South African Breastmilk Reserve - a lifeline for mothers and babies

The veteran NGO and Discovery Fund partner will use its infrastructure and capacity to test donated breastmilk for HIV and hepatitis B instead of taking blood samples, which is the current practice.

Founded by Executive Director, Stasha Jordan, the South African Breastmilk Reserve has breastmilk banks in 27 public tertiary hospitals and provides life-saving milk to 80 neonatal units where mothers are unable to breastfeed nationwide. It has proved itself agile in responding to dire, even more basic needs of mothers and babies.

Jordan says their R5 million annual budget promotes, initiates and enables exclusive breastfeeding while piloting projects that provide basic sanitation, water and food to mothers in disadvantaged communities.

"You get newborns in neonatal intensive care units, with the mother too ill to lactate, or even dying from COVID-19 or other ailments. If not breastfed, that baby will succumb to necrotising enterocolitis [bacterial infection of the intestinal wall], a condition so common that it impacts hugely on hospital and medical aid budgets," says Jordan of the NGO's primary function.

Double or Double - a success story

The South African Breastmilk Reserve launched its Double or Double initiative during the first wave of the COVID-19 pandemic in 2020. The NGO adopted seven new neonatal ICUs to the pro bono top-up programme, which sends milk from the Reserve's head office to the 27 banks or hospitals that don't have a human milk bank, to meet the need for breastmilk in the neonatal ICUs.

"In the third wave we've further extended our coverage to three new hospitals, and officially extended the offer of support to the directors for maternal and child health of all the provinces we work with," she adds.

The need to top up hospitals arises when the maternal population is exposed to HIV, which makes viable milk donors difficult to find. With the COVID-19 pandemic, access restrictions have resulted in mothers unable to meet daily feeding requirements of hospitalised babies.

Thanks to this initiative, 5 729 hospitalised premature babies received breastfeeding support from the South African Breastmilk Reserve in 2020 and 2021 - 2 700 more than the previous financial year.

Giving smart food vouchers to families in need

The South African Breastmilk Reserve also piloted an unstructured supplementary service data system that generates smart food vouchers that people can redeem at a popular local supermarket chain. The US-based Rodenberry Catalyst Fund donated R250 000 to the pilot.

"We spent R150 000 to issue R150 food vouchers to 1 000 people in the informal Mankweng settlement 32 km from Polokwane in Limpopo. We're about to establish a container facility in the area that operates as both a tissue bank and an off-the-grid first 1 000 days childcare clinic," Jordan says. Milk collected there is transferred to Mankweng Hospital.

Digging even deeper

However, Jordan's team realised that the community's needs are even more basic. Only 46% of households in South Africa have access to piped water, with schools and children in rural areas worst affected, the latter underscoring the importance of breastfeeding. An estimated 26.8% of South African households have access to water on their property while 13.3% need to share a communal tap, according to research verified by Africa Check.

"So, we used the rest of the money to sink a borehole. They needed clean water and flushing toilets - everything else was subsidiary," Jordan says.

By the end of November 2020, the NGO had "fed everybody for a month", she adds. On 28 March 2021, the Mankweng borehole was completed and put into service. The toilets followed.

Groundbreaking virology research kicks in

In May 2021, the NGO received the Discovery Foundation Rural Institutional Award to the value of R500 000 to do groundbreaking virology research at the University of Pretoria. Donors provide breastmilk and blood at designated sites simultaneously, with the blood pathology tests validating and testing the breastmilk for HIV and hepatitis B.

"Instead of drawing blood we'll use the breastmilk to run the rival pathology," Jordan explains. The potential public health cost savings and industry implications are profound.

Jordan adds: "We're approaching the labs for market research and collaborating with the South African Medical Research Council, the South African National Blood Service and the National Institute for Communicable Diseases."

COVID-19 a major aggravator

Pregnant women have also been impacted by COVID-19, with one in six women admitted to an intensive care unit in a hospital, and one in sixteen dying.

Jordan's dream is to see all public hospitals creating on-site lodging facilities for mothers with babies in the neonatal ICU. The Chris Hani Baragwanath Hospital leads the way with a 34-bed lodge for exclusively breastfeeding mothers, albeit too few to match the 116 high care neonatal beds. "My dream would be to never allow the mother and baby to be separated," Jordan says.

Discovery Fund committed to mother and child health

In addition to the 2021 Discovery Foundation Award, the Discovery Fund in 2020 contributed R500 000 to the NGO to continue its life-saving work in maternal and child health.

"The Discovery Fund has made child and maternal health one of its funding focus areas," says Ruth Lewin, Head of Corporate Sustainability at Discovery. "We are committed to supporting organisations and initiatives like the South African Breastmilk Reserve that cover a mother and child's health journey."

"We would not be here without the support of social investment partners like Discovery," Jordan says in conclusion. "The contribution that Discovery has made to our cause is tantamount to giving us a foundation from which to work. While the work we do is to support premature babies with donated breastmilk, as a charity, it remains an incredibly resource-intensive exercise and the financial means to do so saves lives."

This article was created for the 2021 Discovery Foundation Awards and has been adapted for the Discovery Magazine.