Recommendations for the collection, delivery and transporting of donor human milk (updated to include Covid-19 contactless operations)
10th January 2016
Current relevant recommendations:
1)NICE Clinical Guideline 93 Donor Breast Milk Banks; Service Operation pub 2010 https://www.nice.org.uk/guidance/cg93/evidence/full-guideline-243964189
Transporting milk to the milk bank
- a) Define critical conditions for transport, including temperature and time limit, to ensure that donor milk remains frozen during transport. (1.2.44)
- b) Transport donor milk in secure, tamper-evident containers and packaging .(1.2.45)
- c) If donor milk is transported to the milk bank by a contracted third party, ensure that a documented agreement is in place to maintain the conditions needed. (1.2.46)
- d) Define in writing the milk bank’s procedures for transporting and storing donor milk. Ensure that these procedures maintain the quality of the donor milk and allow accurate identification of samples. Keep records of inventory and distribution (see also recommendations 1.2.68 to 1.2.75 on tracking and tracing). (1.2.47)
- e) Collect expressed milk from the donors, preferably using an agreed transport provider (ideally a medical courier) or a member of staff from the milk bank. In some instances, donors may be required or may wish to deliver their own milk to the milk bank or depot, in which case they should also follow the milk bank’s requirements for transport as outlined. In all cases, use consistent monitoring processes, including recording the journey time. (1.2.48)
- f) Collect expressed milk from either the donor’s home (see recommendations
1.2.38 to 1.2.43) or from donor milk depots that have practices for monitoring freezers and maintaining standards for quality control, storage and security. Ensure that similar processes are in place in any location where the donor milk is stored. (1.2.49)
- g) Check that donated milk arriving at the milk bank:
- is labelled correctly with the donor’s name and the date of expression
- has remained frozen
- has not been tampered with.
- h) Transfer all donated milk immediately to the freezer. (1.2.51)
2) European Directorate for the Quality of Medicines (EDQM) www.edqm.eu
Guide to the quality and safety of tissues and cells for human application. 4th edition
Chapter 33 Human Milk
Distribution and transport conditions
During transport, milk should remain frozen and dry ice may be used for this purpose.
The use of validated, easily cleaned, insulated transport containers is recommended.
The transport procedure should be validated, and the temperature of the transport container monitored during transportation.
Additional recommendations in response to Covid-19
The pandemic resulting from the spread of the SARS-CoV-2 virus that causes Covid-19 has led to government imposed measures that impact on the collection and delivery of DHM. A non-contact collection and delivery process is required. In addition, donor recruitment, selection and screening has been updated to exclude donors at risk ie who are currently exhibiting or who have exhibited any of the Covid-19 symptoms (new, persistent cough, fever) or who have tested positive for the virus. The exclusion also applies if the donor is a known contact of someone with these symptoms or diagnosis. Self-isolation and social distancing, as imposed by the government on March 23.03.2020 must be observed by donors and social distancing observed by staff, volunteers and couriers engaged on behalf of the milk bank..
Recommended additional measures to be put in place:
Collections from donors’ homes
- Donors should be instructed prior to collection of the new additional measures
- No donor milk will be collected from any “at risk” family
- All donors are screened in accordance with milk bank protocols
- All donors will have been asked to place their frozen, labelled milk containers into labelled bags which should remain in the freezer until the courier arrives
- When courier arrives at location, he/she should phone donor to confirm arrival, and place insulated transport container by the donor’s outer door and stand away by at least 2 metres.
- The donor will place bagged, frozen milk into the transport container together with the completed ‘Donors Do It Safely’ form or other required paperwork.
- The donor will return indoors and close the door
- The transport container should be closed by the courier and tamper evidence completed
- The courier should use ag or straps before alerting colleagues prior to transferring the milk to the milk bank.
- On arrival the courier will alert milk bank staff, deliver the transport container to the entrance to the milk bank and adopt a safe social distance. Milk bank staff will retrieve container, transfer milk to freezer in accordance with standard protocol before disinfecting , changing gloves and returning transport container to entrance where it can be retrieved by the courier once the staff member is at a safe distance.
- Delivery of donor milk should be requested in the usual way
- The milk will be packaged in the normal way
- When the courier arrives at the milk bank the milk to the entrance or to a safe distance from the courier if outside the building
- The courier should collect and transport in the normal manner
- On arrival at the Hospital the rules of the hospital should be followed
- Any issues with the delivery should be communicated immediately to the Milk Bank
- After completion of the delivery the courier’s transport box should be cleaned in accordance with standard protocols.