There are more than 800 mother’s milk banks around the world – about half in developed countries – that collect the nourishing liquid from breastfeeding mothers to give to premature babies whose mothers can’t nurse them.
None of those had the insight of pediatricians at the Israel National Council for Pediatrics and Child Health about the unique circumstances of breastfeeding women who were murdered, abducted to Gaza, traumatized, or wounded by Hamas terrorists – or recruited by the IDF to fight – on October 7, 2023.
The invasion of southern Israel by Hamas led to the massacre of more than 1,200 Israeli civilians – including women and children –the kidnapping of more than 250 hostages into the Gaza Strip, and threats to thousands of families. At the very onset of the Hamas massacre, the optimal continuation of breastfeeding was challenged by many cases of maternal death or disability, or by emergency deployment for active duty of lactating mothers playing critical roles in the army or the air force.
The nonprofit National Human Milk Bank of Magen David Adom is located in Ramle’s MDA Blood Bank. Its professionals were asked to supply breast milk from over 400 women donors to 46 healthy babies whose mothers were not with them.
Some 200 new donors join post-October 7
In addition to the veteran donors, around 200 new donors joined, according to Prof. Francis Mimouni, a veteran pediatrician at Jerusalem’s Shaare Zedek Medical Center and, for the last 15 years, chairman of the national council, who worked with Dr. Sharron Bransburg-Zabary, director of MDA’s human milk bank.
“Because of the war, we have tripled its activity, and in addition to providing the routine milk, there was an emergent need for safe mother’s milk to nourish babies who have been orphaned, whose mothers have been abducted or injured, or for babies whose mothers were recruited to the IDF, said Bransburg-Zabary, a certified lactation consultant who helped found, and who leads, the facility to provide safe, screened donor breast milk to premature, sick, and vulnerable infants.
“We worked around the clock and recruited many new donors to collect about a liter per day for each baby and to continue providing the infants and the premature babies with the safest milk that stands up to the highest supervision levels and passes all the tests and procedures needed for their health.”
Bransburg-Zabary explained that when infants or premature babies are fed exclusively with breast milk, a unique environment of microorganisms, such as beneficial bacteria, is created in their tissues. This environment is part of their immune protection and helps prevent allergies.
“If the biological mother is unable to nourish her infant with her own milk, supervised portions of breast milk from the Human Milk Bank are the recommended feeding option endorsed by health authorities worldwide and by the Health Ministry. Breast milk is defined as a ‘lifesaving treatment’ for infants in need.”
The journal Military Medicine quickly accepted and published the unique study titled “Human milk bank in a war zone: A report of the 2023-2025 war in the Middle East” by Mimouni, Bransburg-Zabary, Dr. Deena Rachel Zimmerman, Prof. Eilat Shinar (who runs the blood bank), and others.
Healthy babies needed donated breast milk
Mimouni told The Jerusalem Post in an interview that “we realized on Oct. 8 that there were babies who needed mother’s milk, even though these were not the usual ones that qualified. It was provided in normal times to premature, low-birth-weight babies to prevent infections like necrotizing enterocolitis.
“Our aim was not to save lives; the babies were all healthy, and at last resort, they could have been given infant formula. But it takes time for many infants to get used to formula after being nursed by their mothers. Some refused. They obviously had to drink from a baby bottle, which involves a very different technique of sucking with the tongue and mouth; but also having to get used to formula makes it harder.”
“Some families to whom we offered the donated milk asked how they could be sure it was sterile and suited to the baby,” Mimouni recalled. “We knew there would be anxieties, but weeks later, we did surveys of families who were involved in this unique experience. Many potential donors came forward after we published requests to apply.
“The project’s success was caused by motivation; what caused success was motivation; giving of your own milk, giving part of yourself while nursing your own baby is the height of unconditional love.”
In normal times, donors who had been given sterile bags brought their milk to a specific place, but with missiles falling and danger in the streets, MDA motorcycles took the bags every day and brought them to the Ramle milk bank.
MDA was chosen to run the milk bank in 2018 because “they’re used to dealing with emergencies,” explained Mimouni. There is no other place in the world where a national mother’s milk bank is run by a blood bank.”
When he was made chairman of the national council, he wanted to know what challenges there were and how to advise the ministry. “My idea was that there would be a mother’s milk bank.” He asked the then ministry director-general, Prof. Ronni Gamzu, to allocate NIS 1 million to start it, and he did. “So many people gave of their time.”
Asked if there was a very memorable case of a mother who needed milk donations for her baby, he recalled a woman Israel Air Force helicopter pilot who decided to halt her maternity leave to go on active duty and fly her Apache.
If another country asked him tomorrow how to prepare for war or a major disaster, his advice would be how to continue to collect contributions from lactating mothers and not to allow a mother’s milk bank to close down in an emergency.
“Some traumatized mothers who survived were unable to breastfeed because of stress, so they decided to give formula or to accept donations for their babies. We asked about the possibility of developing guilt feelings because they couldn’t feed them by themselves, but this wasn’t an issue,” said the council chairman.
“At enrollment, half of families expressed a high or moderate degree of anxiety. In contrast, after the infant received the donated milk, less than 25% still expressed anxiety. More than 80% attested that the donation helped them in handling the consequences of the war and contributed to their child’s health, while more than 90% felt that the donation contributed to their own well-being,” the authors wrote. “In settings of maternal loss or incapacity during war, donor human milk can be effectively provided by human milk.”
“They said they felt ‘the whole country supported me,’ so we saw the donor milk become a symbol of solidarity. So much good came out of it,” Mimouni added.
The donor milk undergoes many tests and has to meet very tough criteria for it to be given to other babies. The mothers are not self-selected. Those who apply have to list any medications they are taking, and the milk that is accepted is pasteurized. The area where the milk is handled at the bank is replete with yellow light to kill any bacteria or viruses in the air.
Asked whether the war since October 7 taught him something about medicine that he didn’t know before, Mimouni said that it clearly showed that medical workers don’t constantly think about their incomes. They came to work in hospitals and health funds, hotels where evacuees were sent. These included Israeli Arab doctors and nurses who asked if they were needed to help.”
The journal study isn’t really about the war, which was the circumstance. The published paper is about how an existing public health system adapts under extreme conditions.
In other words, the authors were asking: “What happens when a service designed for premature babies suddenly becomes part of national emergency response?”
The National Human Milk Bank in Ramle can be contacted by email at milkbank@mda.org.il; by WhatsApp at 052-634-4101; and by phone at 073-263-0200.