RALEIGH — The benefits of breast milk seem to multiply with each new study, from warding off dangerous infections in newborns to reducing the cancer risk of children as old as 15.
And as more benefits come to light, demand for the milk increases among doctors and mothers seeking to feed babies breast milk even if their own mothers cant provide it in some cases by trading or buying it online.
For much of the Southeast, Sue Evans is the keeper of this coveted elixir in its safest form. As director of WakeMeds Mothers Milk Bank, one of only two accredited sources for human breast milk on the East Coast, the longtime nurse makes sure that thousands of vulnerable babies are fed safe, donated human milk.
Evans has run the center since 2007, taking it over after 14 years as a mother-baby nurse, a lactation consultant devoted to helping mothers breastfeed, and an assistant in the milk bank. Shes also secretary of the Human Milk Banking Association of North America, which sets guidelines for the nations 13 accredited milk banks.
Lately, her job has also included educating potential donors about milk banking amidst the growth in online marketplaces for human breast milk. Largely unregulated, these sites have drawn donors away from hospital-based banks just as the demand for human milk has risen dramatically.
A study published last month in the journal Pediatrics analyzed thousands of samples procured through such websites, and found that three in four had harmful bacteria such as salmonella.
The milk at WakeMed is collected from mothers in several states, pasteurized at the bank and sent to hospitals from Florida to Tennessee to Pennsylvania, where it is fed mainly to premature infants. Donors are carefully screened, and the process of collecting and distributing the milk is tightly regulated.
Bonnie Gustavison, director of women and childrens services at WakeMed, calls the little-known bank a hidden miracle. She says Evans nursing background and expertise in all aspects of breastfeeding have helped her work with new mothers as well as handle the technical aspects of milk banking.
Its great because she can identify with these mothers and work with them to get the best supply she can, Gustavison says. And shes very meticulous to make sure its all done as safely as possible, with the newest standards in mind. Shes very dedicated to what she does.
Evans, 52, grew up in New York state, and wanted to be a nurse for as long as she can remember, though shes not sure why; no one in her family had any connection to the medical field.
I guess I had just watched medical shows on TV, she says.
She started working as a nurse when she was 18 after finishing her last year of high school while also attending community college at the urging of her father, a guidance counselor.
She continued working as a nurse in different positions, including intensive care and general surgery wards. She started moving south seeking warmer weather and worked in Virginia and Florida, where she met her husband.
The couple and their three boys moved to Raleigh in 1992. Despite her many years of nursing experience, Evans had never worked with new moms and babies and had little interest in a job in the maternity ward. But it was the only position available at WakeMed, so she took it.
I found right away that it was my niche, she says. Its such a happy time, and you can teach the mothers so much.
One of the things she helped the new mothers with was breast feeding, which at the time was not as common a choice for new moms. Evans breast fed her three children and had been breast fed herself.
She eventually decided to train as a lactation consultant, working full time helping mothers and babies with nursing as the trend toward breast feeding grew. But she didnt do it long before the milk bank needed help, allowing her to take her strong beliefs in the power of breast feeding to a different arena.
Evans says she was reluctant to leave her job for a more administrative role at the bank. But she knew it was important work.
This was totally different from anything I had ever done, but I saw the need for it, Evans says. I knew that these babies need to start their lives with this milk to have the best chance they can have.
Sustaining the tiniest babies
WakeMed was one of only a handful of hospitals to have a milk bank when it opened in 1992, the same year Evans arrived at the WakeMed maternity ward. The closest accredited milk banks now are in Texas and New England.
The bank itself is just a few small rooms with freezers, a collection of coolers and paperwork, a small office, and a pasteurizing machine. It started out providing about 4,000 ounces a month, and now produces up to 20,000 ounces a month.
These days its hardly even a bank. Thanks to the ongoing shortage of human milk, much of the milk it receives is shipped back out to hospitals, or fed to babies at WakeMed, as soon as its pasteurized.
The vast majority of it goes to the smallest premature babies, who most need the benefits of human breast milk, and whose mothers are often not able to produce enough of it.
WakeMed neonatologist James Perciaccante says milk from the bank has been particularly helpful in preventing necrotizing enterocolitis, an often fatal disease that is most prevalent among premature babies. WakeMeds rates of the disease are below average, says Perciaccante, even though they treat the tiniest babies in the county.
The only thing we can do to reduce this is breast milk, says Perciaccante, medical director of the neonatology ward. The bank has made a huge difference for us.
Milk donors needed
Evans would love to have enough milk to feed older and larger babies as well, but she needs more donors.
About 150 mothers currently donate to the WakeMed clinic, most of them working mothers who pump more milk during the workday than their own children need. A few continue to pump after an infants death as a gift for another child.
Interested mothers go through a phone interview, fill out a lengthy questionnaire and have their blood screened. They arent paid for their efforts, which Evans says is ethical, but leads some mothers to choose online trading places where they can sell their milk.
If you pay them, you have to wonder if the mom is going to sell her milk and let her own baby go without, she says. Our donors do it because they want to help babies.
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