By Aiman Najiha, Luqman Hakim, Sofea Adira, Amzar Samat, Nursakinah Suhaimi and Hamizan Nazifi
Human milk bank is basically a service which collects, screens, processes and dispenses human milk from mothers who are not biologically related to the receivers or infants.
Optimal nutrition for infants in their first six months is giving them breastfeeding, then followed by a suitable diet. Breastfeeding if possible, can be carried out until the infants reach the age of one or more.
According to the Centre for Disease Control and Prevention, there are some reasons for a mother not to breastfeed her infant – when the mother is infected with the human immunodeficiency virus (HIV), have untreated, active tuberculosis, is taking prescribed cancer chemotherapy and many more.
That’s why in this era there are some mothers who cannot afford to milk their children because milk is unavailable or in short supply and this is where pasteurised donor breast milk is widely used.
Pasteurisation, according to Merriam Webster, is a process of sterilisation of some of the substances and especially liquids (such as milk) at temperatures and for periods of exposure that will destroy unpleasant organisms without the alteration of the major chemicals of the substance.
According to Northern Star Mothers Milk Bank, there are several steps that need to be done by the donor’s mom in order to give their milk to other infants.
Step 1, potential donor moms contact the milk bank and are guided through a multi-step screening, which includes lifestyle and medical history.
Step 2, donor moms’ health care providers complete forms that verify a donor is healthy and that excess breast milk would be appropriate for donation.
Step 3, donor moms have a blood test done to test for infectious diseases.
Step 4, donor human milk is processed in our lab, where staff are required to scrub in prior to working with the milk.
Step 5, donor human milk is poured into flasks, filtered, homogenised, poured into bottles, visually inspected and then heat sealed and labelled. The label allows each bottle of milk to be traced forwards or backwards through each step in the milk tracking system.
Step 6, donor human milk is pasteurised using the Holder method of pasteurisation. The milk is heated to 62.5 C for 30 minutes. This pasteurisation process kills bacteria, CMV and other viruses while still preserving immunological properties unique to human milk. The macronutrients are unchanged by pasteurisation.
Step 7, a sample of milk from each donor before pasteurisation and a bottle from each batch post-pasteurisation is sent to a third-party lab to ensure there are no harmful bacteria. Milk is only dispensed once a post-pasteurisation culture shows no growth.
Step 8, the milk is then stored in our industrial freezers at -20 C and is dispensed to hospitals or babies in the community.
Islamic Input / Responses
Human milk bank issue has been debated by Muslim scholars whether it is permissible or prohibited.
There were many issues that have arisen regarding human milk bank. The issue such as the background of the donor has been discussed among them.
The issue of future marriage also been seriously discussed by Muslim scholars because Allah says in Al-Quran that it is prohibited for you (for marriage) your sister through nursing, but if the marriage was not consumed, this is not a sin for you [4:23].
Yusuf Al-Qardawi, the famous Muslim scholar, said that milk banks were created to help premature infants, thus it is a noble act and permissible. It is also supported by the Muslim community. Islam calls for assistance to help persons who are in need especially the premature infants.
Another response is by the Muslim Theologian, Imam Ibn Hazm. He said that if a baby drinks the milk from bottle, pumped from breast or it is poured into his mouth, the sibling bond is not created and marriage is not forbidden.
Another statement was human milk bank or donation is tolerated as long as the milk is coming to the baby by other means than sucking. This statement was agreed by Al-Layth Ibn Saad and Imam Dawud.
Analysis of the Islamic Input / Responses
As far as we are concerned, these are the responses by Muslim scholars aimed to answer the issue regarding human milk bank. The response from Yusuf Al-Qardawi is to answer about the act of human milk bank itself whether it is permissible or not.
He said that human milk bank is a noble act, thus it is permissible. Imam Ibn Hazm’s response regarding the issue of future marriage whether the sibling bond were created or not through human milk bank and he said that it was not created at all because the milk was pumped from the breast so that the baby gets the milk indirectly from the breast.
His statement also supported by Al-Layth Ibn Saad and Imam Dawud which they said that this act is tolerated as long as the milk that the baby receives is not from the way of sucking (direct from the breast).
Conclusion & Recommendations
Since many Islamic scholars had come to an agreement that in Islam, human milk bank is indeed permissible as it does way more good than harm, not only to the newly-born child but also in some cases, to the donor themselves, we believe that more human milk bank should be established all across the world, especially in Malaysia, as it was in countries that already have human milk banks such as Brazil, America, and Australia, which is the biggest and the most advanced in terms of such bank.
Human milk bank can benefit not only the receiver of the milk, which is the child, but also the donor. For the children who receive the donation, he or she will get the gold standard or the most nutrition in the form of breastmilk that a newly-born baby needs to grow properly and healthily in the best of manner.
On the other hand, in some cases, donating their own milk can turn beneficial to the donor as some females might suffer from some discomforting and agonising conditions such as hyperlactation. Veldhuizen-Staas (2007) defined hyperlactation as overactive production by the milk-producing glands during lactation. In other words, hyper lactation is when a female produces more milk than what is needed for their own child.
Therefore, it is evident that human milk bank is favourable to many parties and should be more popularised in Muslim countries, primarily Malaysia.
Malaysia, in establishing a proper human milk bank for Muslims, should take Singapore as an example as they had established such bank in a properly monitored and controlled circumstances.
The Fatwa Committee of Singapore had permitted the establishment of human milk bank but only for prematurely-born babies and will stop offering donor milk when the baby reaches 34 weeks old, and/or weighs at least 1.8 kg, and has no other health complications. Along with other rules and regulations, Singapore had successfully established the human milk bank which they had said, is in line with the Maqasid Shariah, that is the need for the preservation of human life.
Based on Taqwa (2012), Malaysia is not allowed to establish milk bank but there are three alternatives that can be used to replace human milk bank, which is the establishment of human milk bank, produce milk products by using modern technology and search the people who can give milk in social media.
Yusuf Al-Qardawi also stated on his research that human milk bank is relevant in Malaysia because we can see that it gives benefit to babies, especially premature babies. It is to make sure that they are healthy. For example, there are some cases in which the mother could not give milk to the child due to some disease that the mother suffers from. ***