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Thursday, October 19, 2017

Maria Fareri’s Liquid Gold Program Gets Babies the Donor Milk They Need

Posted By: Advancing Care

Neonatologists at Maria Fareri Children’s Hospital are fighting to ensure that the most vulnerable babies have access to the lifesaving benefits of human milk.

By Lisa Cesarano 

Suffering from the sudden onset of pre-eclampsia, a potentially fatal pregnancy complication, Warwick resident Alana Bellizzi was admitted to Westchester Medical Center, the flagship of the Westchester Medical Center Health Network (WMCHealth), late in the summer of 2016.

Because the only treatment for pre-eclampsia is delivery, Bellizzi’s son, Rocco, was delivered via emergency C-section on August 21, 2016. Born 10 weeks early, at a weight of 2 lbs., 7 oz., Rocco had suffered from intrauterine growth restriction, a condition in which an unborn baby is smaller than it should be due to an abnormal growth rate inside the womb.

When Bellizzi could not produce sufficient milk on her own, due to her son’s prematurity and other health conditions, the neonatologists in the Regional Neonatal Intensive Care Unit at Maria Fareri Children’s Hospital, a member of WMCHealth, provided Rocco with supplemental human donor milk through its donor-milk program, Liquid Gold.

Since its establishment in 2015, Liquid Gold has provided the unique and lifesaving nutritional advantage of human milk to premature infants weighing under 3 lbs., at Maria Fareri Children’s Hospital.

When a mother’s milk supply is unavailable or inadequate, using human donor milk has been shown to prevent high-risk infants from acquiring the potentially fatal condition necrotizing enterocolitis (NEC) — a sudden onset intestinal disease — and many other health complications that can afflict this highly vulnerable population.

“When a mother cannot produce sufficient milk on her own, donor milk is the next best thing,” says Boriana Parvez, MD, IBCLC, FAAP, neonatologist at Maria Fareri Children’s Hospital and Medical Director of the Liquid Gold preemie milk bank. “It is the safest and the most natural way to nourish premature infants when their mother’s milk is insufficient in quantity.”

According to Dr. Parvez, human milk contains a host of anti-infective factors and intestinal growth factors, and it promotes the growth of healthy intestinal bacteria, all of which are shown to improve health in preterm infants.

“Rocco started receiving 75 percent from my milk and 25 percent donor milk, and ended up receiving 50/50,” says Bellizzi. Rocco continued to receive donor milk until he was healthy enough to tolerate formula supplementation. Bellizzi is grateful for the program, particularly because of her family history of issues digesting cow’s milk. “I believe human milk is better. When Rocco was on donor milk, he never suffered from reflux; he did beautifully.”

Despite the scientifically substantiated health benefits of human milk, insurance coverage continues to be an obstacle for many families. At a cost of two to three times that of formula, donor milk is unaffordable for many families who would benefit from it. That’s why Dr. Parvez and her colleagues became involved in a recently passed legislative measure that now requires Medicaid to reimburse families in New York State for human donor milk given to preemies under 3 lbs.

Alana Bellizzi delivered Rocco 10 weeks early, via emergency C-section. When she could not produce sufficent milk on her own the Regional Neonatal Intensive Care Unit used supplemental breast milk.

Now, the most vulnerable infants in New York State will receive the vital nutrition they require to develop properly.

Joined by her colleagues, Shetal Shah, MD, and Heather Brumberg, MD, Dr. Parvez provided expert testimony at the NYS Assembly and Senate hearings that ultimately led to the passage of this landmark legislative measure.

Despite the costs, ensuring that the most fragile infants have access to donor milk when in the NICU will ultimately save Medicaid dollars, Dr. Parvez says. She adds that critically ill, very low birthweight, premature infants make up the majority of the total Medicaid budget for neonatal care. “The measure was passed in the spring of 2017 and is included in the state budget to cover provision of milk to NICU patients weighing under 3 lbs.,” says Dr. Parvez.

On the heels of this legislative win, and with a solid foundation for the program in place, Dr. Parvez and her team are now incorporating leading-edge technologies and equipment to further boost the efficacy and reach of Liquid Gold. While all NICUs in the U.S. provide “standard fortification” for donor milk, Liquid Gold has taken this practice one critical step further. Because the nutritional content of breast milk can vary significantly, the program recently purchased a state-ofthe- art milk analyzer to determine the precise amount of nutrients it contains. This enables the NICU staff to provide “individualized fortification” for the unique nutritional needs of each infant.

Liquid Gold’s donor program is also expanding. From a dispensing center, it will grow into a state-of-the-art premature milk bank. The milk from mothers of premature babies is richer in protein, calories, antiinfection factors and various growth factors. Currently, milk banks provide only fullterm milk. The women who donate their milk follow a rigorous, four-step screening process to eliminate any potential risk of infection. The milk is then analyzed and frozen until ready for use.

A milk pasteurizer will also be added to the program by year’s end, and a new Liquid Gold housing facility is scheduled to open in early 2018. According to Dr. Parvez, programs like Liquid Gold are crucial “not only for optimizing [physical] health but to help children meet their developmental milestones.”

For Bellizzi, who works at a New Jersey autism center and is active in the autism community, Rocco’s development as a preemie was a chief concern. Now 1 year old, “Rocco is sitting, crawling, standing and walking — all on target. He’s social; he’s vocal,” she says. “We’re happy; the developmental pediatricians are happy; and Rocco is super happy.

Feature image by Rachel/ Crittenden; Bottom photo by Benjamin Cotten