr Salhab el Helou

Thank you very much for giving me the opportunity to be here. I was asked to say a few words and wondered how I could contribute to this important topic. Perhaps I will reflect a bit on the experience I have had with breast milk and human milk feeding throughout my career in Neonatology.

First, if we talk about human milk in general, wet nursing was first documented in ancient Egypt or in the Babylonian law Code of Hammurabi at about 2000 BC. Why was this? Because babies died who were fed with animal milk.

Much much later the first milk bank in Europe was founded in 1909 in Vienna, and the first in North America in 1910 in Boston. In our western world they later disappeared due to the promotion of formula. The last donor milk bank in West Germany, my home country at that time, was closed in 1972.

In the mid 90s when I did my fellowship in Heidelberg, Germany (one of the best NICUs in the country) we had a significant rate of between 5 and 10 percent of babies born at less than 1500g birth weight developing Necrotizing Enterocolitis or NEC. This is one of the most devastating and most feared diseases or complications in Neonatology. Up to 30 to 40 percent of babies with severe NEC actually die. Hence we tried, as every NICU does, everything possible to bring this rate down with all measures that were available. A neonatologist of the old German Democratic Republic told us, “Guys, what you need is a donor milk bank.” I am not defending the political system of the GDR, but you need to know that every city with more than 20,000 inhabitants had to have a milk bank in the GDR.

Unfortunately there are no reliable or comparable data available about NEC in the former GDR. However, in 2000 I moved to Switzerland. And, suddenly I worked in a unit with a donor milk bank. We would have had about 800 preterm infants below 32 weeks of gestation during the close to ten years I stayed there as a Neonatologist. The number of NEC cases throughout all those years you could count on one hand.

Then, in 2010 I came to Canada. After a few weeks I thought, “Not again …. these NEC cases, where is the donor milk bank?” Again, we engaged in efforts to bring down those rates of NEC and infections, but no donor milk was available for our highest risk patients. And then finally, a few years ago, the Rogers Hixon Milk Bank was established. And you can already see NEC rates declining.

Moms’ own milk and donor milk have been shown to improve outcomes in our preterm patient group. Breast milk or exclusive human milk lowers the rate of infections acquired during a baby’s initial hospital stay. It improves outcomes in terms of brain, lung and eye development.

There are many reasons to focus on providing exclusive human milk diets to all our preterm patients. This is why we are all here, and it is exciting to see all these people coming together to achieve this goal. Thank you very much!

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