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The Mothers’ Milk Bank of TN from the eyes of an Intern

Hello, my name is Hannah Van Houten, and I was an Intern with the Mothers’ Milk Bank of

TN (MMBTN) in the final spring semester of my master’s program at Middle Tennessee State


While I grew up around the world of breastfeeding and milk banks (my mother is a lactation

consultant and nurse, and she also donated to milk banks) there was a lot I didn’t know going into this internship. The extent of my understanding of breastfeeding and milk banks was basically as follows:

● Breast milk was really good for babies- the number one choice for feeding them, if


● Breast milk often changes to fit the needs of the baby

● Milk Banks took donated human breast milk and made it available to babies who

needed it

● Women often have trouble breastfeeding

● Some women produce too little breast milk, and some produce an overabundance of

breast milk.

After working with the MMBTN for around 5 months, I realized there was a lot more to the story than that. Because my background was mainly in nutrition, that is where my knowledge was focused. But my eyes were opened to the other sides of the story during my time with this milk bank. There are so many organizations and groups involved in the process whether it’s from the breastfeeding side, like lactation consultants, or from the milk bank side, like the Human Milk Banking Association of North America (HMBANA) and the Tennessee Initiative for Perinatal Quality Care (TIPQC).

Here are a few of the things I learned, and areas my eyes were opened to, during my time with MMBTN.

● Most milk banks are HMBANA certified, but not all of them are

The Human Milk Banking Association of North America (HMBANA) mobilizes the healing power of donor milk by accrediting nonprofit milk banks in the US and Canada and setting international guidelines for pasteurized donor human milk( HMBANA). Non-profit milk banks, like Mothers’ Milk Bank of TN, are accredited through HMBANA and are required to follow their standards. Not all milk banks are accredited through HMBANA. Some milk banks are for-profit and pay mothers to donate their milk.

● What is HMBANA?

HMBANA, or the Human Milk Banking Association of North America, is a group of nonprofit Milk Banks that chose in 1985 to join together and focus on the goal to mobilize the healing power of donor milk by accrediting nonprofit milk banks in the U.S and Canada, as well as setting international guidelines for pasteurized donor human milk. HMBANA advances the world of nonprofit milk banking through member accreditation, development of evidence-based best practices, and advocacy of breastfeeding and human lactation to ensure an ethically sourced and equitably distributed supply of donor human milk. HMBANA believes in a world where all infants have access to human milk through supporting breastfeeding and the use of donor human milk when milk from the babies’ own mothers is not available.

● What TIPQC?

TIPQC or the Tennessee Initiative for Perinatal Quality Care is an organization that seeks to

improve health outcomes for mothers and infants in Tennessee by engaging key stakeholders in a perinatal quality collaborative that will identify opportunities to optimize birth outcomes and implement data-driven provider - and community-based performance improvement initiatives

● How is breastmilk pasteurized in an HMBANA Member Milk Bank?

Before milk can be accepted at a milk bank, each donor mother is required to undergo

screening and approval. This screening process involves the medical and health history and

status of both mother and baby, to ensure that no diseases are present. Once a mother is

approved to donate, her milk can be pasteurized. HMBANA Member Milk Banks, like MMBTN, follow a carefully standardized protocol for pasteurizing the breastmilk donated.

When donated, the breastmilk is frozen and unpasteurized and will remain that way until

it is ready to be pasteurized. Pasteurizing the milk ensures that any bacteria or viruses

are removed. It is an important step in the PDHM process and must be carefully

followed. To begin the pasteurization process, the breastmilk is allowed to thaw either in

a refrigerator or outside a refrigerator, as long as it is prevented from being altered or

contaminated. Is it then run through a filter to remove any foreign objects that might be

present. Cultures are taken of the milk from each mother and sent to a lab for testing.

The next step is the pooling process, in which the breastmilk is thoroughly mixed to

ensure an even distribution of nutrients the milk contains. Each bottle is filled, leaving

enough air space for expansion during heating and freezing, and all bottles are filled

with the same amount. Bottles are carefully examined, and each one is closed tightly to

prevent leakage. Once the bottles are prepared, they can be pasteurized. The bottles of

breastmilk are submerged in a pre-heated water bath, and a temperature probe is