It has been over three years since the country’s first ever human milk bank was launched, but the initiative is not progressing and is at risk of shutdown as well.
Officials said the programme’s religious sensitivity and lack of interest from the health authorities are the key reasons why it has not picked up momentum.
The programme was launched by the Special Care Neonatal Unit (SCANU) and Neonatal Intensive Care Unit (NICU) at the Institute of Child and Mother Health (ICMH) in the capital’s Matuail on December 1, 2019.
During the launching, the hospital authorities said premature or sick babies staying at the SCANU or NICU will be fed the breast milk preserved at the bank.
They said the milk could be used for adopted or abandoned infants as well, adding this could reduce the death of premature babies to a great extent.
Besides, they said lactating mothers whose newborns have died or who have leftover milk after feeding their infants could store breast milk at the bank.
Associate Professor Mohammad Mozibur Rahman, head of SCANU and NICU, told The Business Post their team had long wondered whether the milk bank could be run in compliance with the country’s Islamic law.
Establishing a human milk bank is not an unusual incident in the Muslim world, with Kuwait being the first country to take the initiative. Some other countries like Iran, Iraq, Pakistan, and Turkey have also taken similar initiatives, but very little is known about their progress.
Donor milk banking as conducted in the Western society is not considered to be ethical in Muslim society, where the milk donor and the recipient are required to know each other, says an article titled “The introduction of breast milk donation in a Muslim country” and published in the Journal of Human Lactation in 2000.
Sources at Bangladesh Islamic Foundation said some Islamic scholars of the foundation were initially in favour of establishing the milk bank for the greater benefit of society but their support was conditional, such as ensuring measures to record the identities of donors and receivers.
However, considering the social and religious aspects, possible behaviour anomalies, and whether the health authorities would be able to ensure strict monitoring, the scholars eventually went against the initiative.
From clinical aspects, human milk banks are important for the care of premature babies and critically-ill newborns who do not have access to their biological mothers’ milk.
However, many Muslim scholars have raised their concerns referring to Islamic rules, saying if a boy and a girl are not biological siblings but suckle the same woman, they still cannot marry each other when they grow up.
That is why the government or any organisation providing milk bank facilities will have to exercise great caution, they said.
The authorities will have to keep records of which woman breastfed which child, which is a difficult task as most Muslim countries do not have a good data management system, they added.
However, Fahmida Akhter in Dhaka, who has a daughter, thinks milk banks could be established even if there is not a good data management system in place.
“It is about the two families maintaining caution themselves. If a woman is breastfeeding the child of someone else, the two families will have to be careful about the marriage thing,” she explained.
“I see milk banks positively. I think such an initiative will also play a role in creating good relationships between families,” she added.
Mozibur said the ICMH milk bank is equipped with a pasteuriser that has a special shell to pasteurise a small amount of breast milk, a laminar air flow machine, a hot air oven, stainless steel containers labelled with heat- and water-resistant IDs, deep freezers, high-quality breast pumps, a data entry system, and ID card printers.
The bank has the capacity to collect, process, and preserve 50-250 millilitres of milk daily, which can be served to 50-100 newborns, he added.
Apart from religion, there are administrative reasons why the milk bank initiative has not progressed. Human milk banks are related to nutrition and thus fall under the jurisdiction of the maternal and neonatal healthcare and nutrition entities at the Directorate General of Health Services (DGHS).
But ICMH officials related to the milk bank said none of the government entities cared about the programme, which is why it is now on the verge of closure.
The hospital’s Executive Director Professor Dr MA Mannan said, “We are now preserving the donated machinery worth over Tk 1.5 crore so that the government can use those if they want to fully implement the programme later.”
“If the health authorities wanted, they could continue the programme under some conditions. But it seems they do not care,” he added.
Maternal, newborn, child and adolescent health (MNC&AH) Line Director at the DGHS Dr Saiduzzaman could not give any information about the programme.
Shamsul Haque, former MNC&AH line director, spoke on some occasions about the ICMH programme. After his retirement late last year, The Business Post tried to learn who dealt with the milk bank matter at the DGHS but to no avail.
No one at the National Nutrition Services unit under the DGHS could provide any information either. Some officials of the unit said it was not their project and they know nothing about it.
The ICMH programme was among four launched in 2019. The three others got nipped in the bud.
