Challenges in implementation of mother milk banks in Rajasthan: A situational analysis

Sub-Categories	Verbatims
A. SYSTEM CHALLENGES
	“I came along with my mother-in-law. She is in her 60s.
Structure	There is no sitting arrangement for her.” (M)
	“Sometimes we try to manage activities at our own cost.
	There is always a shortage of recurring funds.” (H)
Financial Support	“There should be the provision of the separate pool to protect established milk banks through constant funding.” (H)
	“Mothers often fail to maintain hygiene which leads to contamination of the donated milk.” (H)
	“Every drop of milk is precious for a sick infant. We
Operational process	screened all mothers and keep all hygienic practice throughout the process.” (H)
	“Mothers post-pregnancy are weak and lethargic. Long waiting period makes them tired. They should be provided some refreshment.” (H)
	“During COVID times, families fear the risk of transmission of the virus. We were helpless in lack of any Disaster Management plan and frequently changing guidelines.” (H)
Technical Process	“The laboratory should be functional inside mother milk bank with strong monitoring framework to ensure safety and avoid contamination.” (H)
	“We filed complaints a couple of times for improper functioning of equipment, but nobody replies.” (H)
Quality Maintenance	“Systematic database management is lacking.” (H)
	“There is a lack of systematic communication channel for problem-solving.” (H)
Human Resources	“It takes few minutes to counsel mother and families about benefits of donated human milk over formula feed. But there is the shortage of staff.” (H)
	“To run mother milk bank efficiently, there is need of dedicated staff.” (H)
Demand-Supply Ratio	“Donated human milk is a blessing for the child with no mother. We promote and encourage the mother to donate extra milk for orphans and abandoned child.” (H) “Motivating mothers to return for a donation once they leave hospital premises is challenging.” (H)
	“I lost my baby. I want to donate milk to help other mothers with less milk, feed her baby properly. It is satisfying and provides peace.” (M)
Knowledge about DHM & MMB	“Donating milk is an act of kindness. It will not only help me express more milk but will also help someone else’s baby to get food.” (M)
	“Expressed milk should be discarded after few hours as it loses its properties.” (H)
	“We promote exclusive breastfeeding as this keeps child thriving and away from infection.” (H)
	“If I’m convinced that donating mothers are strictly screened…I don’t have any issue using donated milk for my baby.” (M)
	“If no judgment is passed, I will be happy to assist a mother feed her baby.” (M)
Attitude (Willingness /Unwillingness to	“My milk is only for my child. It symbolizes my love for my child.” (M)
donate /utilize DHM)	“It sounds insane. How can I feed my child with someone else’s milk of other caste or no cultural values? What if my child inherits their values?” (M)
	“I wish to donate, but fear my in-laws. They don’t allow me, saying that first feed own child properly instead of donating.” (M)
	“My relative donated when she was lactating. She motivated me to do so.” (M)
	“One family directly came to us enquiring for donated milk.
	We counseled them and gave lactational support to the mother and it had been successful. One should understand
Practices (Barriers/ Influencers)	DHM isn’t a replacement of breastfeeding” (H)
	“Some communities are rigid. They treat milk banking practices as sin. We need to educate them” (H)
	“Some mothers hide their breastfeeding problems. Fear of in-laws is a major contributing factor to this behavior.” (H)
B. COMMUNITY-RELATED CHALLENGES
	“In our culture, feeding our child with someone else’s milk is a bigger obligation. We can’t bear this loan” (M)
Awareness/Motivation	“Donated milk is not safe. It is a combination of milk of various mothers. Who knows if any one of them is infected?
	We can’t take chance with our son.” (M) “Public leaders must take this agenda in community and create awareness” (H)

Matrix Elaborating Levels of Facility-Based Lactation Management Centers in Public Healthcare System

	CLMC*	LMC†	LSU‡
Other Name	Tertiary Milk Bank	Mini Milk Bank	Milk Storage Unit
Infrastructure	Elaborate setup for heterologous milk collection, screening, processing, storing and distributing DHM^§.	Setup with homologous milk collection, storage and dispensing of milk for consumption by her baby.	Setup to store small quantity of processed milk on a consumption basis.
Location	Medical College with NICU^¶ or Large District Hospital	District Hospital /Subdistrict Hospital /First Referral Units (FRUs) with functional SNCU^#	At Subdistrict Hospital /CHC/PHC with high case load NBSU**. (all delivery points)
Complexity and Resource Intensity	Highest	High	Low
Responsibility	Act as an ancillary support to the Baby Friendly Hospital Initiative (BFHI).Act as a supply unit for Milk Storage Unit.	Provide lactation support to all mothers within facility.	To maintain continuum of care by providing round the clock breastfeeding support, lactational counselling and Kangaroo Mother Care (KMC) support to mothers.
Recommended Space	Approximately 350 square meters	Approximately 160 square meters	Any identified space for breastfeeding as per Mother Absolute Affection (MAA) guidelines.
Recommended Minimum Bedded	20 bedded NICU along with SNCU	12 bedded SNCU	High caseloads NBSU
Recommended Full-time Staff	Manager (1) Lactation Support Staff (5) (only female staff) Technician (1)	Lactation Support Staff (2) (only female staff)	No dedicated human resource.
Recommended Part-time Staff	Microbiologist (1) Hygiene Helper (one per shift)	Hygiene Helper (1)
Recommended Existing Staff in facility to be utilized	Neonatologist (2)	Neonatologist (2)	FIMNCI Nurse†† and Doctor in-charge NBSU
Set-up cost (One time)	Rs. 33,114,00/-	Rs.9,75,000/-	Cost of deep freezer, foot-operated basin, glass bottles if not already available.
Recurring cost Per annum	Rs. 14,76,000/-	Rs.4,65,000/-	-

Język:: Angielski

Częstotliwość wydawania:: 1 razy w roku
Dziedziny czasopisma:: Medycyna, Medycyna kliniczna, Pediatria i leczenie młodzieży, Hematologia i onkologia dziecięca, Zdrowie publiczne

Kanał RSS czasopisma

Challenges in implementation of mother milk banks in Rajasthan: A situational analysis

Kategoria artykułu: Original research

Data publikacji: 01 kwi 2022

Zakres stron: 86 - 94

Otrzymano: 20 kwi 2021

Przyjęty: 05 sie 2021

DOI: https://doi.org/10.34763/jmotherandchild.20212502.d-21-00009

Słowa kluczowe
Breastfeeding, breastmilk, milk banks, lactation, root cause analysis, infants

© 2021 Neha Mantri et. al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

j_jmotherandchild_20212502_d-21-00009_tab_002

Matrix Elaborating Levels of Facility-Based Lactation Management Centers in Public Healthcare System

Challenges in implementation of mother milk banks in Rajasthan: A situational analysis

Neha Mantri

Akhil D Goel

Nitin K Joshi

Pankaj Bhardwaj

Vaishali Gautam

Manoj K Gupta

Kategoria artykułu: Original research

Data publikacji: 01 kwi 2022

Zakres stron: 86 - 94

Otrzymano: 20 kwi 2021

Przyjęty: 05 sie 2021

DOI: https://doi.org/10.34763/jmotherandchild.20212502.d-21-00009

Słowa kluczoweBreastfeeding, breastmilk, milk banks, lactation, root cause analysis, infants

© 2021 Neha Mantri et. al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

j_jmotherandchild_20212502_d-21-00009_tab_002

Matrix Elaborating Levels of Facility-Based Lactation Management Centers in Public Healthcare System

Słowa kluczowe
Breastfeeding, breastmilk, milk banks, lactation, root cause analysis, infants