Milk delivery: the bikers bringing breast milk to vulnerable infants
For Blood Bike volunteers, one of the most rewarding parts of their job is transporting breast milk to sick and premature babies
Blood Bikers: “They work 24 hours a day and are here within 30 minutes of us contacting them. They are an incredible team.”
Blood Bike volunteers are a familiar sight in the country’s hospitals, as the motor-bikers courier urgent medical items – including blood and X-rays – between hospitals and healthcare facilities.
One of their lesser-known cargoes is human breast milk.
“One of the most positive things we do is human breast milk support,” explains Brendan Conroy, chair of Blood Bikes East, which regularly delivers milk between mother and baby, and to and from the national Human Milk Bank in Enniskillen, Co Fermanagh.
He believes it is the speed of their service, rather than any cost-saving benefits, that makes it invaluable to hospitals. “Time is critical to them, and with 97 volunteers, we’ve never let them down.”
“They work 24 hours a day and are here within 30 minutes of us contacting them. They are an incredible team,” says Aisling Bhreathnach, one of the Rotunda Hospital’s lactation specialists. “One scenario would be that if a mother is discharged home and her baby is in the NICU. The blood bikers will collect expressed breast milk from the mother’s home and transport it to the Rotunda NIC. Another scenario would be a mother expressing for her sick baby that has been transported to Crumlin Hospital or Temple Street Hospital, who may be having surgery or has a heart problem. The bikers will collect from Rotunda NICU and transport it to the relevant hospitals.”
The Rotunda’s lactation team works with mothers antenatally and in the NICU to ensure that babies born early are given breast milk. “Premature babies are very prone to a life-threatening bowel condition known as necrotising enterocolitis NEC,” explains Bhreathnach. “Mother’s own milk colostrum [the first milk that is produced] can protect the baby’s gut from infection and save babies lives. Providing these vulnerable babies with colostrum as soon as possible after birth is a very powerful medical intervention.
“It also has a whole range of antibodies and immuno factors to protect the gut from infection and protein, which helps to digest the breast milk efficiently. It’s our policy here now. They have to receive expressed breast milk as soon as possible after birth, or within the hour. If a mum cannot produce their own milk – initially that can happen – we go for donor milk.”
Donor milk comes from the Human Milk Bank, recently re-opened after months of closure. Blood Bike groups collect donations for processing and storage, and then distribute to hospitals as required. “Six Blood Bike groups have created a national network,” says Conroy. “We might link up with Blood Bike Mid-West to bring product to Limerick or Tralee, or with Blood Bike South to get it to Cork.”
Donations are made by lactating women who meet Milk Bank criteria. “The donors would be mothers that are breastfeeding, that have a healthy term baby, and after a month they will express for the bank,” says Bhreathnach. “Mothers with babies in the NICU often like to donate premature milk. There are also occasions where a mother’s baby might die in the NICU and the mother is so compassionate about other sick babies she may offer to donate her premature breast milk.”
Catherine Beckett’s second daughter Robyn was born earlier this year. They knew in advance she would require life-saving medical attention as soon as she was born. “She was born by what is known as an EXIT procedure (ex utero intrapartum treatment) where they leave the cord connected to the baby. A team came over from Crumlin Hospital and there was another team from the Rotunda, so there were approximately 33 people in the operating theatre. I was under general anaesthetic, so I didn’t know when I went to sleep if I would even get to see her alive.
“It was a success and they put in a breathing tube – a tracheostomy – while she was still connected to the umbilical cord. They cut the cord when her airway was secured and she went straight from the operating theatre to Crumlin in an incubator. I woke as they were wheeling her out, so I got to see her, and then she went straight in the ambulance to Crumlin with her dad.
“It was really traumatic but we were just so happy that she was alive. I started to express breast milk within an hour of her birth. One of the lactation consultants came to help me. Because Robyn was two months’ premature, had such a dramatic delivery, and had major surgery coming up, we knew it was really important that she got breast milk. It was colostrum at the start and I was hand-expressing, then we moved on to the pump after three days.
“I was so glad we did it – it is what kept her alive. The midwives were calling it liquid gold. I was in the Rotunda expressing and sending breast milk over every day, while her dad was in Crumlin. She was so fragile. We could have lost her at any minute, so neither of us wanted him to leave her bedside.
“I was expressing every three hours, day and night. I would build up a little stash and then the Blood Bikes would come over at least once a day and bring it over to Crumlin, where it would go up to Robyn and they would put it in her feeding tube. The Rotunda just made it so easy. We didn’t have to organise anything, it just happened. I would hand the milk to a midwife and the next thing Robyn’s dad would be texting me to say they were giving her the breast milk.”
Beckett never saw the Blood Bikers while she was in the Rotunda, but is so thankful to them. “I’ve now seen them coming and going from Crumlin. It is an absolutely amazing service and I didn’t really appreciate it at the time. With all that was going on in the moment it was great to have it taken care of.”
Conroy says they are always delighted to help families. “I recall one lady from the Rotunda whose father was dying in another part of the country, but her child was still in hospital. Her husband was driving up and down so the Rotunda asked us what could we do?
“There was a Blood Bike group in that area so we contacted them and set up a relay to bring it to the unit. It’s a very small thing you’re doing, however, when you see the relief on parents’ faces when you walk in with what their child needs, it provides a great sense of purpose.”