Carina Cervantes never thought she would become a breast milk donor.
After three years of trying, she finally got pregnant last year. The first-time mom was overjoyed to welcome her daughter, Rosabell, into the world. In June, she celebrated with a gender reveal party.
A few days later, Cervantes wasn’t feeling well, so she went to Stormont Vail Health in Topeka, Kansas. There, at 23 weeks, she gave birth to her micro-preemie.
Rosabell spent three months in the neonatal intensive care unit (NICU) until she died Sept. 13. Women are often already lactating when they’re 16-18 weeks pregnant, so some mothers who have lost their baby have a choice between expressing or suppressing their milk.
After the trauma Cervantes had from losing her daughter, she almost chose to suppress her milk supply. But she said the memories of feeding Rosabell during the months before she died caused her to change her mind.
“(The hospital) would provide us with a little cotton swab, and we would be able to dip it in my breast milk and go around her mouth and lips, just so she would have that taste because she was getting fed through a feeding tube. It was really nice for us to see that she was really enjoying my milk,” she said. “Once she passed away, we both agreed that, instead of me throwing (away) my milk, (donating) it would mean a lot for both of us and just in honor of her.”
Cervantes is one of nearly 2,000 donors who’ve been approved by the Oklahoma Mothers Milk Bank since the nonprofit started ten years ago. It distributes donated breast milk to hospitals across the region, and its vision is to help every baby have a healthy start — especially those who need a little extra help getting nutrients to grow and reduce illness.
On March 2, the bank will celebrate ten years of supporting those babies and their parents with over 1 million ounces of donor milk dispensed since its inception.
Bridging the gap
The bank began with Anne Darnell. Her first daughter spent five weeks in the NICU at Saint Francis in Tulsa, and Darnell struggled to breastfeed. A lactation specialist taught her how to pump milk for her baby, and she ended up having milk left over that she donated to a North Texas milk bank.
“When I ended up pregnant with my second child, I had a conversation with another mom, and I said, ‘It's really a shame that Oklahoma doesn't have a milk bank like North Texas,’” Darnell said.
Little did she know, Becky Mannel, an international board-certified lactation consultant and the bank’s now-executive director, was also considering what a milk bank could mean for Oklahoma. The pair teamed up in 2011, and by August 2013, they found the funding to start dispensing milk.
The nonprofit went from distributing around 10,000 ounces in its first year to nearly 160,000 last year. A little over 90% of the milk goes to hospitalized babies, and the rest goes to outpatients, which include moms and babies with medical needs in home settings. The bank serves over 30 hospitals, including every hospital in the state with a NICU and locations in Kansas, Missouri and Arkansas.
Mannel said the difference between breast milk and formula is breast milk is easier to digest and reduces the risk of premature babies developing necrotizing enterocolitis — a life-threatening illness that causes inflammation of the intestine. It also contains stem cells that provide babies with passive immunity that can continue until the baby’s immune system fully matures.
“We want to bridge that gap and have that baby have the strongest immune system possible,” Mannel said.
To guarantee safety, the milk bank has a screening process for donors that includes verifying their medical history, which takes about two weeks. The bank also ensures the milk maintains its nutrients by completing a pasteurization process on-site with milk batches that combine the donations of three to five mothers. This helps equalize the nutritional composition of each batch, which may differ between mothers.
The bank’s operating guidelines are set by the Human Milk Banking Association of North America. It accredits its 33 nonprofit member milk banks.
“Since our inception, donor milk has successfully been provided to babies in need without incident due to our tremendous safety record,” said Lindsay Groff, the association’s executive director.
Groff said a main difference between nonprofit milk banks like Oklahoma’s and for-profit banks is that they have a volunteer-only donor pool.
“The reason we accept donations rather than remunerate or pay donors is essentially to keep the costs as low as possible. … What that means is it's a more equitable distribution so that the costs are lower and more babies can receive donor milk, regardless of ability to pay,” Groff said.
Milk banks also work together, meaning if Oklahoma ran out of donor milk, it would receive assistance from the association’s other members. Together, the banks have distributed nearly 10 million ounces of milk.
“Behind every drop of milk is a story, and it is a selfless act where our donors step up, and they want to give to babies in need,” Groff said.
Who is benefiting from the bank?
Mothers often hear about the program through hospitals or word-of-mouth.
For example, Kelly Pineda, an Oklahoma Women, Infants & Children Program (WIC) employee and mom from Pauls Valley, directly donated milk to family members and other moms due to an excess after both of her pregnancies. Through her donations, she heard about Oklahoma’s bank, and now she refers her clients there.
“I'll refer them to the application and say, ‘Hey, see if you can get milk through them.’ Or there's moms who make an excess — if you're making too much, go through the milk bank because they're always needing breast milk,” Pineda said.
The bank also offers a bereavement program that mothers like Cervantes have donated to.
To honor those donors, the bank recruited local artist Aditi Heins to paint the Sylas Murphy Memorial Wall. The wall is dedicated to the bank’s first donor, who lost her baby, Sylas. It’s adorned with butterflies and plaques with the names of bereaved donors and their babies.
“It's public affirmation for them that they were pregnant, they were a mom, they had a baby,” Mannel said.
Holly Skinner, the bank’s community engagement coordinator, said she sends an additional butterfly to bereavement donors with a pearl made of 10 milliliters of their breast milk. Cervantes picked a purple butterfly for Rosabell.
“I think that's something that is really meaningful for anybody that's donated due to their baby passing away,” Cervantes said. “It really meant a lot for me to see that her name will always be there and on that wall as a memory … that my baby was able to help another baby.”
Those donations go to families like the Huddlestons, who live in Mustang and have had two NICU babies. The father, Bryan, said they relied on milk from families at their church after their first pregnancy. But after their second, they received donor milk, which helped his wife transition out of the hospital and eventually start breastfeeding when she was ready.
“Actually getting to partake in the program was beneficial and actually very rest-assuring for us, knowing that they have a program that's out there with moms that are able to donate and be able to help other families that sometimes just don't have the supply or can't produce at that time,” Huddleston said.
What comes next?
As Mannel looks toward the future, she said she has big plans for the Oklahoma bank.
The bank is currently working to get more outpatients after the Oklahoma Health Care Authority (OHCA) expanded Medicaid coverage for donor milk to home settings.
Mannel said the bank has worked to get Medicaid coverage for donor milk since it began, and it even received support from Sen. Carri Hicks (D-Oklahoma City), who authored Senate Bill 469 to extend coverage to outpatients in 2021. The bill made it through the Senate and died on the House floor. Then, the OHCA decided to extend coverage through its budget.
The bank is also advocating for legislation at the federal level through the Access to Donor Milk Act of 2023. The bill was a product of the 2022 infant formula shortage, and Republican U.S. Rep. Stephanie Bice (OK-05) is a lead sponsor. She toured Oklahoma’s bank and signed on to the bill.
The bill would:
- Allow state agencies to use WIC funding to promote and support donor milk.
- Provide funding for milk banks in case there is an increase in demand for donor milk, like during a formula shortage.
- Create a donor milk awareness program at the Department of Health and Human Services.
- Require the Secretary of Health and Human Services to clarify the regulatory status of donor milk provided by nonprofit banks.
“We're really excited about this bipartisan, bicameral legislation that is out there right now, and we hope to see more movement because we can all agree that saving babies' lives through donor milk is something that we all want,” Groff said.Mannel said her ultimate goal would be to expand access to any baby who needs breast milk.
“There could be a term-healthy baby whose mother … is diagnosed with cancer and is starting chemotherapy next week and has to stop breastfeeding. We still want that baby to get human milk,” Mannel said.
Until then, Mannel said they’ll keep fighting to support healthy starts for babies and moms – whether that’s a new beginning for families like the Huddlestons or honoring the lives of babies like Rosabell.
