Breast milk is the optimal source of nutrition for babies, and for extremely premature and critically ill newborns, it can even save their lives by preventing infections and complications. The Hong Kong Children's Hospital operates the city's first breast milk bank which supplies pasteurised donor breast milk to the neonatal intensive care units (NICUs) of all public hospitals for babies with clinical needs.

▲ The HKBMB held its opening ceremony on 16th June, marking a milestone in neonatal care. Secretary for Health Prof. Lo Chung-mau; Director of Health Dr Ronald Lam; Chairman of the HA Mr Henry Fan; and Chief Executive of the HA Dr Tony Ko officiated at the ceremony.

In the 2023 Policy Address, the government announced the establishment of a breast milk bank and the donation mechanism. The Hospital Authority then set up a steering committee and working groups to plan for the service. The Hong Kong Breast Milk Bank (HKBMB) commenced operation this January. HKBMB Director Dr Rosanna Wong, who is also the Chief of Service of HKCH Department of Paediatrics & Adolescent Medicine, said, “Since there was no local precedent, we visited the milk banks in Shenzhen, Guangzhou, Singapore and Australia to learn about their physical set up, service model, manpower establishment and promotional strategies. We also considered local factors in formulating our guidelines and workflows. For example, as most Hong Kong mothers are in the workforce, we arrange courier service to collect milk from donors’ homes to save their hassles.”

Dr Wong explained that the HKBMB is responsible for coordinating the collection, processing, screening, storage, and distribution of donor milk, similar to the hub-and-spoke paediatric service model of HKCH. This makes HKCH a natural choice to host the milk bank.

Rigorous procedures to ensure safety and hygiene

Breast milk donation is a new concept in Hong Kong. Donors and recipient families are understandably concerned about its hygiene and safety. Therefore, gaining public trust is of utmost importance. HKBMB Deputy Director and microbiologist Dr Sally Wong said, “We have overcome various challenges and developed protocols adhering to international standards. The HKBMB has obtained ISO 22000 and HACCP accreditation in food safety management.”

▲ Donor breast milk goes through meticulous processing including pasteurisation, microbiological testing and nutritional analysis, all under precise temperature control to ensure quality and safety.

▲ The HKBMB and the Information Technology Department set up a system to track and trace every step from breast milk collection, processing, testing, storage to final dispensing to infants. The relevant information will be retained for 30 years.

Medical Technologist Wong Hoi-wai supplemented that some essential equipment does not even have a local distributor. She thanked the hospital’s procurement team for communicating with manufacturers, ensuring that the milk bank would be equipped with a clean environment and high-quality equipment.

Every drop is a gift of love

A sufficient and continuous supply of donor milk is vital in sustaining the milk bank service. Advanced Practice Nurses Christine Lam and Rebecca Wong are responsible for donor recruitment and support. Once they took up the role, they have worked tirelessly to produce promotional materials and liaise with the obstetric and paediatric units in various HA hospitals as well as the Maternal and Child Health Centres to invite breastfeeding mothers to register. Their daily work also includes interviewing potential donors for health screening, arranging blood tests, providing breastfeeding counselling to donors, and regularly following up their health condition.

▲ The HKBMB set up a breast milk donor service centre in the HKCH lobby, providing information, counselling and breastfeeding support.

▲ The HKBMB produced some tote bags as a token of appreciation for donors’ invaluable contributions.

In just six months after service commencement, the HKBMB had already collected over 1,000 litres of donor breast milk, which already reached the yearly target. As of mid-July, over 280 donors have successfully registered, and about 200 babies have been benefited. Dr Rosanna Wong expressed her gratitude, “The achievement has far exceeded our expectations. It demonstrates the love of Hong Kong mothers and the collective effort of all parties involved. We will continue to deliver high-quality service, and increase parents’ acceptance of donor milk. Our long-term goal is to conduct related research to further improve milk quality, and leverage the success of the HKBMB to promote breastfeeding in the society.”

▲ Pasteurised donor milk is distributed to all nine public hospitals with NICU. Healthcare professionals then administer appropriate portions according to each recipient infant's needs.

▲ Breast milk donors Fuk and Yoyo (left side), along with Mr and Mrs Tong, parents of breast milk recipients (right side), share their touching experience at the ceremony.

A lifeline for premature twins

Mrs Tong still remembers the gut-wrenching arrival of her twin daughters at just 32 weeks. They were immediately admitted to the NICU of Queen Elizabeth Hospital. “I burst into tears the first time I saw my daughters. They were so tiny, with tubes all over their bodies.” When the parents were first introduced to donor milk, they hesitated. Said Mr Tong, “I had prejudice to use some strangers’ milk. But when I read the pamphlet that donor breast milk could reduce the risk of necrotising enterocolitis in premature babies, I gave consent immediately. I simply wanted my daughters to be safe and well.”

▲ Mrs Tong's premature twins were born at just over 1 kg and required ventilation support in the NICU. With medical treatment and nourishment by donor breast milk, they made a full recovery and were discharged more than a month after. Mrs Tong said they were very lucky to benefit from this new service.

Mrs Tong said that donor milk greatly alleviated her anxiety when she was unable to produce enough breast milk for both babies. “I’m very grateful to the donors for dedicating their time and effort to express milk. They are so loving and selfless.” The twins eventually recovered and went home, while Mrs Tong has successfully built up her own milk supply to feed them adequately.

More about donor breast milk

• Donors must be breastfeeding their own babies under one year old and receive health screening interview and blood test for infectious diseases.
• Donor are given guidelines for expressing and storing breast milk properly. The milk is then collected from their homes by the designated courier service and delivered to the HKBMB via cold-chain transport.
• All milk undergoes rigorous processing at the HKBMB, including microbiological testing, pasteurisation and nutritional analysis to ensure safety and quality.
• With parental consent, qualified breast milk is prescribed by doctors for infants who meet the clinical criteria.

Click here for more information on breast milk donation