There’s no argument about the health benefits of providing donor milk to hospitalized infants. Because of this, usage of donor milk has sharply increased in hospitals and is now the subject of greater scrutiny in the areas of cost and safety. It’s been a land of smoke and mirrors where, ironically, scant information is provided to the very health care providers who are responsible for the health and safety of fragile babies.
AND that scant information decreases the value of donor milk substantially. Some doctors call it “mystery milk” because they don’t know how it’s tested, processed or what nutrient levels it contains and it is often processed by volunteers with no experience in food safety or processing.
So, typical donor milk is too expensive.
Many hospitals are purchasing donor milk with no professional nutritional label, or with caloric content that varies from lot to lot. If nutritional information is provided, it is often incorrect, with protein and calories overstated. Hospitals are puzzled by the inability to calculate nutritional density and often disappointed by poor weight gains.
While many hospitals simply look at the cost per ounce to compare the economics between suppliers, a government sponsored cost benefit analysis demonstrated that the true cost is a combination of several factors. Of course, in addition to cost, safety factors also come into play. This article will cover the cost factors in an effort to guide hospitals in their economic analysis. The cost per ounce charged by the milk banks is just the start. Consider the following factors:
- Waste reduction. Once thawed, pasteurized donor milk must be discarded 24-48 hours after thawing. Medolac makes the only commercially sterile donor milk that can be shipped and stored at room temperature for three years. In the abovementioned analysis, a 35 bed NICU found that, on average, 10% of their frozen/thawed donor milk was rendered unusable, with an annual cost of $1,296.
- Reduced cost of inbound shipping. Personnel in the same NICU spent 72 hours to pick up the frozen donor milk via military courier from a local milk bank for a total annual cost of $1,520. This was substantially more economical than the overnight express shipping required by most hospitals which is often overlooked because the milk bank uses the hospital freight account to ship. Medolac milk is shipped regular ground freight and the cost of shipping is often rolled into the hospital contract price.
- Reduction in milk technician/nursing hours. The time required by clinicians to thaw the milk ranges from one to three hours per day. The average annual cost associated with this process equates to an annual cost of $13,477. Medolac’s shelf stable donor milk requires no thawing and is ready to use when needed. This has the additional clinical advantage for infants who may experience a rapid drop in blood sugar, requiring immediate access to donor milk without the delay from thawing.
- Eliminating the cost of milk warmer liners for donor milk. In the report, the cost associated with utilizing new milk warmer liners for each warmer to thaw frozen donor milk equates to $400.00 per year.
Using this model, the hospital NICU which was the subject of this review, had a net annual savings of $12,093 despite the fact that they were paying $1.25 more per ounce for Medolac’s donor milk.
Other Economic Factors to Consider
Access to reliable supply. Valuable staff time is spent calling community milk banks to look for available inventory. Medolac reserves a par level for its hospital accounts, ensuring that there is a ready supply even during high census periods.
Homogenization. Some milk banks misuse this term when they really mean that the ilk from several donors is blended. True homogenization emulsifies the fat portion, breaking it into smaller, more digestible pieces. Medical studies have reported better weight gains for preterm infants receiving homogenized mother’s milk AND hospitals report that Medolac’s homogenized donor milk eliminates or reduces clogged feeding tubes. If less fat is stuck to the tubing, more fat is available to the baby.
Consistent nutritional formulation and labeling. With Medolac donor milk, fortification strategies do not need to be modified with each batch of donor milk received. Community milk banks often have no label or the label claims are incorrect. Ask your vendor how they determine the nutritional information they provide.
So, while typical donor milk is too expensive, we have worked hard to deliver more of what hospitals and parents of hospitalized infants need to be confident. We would love to continue reducing the cost of using donor milk while improving safety and ease of use. With improved safety and decreasing costs, we hope to end donor milk rationing in neonatal intensive care units once and for all.