Expressing love through breast milk

The HIV AIDS virus can easily be transmitted from mother to her new born child. But this is avoidable. A HIV positive mother can ensure that her new born stays HIV negative. So, apart from feeding the baby on formula milk, what are the options available to a mother that ensure baby’s health is protected? Georgette Kareithi, the executive founder and director of Pure Love Expressed (PLE)—an organization that encourages mothers to donate breast milk for infants born to HIV positive mothers, spoke to Rebecca Njoki on her quest to ensure that babies remain HIV negative, at the same time being nutritionally fed.

Mothers are amazing. They will go to great lengths to provide for their children. If they have the HIV virus and are expecting, many will religiously get the antiretroviral injections to ensure that their unborn child does not contract the virus from them. So why should a baby be born HIV negative and contract the virus while breast feeding? Most HIV positive mothers are aware that there is a chance that her child can contract the HIV virus through breast feeding. And if she cannot afford formula milk what next? PLE brings the solution to this dilemma. They plan to coordinate and distribute donated breast milk free of charge to HIV positive mothers who are needy.

Getting started
‘My mother told me she had seen some women on a local television programme pooling resources together to buy formula milk for needy newborns. I thought to myself that though the project was noble, it must be expensive. It occurred to me that women could offer their breast milk to the needy, after being tested to ensure it is fit for the baby. My mom would express milk for other mothers while visiting me in the hospital. I did research and found out that there is a similar programme in the US, whereby mothers with premature babies get breast milk in hospitals to feed their newborn. This they get for a couple of days but when they leave hospital, the milk is no longer available to them. I thought of doing something more by making it accessible to mothers on a daily basis.

Testing
Before a mother donates her milk she has to get tested for infectious diseases such as hepatitis and syphilis to ensure that she is healthy. I have enlisted the assistance of Dr. Florence Kiboi, a doctor running one of the busiest maternity hospitals in Kayole and a health centre in Buruburu. I thought she was suited for my project since she will be able to reach out to more women living in poverty. So with her support, I came up with a plan. Dr. Kiboi, who is the executive director accepts anything in return of her services as most of her clients cannot afford the maternity services. These include blankets, fruits, cell phones, bracelets, just anything that the mother can give.

At first, I had 250 women in mind that I would start with, both donors and recipients. But every hospital that hears of this, wants to get involved and instead of the two hospitals I had planned to start with, I now have 25 hospitals on my list.
The project will start running in February 2009. Since getting media support there has been enormous response countrywide.
I now realise that the name I chose, Pure Love Expressed is appropriate. Mothers are willing to share their love through their involvement.

When I first started, I thought the problem would be in getting donors but I have realised now the work is in capturing the recipients. This is so because the recipients fear stigma. I also had to plan a way in which the milk could be tested quickly and pasteurized so that it would not take long before it reached a recipient. Fortunately, the Kenya Medical Research Institute (KEMRI) agreed to working with me.

I had an approximate number of 250 women in mind for starters. But since there is a large overwhelming response, I intend to move on increasing the numbers until we go countrywide. Initially, my aim was to work with the VCTs (Voluntary Counseling and Testing Centres) and hospitals. Since VCTs are in every constituency, they are accessible to anyone so we will start a small control group. But I thought of the stigma that mothers would face if they went to VCTs to donate or get breast milk, then thought it better to work with all medical service providers.

What is the procedure?
When someone comes to donate breast milk, she fills an application form. Then the mother is screened for HIV virus and syphilis (a serious sexually transmitted disease caused by the spirally twisted bacterium treponema pallidum that affects many body organs and parts, including the genitals, brain, skin, and nervous tissue). If she is healthy, she goes through counseling whereby we explain why we need the breast milk and how the procedure would go. Then she decides to proceed, she signs the patient consent form. We agree on how and when they want to participate. She is then shown how to use a manual breast pump. It is easy to use the pumps in hospitals because they will be sterilized by KEMRI. To ensure complete hygiene, we provide a requirement that the milk must only be expressed in hospitals, then screened by KEMRI before they collect.

The challenges
Since I am dealing with the economically challenged, there is the chance that the milk could go bad because most of the mothers do not have electricity or refrigerators. I am planning to give them ice cooler containers. Hence every day a mother comes in, she picks an ice cooler pack with milk inside it and returns it on her next visit. People are also wary of the service being free, especially the recipients. But this is help I am providing; I want to reach out to the needy through mothers because they represent continuity in life.
I want my clients to be as familiar and sensitive to AIDS patients as possible. The manual breast pumps have to be used in hospitals; we need several of the equipment, so anyone who needs to donate at the hospital can do so.

So is breast milk from various donors mixed?
Yes, breast milk is breast milk; it has the same quality of immunity. As long as it is screened and handled hygienically, it should not pose any danger to an infant. Just as cow milk is mixed and processed for people to buy in shops, that is how breast milk will be, only that it is free and available in hospitals for better monitoring.

Given that some children are allergic to some foods, is a donor required to be on a specific diet?
Not really. We advise mothers to eat a balanced diet but beyond that they have to ensure it is rich in diet for the sake of the recipient.

What were your initial fears?
That we would not get enough donors. I was afraid of having a false start for lack of milk. But the response is overwhelming. Instead, I find myself wondering whether there will be enough people to receive all of the donations. I have realised that people are afraid of taking up the breast milk because of stigma associated with HIV positive people.

Any other way the mothers will benefit?

PLE understands that people lacking financial power need help. So the job opportunities that will be created will be open to the mothers. There is a plan to provide an incentive for donors but each case will be evaluated. They will also be trained to counsel, teach women on social issues and HIV Aids prevention.

Is the recipient only supposed to be HIV positive?
The project focus is for mothers who have infants that need breast milk. Whether they lack enough milk or that the babies are orphans. But I figured the best target would be HIV positive mothers, if only to ensure children do not contract the deadly virus through breast feeding. Because babies die easily and quickly when they breast feed from a HIV positive mother.’

END: BL18/54-56