Overview
The Family Welfare Division has released a guideline for Lactation Management Centre. This guideline aims to provide a technical requirements and guidance for the establishment and operation of the Lactation Management Centers in Nepal.
Purpose of the guideline
- Ensuring timely initiation of breastfeeding and promoting breastfeeding practices.
- Providing guidance to establish:
- Comprehensive Lactation Management Centres (CLMCs) for donor human milk collection, storage, processing and dispensing for babies admitted in health facilities.
- Lactation Management Units (LMUs) for collecting, storing and dispensing of mother’s breast milk, expressed and stored for consumption by her own baby.
- Lactation Support Units (LSUs) for providing lactation support to mothers at all delivery points.
Operationalizing evidence based and standardised technical protocols for donor screening and collection, processing, storage and dispensation of human milk.
Ensuring the quality and safety of donor human milk (DHM) is the ultimate aim of these guidelines and recommendations have been made to minimise the risk of DHM to recipients.
Key definitions
Comprehensive Lactation Management Centre (CLMC): is a centre at a health facility for the purpose of providing comprehensive lactation support and management for all mothers within the hospital. Facilities for collection, screening, processing, storage and dispensing of donated human milk for babies without access to their own mother’s milk and expression and storage of mother’s own breast milk for consumption of her baby are available in CLMC.
Lactation Management Centre (LMC): is a centre established in the health facility for the purpose of providing lactation support to all mothers within the health facility for collection, storage and dispensing of mother’s own breast milk for consumption by her baby.
Donor: A lactating woman who voluntarily donates milk after screening and approval. A donor shall not receive remuneration for the donation of human milk.
Principles of donation: Donation should be done freely and voluntarily without any monetary benefits to the donor and with an understanding that the donated milk may be used to feed the baby of another mother admitted in the hospital free of any cost.
Donor Human milk: Donor Human Milk is milk expressed and voluntarily donated by lactating women other than the biological mother of the recipient. This donor human milk is pasteurized using the Holder Pasteurization Method and dispensed for use of the recipient.
Mother’s own milk: Human milk expressed for consumption by the mother’s own baby. Preterm milk: Human milk expressed within the first 4 weeks’ post-partum by a mother who delivered at or before 37 weeks of gestation.
Term milk: Human milk expressed by a mother giving birth after 37 weeks, or before 37 weeks but after 4 weeks postpartum.
Fresh raw milk: Human milk expressed within 24hrs and stored at temperature at or below +40C (+2 to + 4oC). Frozen raw milk: Human milk that has been frozen after expression and stored at –20oC.
Donor human milk-contact surfaces: All surfaces that contact donor human milk during normal course of operations. This includes utensils and food-contact surfaces of equipment, such as flasks, bottles and caps.
Collection: The act of expression and obtaining human milk.
Processing: The use of evidence based methodologies and criteria required to prepare and identify human milk for use for the recipient.
Pasteurized donor human milk: Donor human milk which has undergone process of pasteurization in a defined apparatus as per these technical guidelines.
Pasteurization: It is a process where the milk in a sealed container is heated up to 62.5oC and held at this temperature for 30 minutes followed by rapid cooling in a definite apparatus.
Thawing: To change from a frozen solid to a liquid by gradual warming ideally by transferring from the deep freezer (–20oC) to a refrigerator (+2°C to +8°C) over a period of 24 hours.
Equipment clean: Equipment that is cleaned and maintained according to manufacturer’s instructions.
Sanitize: To adequately treat donor milk and contact surfaces by a process that is effective in reducing or destroying pathogens but without adversely affecting the product or its safety for consumption.
Refrigerator: An instrument to maintain temperature from +2°C to +8°C. Deep freezer: An instrument to maintain temperature at or below –20°C.
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