In this episode of The Care Circle podcast powered by Motherhood Hospitals, host Sahiba engages in an eye-opening conversation on breastfeeding, nature’s most powerful start to life. Joined by two phenomenal guests – one, a certified lactation counsellor and maternal support practitioner, and the other, a senior paediatrician and neonatologist who leads Coimbatore’s first-ever Human Milk Bank ATM.

The discussion covers the science behind colostrum, the importance of breastfeeding in the first hour after birth, the role of human milk banks, and how mothers can overcome common breastfeeding challenges. The episode also addresses myths, emotional barriers, and the importance of community support for nursing mothers.

Here are the key takeaways you shouldn’t miss from this episode:

• Breast milk is often called a baby’s ‘first medicine’ because it is rich in antibodies, nutrients, and growth factors that support immunity, brain development, and overall health from birth.
  The first milk, colostrum, is produced during late pregnancy and in the initial days after delivery; it is thick, yellowish, and packed with protective properties.
• Exclusive breastfeeding is recommended for the first six months, followed by continued breastfeeding alongside solid foods up to two years or beyond.
• Breastfeeding lowers the risk of infections, allergies, obesity, and chronic diseases in babies, while also benefiting mothers by reducing postpartum bleeding and lowering the risk of certain cancers.
• Common breastfeeding challenges include latch issues, sore nipples, engorgement, and perceived low milk supply, most of which can be addressed with the right guidance.
• Working mothers can maintain breastfeeding by learning to express and store breast milk safely, ensuring babies receive the benefits even in their absence.
• Human milk banks provide screened and pasteurised donor milk for babies whose mothers cannot breastfeed, especially premature or sick newborns.
• Myths like ‘thin milk is not nutritious’ or ‘you must drink milk to produce milk’ are unfounded; breast milk quality is rarely an issue if the mother is healthy.
• Adequate hydration, balanced nutrition, rest, and emotional support play a crucial role in sustaining milk supply and maternal well-being.
• Breastfeeding is not just about nutrition; it strengthens emotional bonding, skin-to-skin connection, and the baby’s sense of security.
• Final advice: Start early, seek help when needed, trust your body, and remember that each breastfeeding journey is unique and valuable.

Parul Mudit Mishra is a Travel Industry Corporate Employee turned into a Maternal Support Practitioner. After personally struggling with infertility for 5 years and becoming a mom of IRISH Twins, (born within a year) Parul Mudit Mishra joined Mommy Squad head for Nutrizoe, a leading company in women’s wellness to support new moms supporting Moms as a peer counselor while

Dr. Nithya Ponmudi is one of the best Paediatricians in Coimbatore with experience in 12+ years of experience in the field of Paediatrics and Neonatology. She was trained in one of the premier institutions and was the best outgoing postgraduate in MD Paediatrics from CMC Vellore. Her aim is to provide evidence-based holistic care to everyone.

Dr. Nithya has extensive exposure to Neonatology and is well trained with skills related to management of high risk newborn like extreme preterm, extremely low birthweight, birth asphyxia, PPHN, pre- and post-op management of surgical conditions like congenital diaphragmatic hernia, trachea-esophageal fistula, intestinal atresia, etc. She is well versed with use of TPN, mechanical ventilation – both conventional and high frequency, Inhaled nitric oxide, aEEG, whole body cooling in birth asphyxia.

0:10 – Intro: “World Breastfeeding Week” and why support matters beyond encouragement
0:42 – India’s breastfeeding stats and the big question: What stands in the way?
1:36 – Guest intro: Parul Mudit Mishra – lactation counsellor, maternal support practitioner, and mom of Irish twins
2:32 – Why breastfeeding often takes a backseat after birth
3:11 – What breastfeeding means today: Emotional, social, and environmental impact
5:30 – Breast milk as a baby’s first medicine: Understanding colostrum and its power
7:18 – Parul’s personal struggle: Engorgement, lack of guidance, and postpartum depression
9:42 – Why mothers stop early: Misinformation, perceived low supply, and workplace barriers
12:54 – The partner’s role: How active involvement boosts duration and confidence
14:35 – Golden hour feeding in OT – how it changed outcomes in Parul’s hospital
15:16 – Are public spaces and workplaces evolving for breastfeeding moms?
16:38 – The need for public nursing rooms and breaking modesty policing
17:18 – How to normalise breastfeeding in public and watch for postnatal depression signs
18:44 – Guest intro: Dr. Nithya Ponmudi – Paediatrician, Neonatologist, and Head of Coimbatore’s Human Milk Bank ATM
19:43 – Why human milk banks are vital: Donor milk as “bridge milk”
20:28 – Who can donate breast milk, and the eligibility process
22:30 – How milk banks ensure safety: Pasteurisation and culture tests
24:39 – Which babies benefit most from donor milk – preterm, post-surgery, and high-risk infants
27:14 – Milk bank impact: 66 donors and over 1,73,000 ml collected in under 2 years
27:46 – Donor story: A mother who donated over 100 litres while her preterm baby was in NICU
29:11 – Myths about milk donation: Nutrition loss, supply fears, and cultural hesitations
31:01 – India’s milk bank access – where we stand and the gaps to fill
33:01 – The future: Making breast milk donation as normal as blood donation
34:38 – Closing: A shared responsibility to make breastfeeding supported and sustainable

(0:10) Sahiba: Hello everyone and welcome back to the Care Circle, a podcast series powered by Motherhood Hospitals. I’m your host Sahiba and today we are diving into a completely natural topic, but often overwhelming and widely overlooked, that is breastfeeding. As we mark World Breastfeeding Week, we’ll explore what it truly takes to support breastfeeding in real, sustainable ways beyond just encouragement through systems that help mothers succeed.

(0:42) Sahiba: In India, while 99.5% of mothers initiate breastfeeding, only 45.3% continue to breastfeed for 6 months exclusively, often due to lack of support at home, at work or in public spaces. So today we are going deep. What does breastfeeding mean in today’s world? What stands in the way? And how can we as families, workplaces and communities do better? 

We are joined today by two phenomenal guests, one a Certified Lactation Counsellor and Maternal Support Practitioner and the other a Senior Paediatrician and Neurologist who leads Coimbatore’s Human Milk Bank ATM. They’ll help us explore both personal and public sides of breastfeeding from emotional challenges to life-saving milk banks. 

(1:36) Sahiba: So grab a warm cup of tea or coffee or maybe your baby’s next feed and let’s get started. So our first guest is Ms. Parul Mudit Mishra, a Certified Lactation Counsellor and Maternal Support Practitioner whose passion for helping mothers began with her own story.

After a five-year struggle with infertility, Parul became a proud mom to Irish twins, two babies born less than a year apart, and experienced hurdles of early motherhood. Since 2021, she has been supporting new mothers through breastfeeding challenges, from NICU transitions to tongue-tie issues. With additional training in weaning, picky eating and maternal wellness, Parul brings a rare blend of experience, expert knowledge and care to every family she works with. Welcome Parul to the podcast. 

(2:32) Dr. Parul Mudit Mishra: Hi, dear. Thank you so much for having me here. It’s a pleasure. It’s a blessing. And also I would say I am glad we are talking about breastfeeding because a lot of times when a baby is born, we are engaged, celebrating that a child is here.

We are taking care of the mother. But sometimes breastfeeding and the support that breastfeeding needs takes a back burner. So if we talk about it more, we raise awareness. I think it’s a great thing for all the moms to be there because then they will know what they can look forward to in their breastfeeding journey. So once again, thank you so much for having me here. 

(3:11) Sahiba: Thanks to you for joining in Parul. That means a lot for us as well. So I want to start with something many people overlook. What does breastfeeding mean in today’s world? Not just from a biological standpoint, but emotionally, socially and even environmentally? How has its meaning evolved in the pace of modern life? 

(3:31) Dr. Parul Mudit Mishra: Beautiful question. And it is very much in line with the theme that we have for this year’s World Breastfeeding Week celebration, which is about sustainability and breastfeeding.

So to answer the first part of your question, probably what does it mean for the mother, the baby, the world around us? So the thing is that we keep thinking that, you know, breastfeeding is free. No, it is not free. And it is actually a very taxing job to go ahead and feed a child throughout the first year of its life. And it is something which is very, very nurturing for the baby because there is this emotional bond that a mother and a baby can create if they are breastfeeding. And a bond that is created between the mother and the child is completely dependent on hormones because it triggers oxytocin. It strengthens the mother-infant bond. It helps the baby feel more emotionally secure. And we know all of this. I mean, we have read about all of this. We are aware of all of this. 

So think of it this way, that this is new. This is emerging. Why? This has been there for a very long time. But because of the lack of support from policy perspective, from family perspective, from the partner’s perspective, things are slowly moving in that direction wherein she can actually ask for that support and she’s looking out for that support. So all of that is happening very silently.

And people think that medical costs for a baby between zero to 12 months to see the paediatrician increases so much just because you do not have breastfeeding support because, breastfeeding is supposed to be the first immunisation. 

(5:18) Sahiba: I just love the way you beautifully framed it. And I feel like,  the change is there, but it’s a very slow change that is happening. But eventually in the coming time, we hope that we get there. 

(5:30) Dr. Parul Mudit Mishra: Definitely. 

(5:30) Sahiba: So now we often hear that breast milk is a baby’s first medicine. Why do experts call it that? And what makes it so uniquely powerful from the moment a baby is born? 

(5:42) Dr. Parul Mudit Mishra: So first thing, let’s understand what this first milk is, like when is it being created? How is it being created and what happens with it? So the first milk that we talk about, a lot of times you might have heard, I’m pretty sure you might have that, you know, the milk comes in, especially with C-sections. 

The milk comes in on the third day, right? This is a very common thing that I get to hear at least. Now that’s not true because the milk that the first child has, which is the colostrum that we talk about, that milk starts producing in the female body from the 16th week of pregnancy. Okay, so 16th week of pregnancy, you start getting tenderness in the breast, your breast grows a cup size. And if everything goes well, and if you go for your A&C checkup or lactation support, you would get to know whether the glands are working the fine way and everything seems to be okay on that part. And the milk is there.

Now the first milk, which we call colostrum, it’s actually immunity gold. Now why do we call that? Because the first milk is rich in antibodies, especially IgA, which coats the gut and protects against infections. Okay. Now, breast milk also is not just food. It actually contains life cells, stem cells, hormones, enzymes, and microbiota tailored to the baby’s needs, all right? And it can actually reduce newborn mortality. And in India, immediate breastfeeding within the first hour could prevent 22% of neonatal deaths. First milk would have higher protein content, higher immunoglobulins, which is more or less like preventing some infection because nature wants the baby to survive in the new environment, in the new world. 

Then comes the transitional milk, which works more on the gut because the gut is sort of permeable for a newborn. So it wants to seal the gut so that when that white milk, which is rich in fat, which is rich in certain heavier proteins comes, the baby is able to digest it easily. So nature is first ensuring that you live, then it’s ensuring that your gut is ready for you to gain weight. Then it’s giving you weight gaining milk. 

I’ll tell you by myself, when I delivered, it was in Lucknow, my hometown, and it was what, 2018? And the baby was born. It was an emergency C-section after a long labour and there were complications and stuff. So the baby came out via C-section. Nobody, nobody came to ask me, is it okay to give formula to your child? Nobody did that. Nobody asked me whether you would like to feed the child. On the third day, when all that colostrum was stuck inside of me and I got all that engorgement, I feel that, okay, this needs to come out of my body or else it will explode or something like that. And by then, because of the engorgement, and that was physiological engorgement means there was a lot of swelling. Because of the swelling in edema, the nipple went flat, the ducts were blocked, nothing was coming out and everybody was trying to squeeze it and it was very, very painful and the baby was not able to latch. 

And then this nurse walks in and says, the lady in the other room is flowing, the maid is flowing from her and here you’re not able to feed your new one and you’re giving me the new one on third day to feed when the engorgement has already set in and you expect  me to go ahead and figure this out by myself how to feed this baby. And my gynaecologist comes in and I ask her, can you help me with this? She tells me, take a bottle feed, put it on your nipple and then try to feed the baby.

The moment I did that, from that moment onwards, the baby, which had oral restrictions as well, which obviously people overlooked, because awareness was not there at that point in time. The baby wasn’t able to breastfeed because the baby got an idea of how to bottle feed and then that’s how it went. That’s where I realised I need to be a lactation counsellor because it gave me postpartum depression. Because I had all the milk in the world, but I wasn’t able to feed my child. 

(9:42) Sahiba: I’m just blown Parul by the things you mentioned and you know how your journey taught you and how you thought that, okay, there is like no awareness out there and why we have to generate this awareness and  that breast milk is the nature’s first vaccine and why is it important? 

This brings me to my next question: Now a lot of mothers start their journey to breastfeed, but many stop much earlier than they hoped. So what are some of the biggest reasons for this early dropout? And what do we often miss when we talk about breastfeeding challenges? 

(10:20) Dr. Parul Mudit Mishra: I think the first barrier wherein they would start but then stop would be misinformation, right? So misinformation like one side gives you milk, one side gives you water, one side would perceive a low milk supply. Now perceived low milk supply is something that happens so much, trust me. We are not aware of what accounts for good milk supply, like what are the indicators of having a good milk supply, right? 

So if your baby is peeing more than six to seven times in 24 hours and the baby doubles the birth weight by six months, you do have a good milk supply, right?) So on an average, 100 to 140 grams for a breastfed baby per week should be sufficient. If it is around 200 grams, we are great. If it is below 100 grams, there is something that needs to change and fix. 

That’s where the whole problem is that we are not able to bridge this gap. So there’s another challenge of having workplace barriers. So you could be a breastfeeding queen for the first six months, but when it is time for you to return to work, even though there are laws present, a lot of times women are hesitant  to even ask for a space to pump, for a space to feed, all of that. Now for a lot of bigger companies, MNCs and stuff, they do have these facilities available and women are using that, but obviously not all the workplaces are working over there. 

I had a very good patient of mine, she was a bank manager, she had worked so hard just to be there. But then when I asked her what the challenge was, she said, help me with reverse cycle feeding because in the daytime, only to relieve myself, I have to go to the washroom and drain my breast because there is no space for me to go ahead and set it up. I said, you are the manager, you are the highest authority over there, why don’t you do something about it? It would help other women as well. And then she said, you know what Parul, it’s not that easy. 

So I want to understand how to make it easy. If somebody is in a position of authority and listening to this, let’s make it easy for them. WHO also notes that most mothers stop not by choice, but due to lack of skill support, especially in the first 7-10 days postpartum. And this 7-10 day period is the most crucial period. But support or learning about this period has to start in ANC because I can’t expect a mother fresh coming out of OT or labour and delivery room, listen to me talk about breastfeeding. 

(12:54) Sahiba: I love how you put that up Parul. I feel it’s not the mother who is falling short, it’s the support system that’s not stepping up. Speaking of support, what kind of everyday practical help makes a real difference to new moms, especially in those first few weeks? 

(13:10) Dr. Parul Mudit Mishra: I think we can establish that the biggest support there can be for a new mother is the husband, is the partner. Not only the husband, but the partner because we live in an inclusive world. So the partner has to step up. 

I’m not talking about my personal experience, I’m talking about data, the Journal of Human Lactation 2020. The studies show that active involvement from partners increases breastfeeding duration and maternal confidence. And you know, if I have to give you one piece of advice, if anybody is questioning her supply, just shut them down and take her to somebody who can provide evidence-based support. Shut them down. Just by shutting them down, you increase her oxytocin levels, you increase her confidence, you help her do better.

So that is the first thing that I would want to happen around. So I joined the hospital that I’m working with three years back. The day I joined, the first thing I did was I walked up to the most senior gynaecologist and I introduced myself and I asked her one question. You know what that question was?  I asked her, can I start with golden hour feeding in OT? 

She said, what will a lactation counsellor do in OT? I said, ma’am, if you would allow me, I can show you something. And then she said, okay, tomorrow, in my case, you come. 

(14:35) I said, okay.I went there and I latched that baby that instant. And then that baby was latching again and again, nurses were trained, and this baby didn’t need formula at all. And before this, because of golden hour feeding not being there, formula was something which was very, very routine.

So now, after three years of making this change that, you know, an LC should be present in the OT, I’m not able to do it 100%, but at least 90%, either me or the team is there because those late night deliveries might not get a lactation counsellor, but they do get a feeding nurse. So what changes this has brought is that at discharge, most of them are being discharged on breastfeeding. 

(15:16)  Sahiba: Interesting. So now let’s shift to the outside world a bit. Do you think our workplaces, public spaces, or even social settings are evolving to support breastfeeding mothers, or are they still making it harder than it needs to be? 

(15:33) Dr. Parul Mudit Mishra: I would say changes are being implemented. Things are getting better, but there’s a long way to go. So I have observed on my trips that, you know, from Pune to Mumbai, there are some resting stops. They do have breastfeeding rooms now, which were not there earlier. Even in certain pilgrimage spots, we do have breastfeeding rooms, which were not available earlier. 

I think the challenge is that a lot of times they are locked, okay? And you don’t know where to get the key from. So that is one challenge. The other challenge would be that we do have our maternity law, which says that there are 26 weeks of paid maternity leave. But again, enforcement of the same and breastfeeding breaks in informal sectors are still very, very weak.So if there is a maid that is working and she needs to go back to work, how would the baby feed? Because in informal sectors, again, very, very disorganised.

Even in formal sectors, asking for the breaks is a very big challenge. I mean, we are not making it easier on them. We just discussed it. Then lack of public nursing rooms. (16:38) So now we need to step up at railway stations and malls. So malls, I mean, you have built such a huge mall, you can spare a little space for a breastfeeding mother, right? So that is not being done.

A lot of times when I go to a mall, I have seen mothers feeding in the washroom. Would you eat your lunch or dinner in the washroom? Would you like that? Then why are you forcing a small baby to do that in a washroom? Not a happy feeling.

Then there’s public modesty policing, like, you know, breastfeeding in public, people will start looking at you weirdly.Heck, people start looking at you weirdly when you are fully clothed. Some of them have confidence, some of them don’t. We really need to make it more accessible for them.

(17:18) Sahiba: I wish more people could hear this and understand breastfeeding shouldn’t be a private struggle. It needs to be supported publicly and with proper structure. This brings me to the last question, something many women feel deeply about.

How do we normalise breastfeeding in public? What will it take for us to shift the narrative so that feeding a baby becomes as ordinary as feeding oneself? 

(17:45) Dr. Parul Mudit Mishra: Number one would be the partner’s support. I mean, if your husband doesn’t have an issue with you feeding in public, it gives you more confidence, doesn’t it? If your family supports you, that’s okay, it’s okay. You can just put on a nursing cover and feed, right? And if in case you’re able to go ahead and do that naturally, without having that stigma and to have that unwavering support.

And one thing that we have missed out probably would be that understanding if this whole journey is pushing her towards postnatal depression or not. This is something that has to be done. You need to be able to do that. And you need to understand why it is needed. I’ve spoken enough on this, right? 

(18:32) Sahiba: Well, because I feel that feeding a baby in public feels taboo, then clearly the problem isn’t the mother, it’s the mindset of the people.  Thank you so much, Parul, for such an insightful session with us.

(18:44) Sahiba: Joining us now is our next expert, Dr. Nithya Ponmudi, a leading paediatrician and neonatologist  from Coimbatore with over a decade of experience. Her expertise is in caring for high-risk newborns, especially those born too early or too tiny. Dr. Nithya also heads Coimbatore’s Human Millbank ATM, making donor breast milk easily available for babies who need it the most. From saving fragile newborns to supporting parents through the NICU journey, Dr. Nitya brings both heart and expertise to every little life she touches. Welcome, Dr. Nitya, to the podcast. 

(19:21) Dr. Nithya Ponmudi: Thank you very much, Saiba, for the introduction. It’s a pleasure to be a part of this meeting. 

(19:26) Sahiba: That’s great, doctor. Let’s start.

Your work with Human Millbanks has been nothing short of heartbreaking. Let’s start with the basics. Why are Human Millbanks so vital in today’s healthcare system, especially for newborns in critical care? 

(19:43) Dr. Nithya Ponmudi: Donor human milk has been rightly called as bridge milk. The reason why it’s called bridge milk is because it serves as a bridge for a vulnerable infant to start, to sustain and to maintain on human milk. With the right switch from donor milk to mother’s own milk, this is very, very important. And to regularise the inflow and outflow of milk from an eligible donor to an eligible recipient. That is why we have a human milk bank, which will channelise the entire process in the correct manner. 

(20:18) Sahiba: Doctor, for our listeners who may be hearing about milk donation for the first time, who exactly can donate breast milk and what does the process look like from expressing to donating? 

(20:28) Dr. Nithya Ponmudi: Okay, so there are many cities with human milk banks. They may be public or private breast milk banks. The first and foremost thing is there’s one thing called willingness to donate and the other is eligibility to donate. So a mother who’s willing to donate might not really be eligible and a mother who’s eligible to donate may not be willing. It goes both ways.

So any mother who’s willing to donate and provide for her own baby’s requirement is not compromised in any way, can express herself to any breast milk bank that she would like to donate milk. And the first and foremost process is to contact, following that we usually do a screening to make sure the mother’s health status, that is usually blood bone viral screening, make sure she’s not on any medication which may be passed on through the breast milk. Her blood reports for other things, make sure she’s not on any other drugs or has an infection which makes the milk not fit for donation. And all this criteria if she fulfils, then she is eligible to donate. 

Like in our case, we have a rotary run breast milk bank, in which case after this process when you find an eligible mother, the mother is explained how to express milk either using a pump and they’re actually provided with packets and they can fill the packets and they can contact our breast milk bank in charge. She will make sure that the nectar bees as they are called, that is volunteers who are willing to go and pick up the milk and bring it to the nearest ATM.

The breast milk ATM is what we have in Women’s Centre. So our job is to collect the milk and we make sure that it goes to a centre where the pasteurisation (22:13) process is done. And we are also involved in getting this pasteurised milk and reaching out to people who need it. So that is the entire process of how somebody can be eligible, how they can become a donor and how the distribution is actually done. 

(22:30) Sahiba: That’s quite interesting to know doctor. Now let’s talk about something all parents want to be sure of. How do milk banks ensure that donated breast milk is safe and hygienic before it reaches the newborn? 

(22:43) Dr. Nithya Ponmudi: So suppose we have about 10 different mothers who are donating milk. So usually all the human milk which is collected is pulled together and it’s pasteurised and then they aliquot it in containers. Now before this goes out, it is actually about 5 ml or 10 ml of this milk is sent to microbiology department and a culture is done to make sure that there is no growth of bacteria. And once they find that the culture report is seen and it is fit to be dispatched, only  then the milk is sent to people who need it. 

And the other thing what pasteurisation is something that people should be aware of what is actually done. So the collected milk is labelled.It is first of all stored in a correct, in a refrigerator or in the freezer before it undergoes a process known as pasteurisation. So you can store the milk for up to four hours in the refrigerator. If it’s more than four hours for a nectar bee to collect, it’s best is actually to freeze the milk. And this milk is then, you know, the pasteurisation process is done by a special machine. It kills all the microorganisms. But it is also believed that most of the nutritive value will very much be detained and it is considered safe and comparatively better when mother’s own milk is not available.

So there are different types of high-end pasteurisers. There are some units which actually use a very simple equipment called a shaker water bath. But all those is, those are all the process of pasteurisation. But final thing is to ensure that the culture is sterile, therefore the milk which is being dispatched is safe for use. 

(24:19)  Sahiba: That’s so reassuring to know, doctor. From screening donors to pasteurisation protocols, it’s clear that every drop goes through a science-backed gold standard process.mSo doctor, in your experience, which babies benefit the most from donor milk? And what’s the difference it can make in the earliest days of life? 

(24:39) Dr. Nithya Ponmudi: So most often we end up using donor human milk in the NICO. And the NICU babies, especially the preterm babies, are the first and foremost when it comes to being eligible, who require the most when mother’s own milk is not available. In most cases, if it’s a preterm baby, what happens is either the mother’s had a section or she has not really started producing enough milk and the baby has to be started on only human milk.

So in most cases, we cannot start these babies on preterm formula, which is not at all what we would like. And the other reason is suppose a mother is really sick because of hypertension or any other complication related to prematurity, you know, the baby was born preterm because of maternal condition and the mother is separated from the baby, again, it becomes essential that these babies will require donor human milk. And sometimes we also give irrespective of gestational age.

That is, you may have a baby who’s born at term, but the baby is too small. And suppose it’s a 1.5 kg baby who was born at, let’s say, 36 or 37 weeks. Those babies, their gut is not very sturdy enough to accept formula milk, in which case they are prone to a condition called necrotising enterocolitis. In those kind of babies, we definitely do not give any other milk other than human milk. 

The other, lastly, would be, I would think of babies who undergo surgery, term babies, as well as babies who have gone through perinatal asphyxia, in which case, again, the gut is not got good, you know, blood flow and therefore can develop necrotising enterocolitis. Those kinds of babies are definite candidates for human donor milk. And of course, we have a special category. 

You have certain mothers who are on medication or have an infection, like in case of retroviral positive mothers, in which case, we may have to offer donor human milk till the baby becomes a little more mature. The least eligible babies in this case would be the babies who are with their mothers but still need it. So suppose we have mothers whose supply is not great and there’s excessive weight loss, then we need to think about availability and is it possible for us to sustain it, whether with either human donor milk or a little bit of top up with other milk. 

(27:01)  Sahiba: That’s quite interesting to know, doctor. With this, I have my next question. Do you have any data or milestones from your milk bank? How many litres donated or how many babies held? That highlights its impact, doctor. 

(27:14) Dr. Nithya Ponmudi: I cannot really go into how many babies have been held because we are an ATM which, you  know, not just in Coimbatore, but as far as Tirupur and the neighbouring districts as well. But our breast milk bank was inaugurated on 23rd September 2023. So we will be celebrating our two years soon. And we’ve had about 66 donors. And out of this, we have totally churned out about 1,73,234 ml as of this morning, which  is a very big number.

(27:46) Sahiba: Wow, that’s phenomenal, doctor. I feel each of those numbers represents a heartbeat. Speaking of families, can you share a story where donor milk made a clear and unforgettable difference, doctor? 

(27:58) Dr. Nithya Ponmudi: I would actually express this from a donor’s point of view.

I would not mention the name of the mother. But a couple of months back, we had a mother who had a baby born at about 30 weeks and the birth weight was about 550 grams. So the baby was very small and we were not giving, obviously a small baby is not going to require much milk.

But this mother was producing a lot of milk. And per day, this mother would easily donate about one and a half litres. So she was doing that for and the baby was in NICU for about 100 days. And I think this act of giving is what kept giving them the hope for that this baby would also do well. Because if you ask me, more than money, donating human milk and donating blood is more noble. And I think she has also, you know, reaped her, what I would say is, you know, her hope has come through that her baby is doing very well because of what she has done. She would have easily donated about 30 litres of, you know, maybe even more because they were there for 100 days and her baby is doing well.  And she has helped so many, many other babies by donating milk. 

(29:11) Sahiba: So doctor, are there any common myths or fears you come across when it comes to milk sharing and donation? What do you wish more people understood? 

(29:21) Dr. Nithya Ponmudi: A lot of people are scared as to how this entire process of human milk donation is done. I have already gone through that, that we do screen, we make sure that the milk is safe. But there are some cultural issues as well that do not encourage this practise of sharing milk, which we do respect. And since the milk is processed safely and it’s completely, you know, we have an entire protocol for it. And we know for a fact that we are not doing any harm by giving a baby donor human milk which is safe.

That fear needs to be addressed most often. Some people are actually worried about the nutritional value because they believe that the process of pasteurisation will, you know, like the milk will not have nutritive value at all.

It just looks like milk, but that is not very true. It does bring the protein content a little less because of this. But having said that, it is way better giving a human donor milk rather than giving formula or any other alternative because if fortified with human milk fortifiers for preterm babies, human donor milk is as good as any other milk. 

And people worry about their milk supply. The main reason people do not want to donate is they feel that if they donate milk, they won’t have enough for their own baby. But this is probably the biggest myth, I would say, because the more the demand, the more the supply. So if a mother’s producing more milk than what her baby needs, if she’s going to pump and donate milk, she’s only going to get more and more. It is not going to become this. 

(31:01) Sahiba: Thank you, doctor, for busting those myths for us.Now zooming out, how widely are milk banks available in India today? Are they accessible to all or do we still have gaps in infrastructure? 

(31:33) Dr. Nithya Ponmudi: So I would say there are milk banks available across some cities and towns in India, but not all. So the answer to the second question, that is, do we need more? Definitely yes. With all the awareness and education surrounding it, we will need more breast milk bank because it’s becoming more acceptable.

For this to happen, I would say social media plays a huge role in connecting people and spreading information. And this makes it hassle-free for new parents to go through the entire process very smoothly. And milk banks with designated trained staff who run through the entire process, educate, guide and help, will make sure it is more accessible to people around.Coimbatore Women’s Centre has one ATM. And along with that, we have a government medical college that has one milk bank. And there is one more in PSG, which is called Kaumadenu.These are the three milk banks which are available in Coimbatore. And we work as an involved in distribution. 

But having said that, we do get a lot of demands where very remote areas, the babies do not have human donor milk.And obviously, because there is no mother’s own milk there, and in which case we have to cater. So what happens is, there are no breast milk banks in smaller areas, and there is definitely a need for it. So I would say there is a need for more (2:48) and more breast milk banks to come up.

(32:48)  Sahiba: That’s encouraging to know, doctor, that the progress is happening. Do you see a future where donating breast milk is as common and society accepted as donating blood or platelets ? 

(33:01) Dr. Nithya Ponmudi: I think with the current standard of education, awareness in social media, and discussions in hospitals, it has become more and more commonly acceptable for people to donate as well as receive donor milk. And this already has, and maybe more work can be done in streamlining the process to be able to help a lot more babies. 

And this process is going to be of, you know, our future where you are going to see where any working centre, be it IT or in the hospital, or even in a mall, where you may be looking at areas specifically for breast milk donation, or even expressing whether the mother wants to take it for her own baby, or express and donate it to a breast milk bank is going to become a norm. Women are motivated to do it. In fact, when we had a celebration about a few months ago, there was one mother who had donated 100 litres of milk.

I feel those kind of stories make you have, you know, goose flesh. Your hair literally stands up thinking, how can a mother have donated 100 litres of milk during her, you know, you’re allowed to donate for about the first six months is what we generally accept. Some people even up to one year, and she had donated 100 litres in six months, which is great.And her baby is doing very well too. I hope to see India to be one of the leading examples in this, because we are pro breastfeeding compared to many other countries where formula is propagated right from birth. So definitely, yes, it is going to be a great future for donor milk, where it’s going to be commonly accepted much more than what it is today.

(34:38) Sahiba:  That’s actually commendable, doctor, I think and that’s the future worth striving for. Thank you so much, Dr. Nithya for sharing your insights and passion on breastfeeding and the donor milk and the shared care we aim to give. Thank you. Thank you so much for being a part of this podcast. 

A huge thank you to Parul and Dr. Nithya for sharing not just their expertise, but their hearts. Whether you are a new parent, a healthcare worker, a family member, or just someone who cares, we all have a role to play in making breastfeeding normal, supported and sustainable. Let’s keep the conversation going not just this week, but all year round. You have been listening to the Care Circle, your very own expert-led safe space. We’ll be back soon with more honest and empowering conversations that put you, your health and your voice at the centre of care. Until next time, stay healthy, stay kind and take care.