Hong Kong is set to launch its first human breast milk bank early next year as part of an effort to promote neonatal health and raise public awareness of the importance of breastfeeding.

While allowing infants to enjoy the benefits of breast milk is important, health experts say it’s also vital to promote women’s rights and beef up cooperation with neighboring cities to obtain the best results.

The facility, to be housed in the Hong Kong Children’s Hospital in Kowloon Bay, will make the special administrative region the sixth city in the Guangdong-Hong Kong-Macao Greater Bay Area to operate such a service.

The aim is to support an estimated 450 to 600 extremely premature infants in the special administrative region annually and offer essential nourishment to nine public hospitals with neonatal intensive care units.

Breastfeeding is widely recommended by the World Health Organization as one of the most effective ways to ensure child health and survival. It’s the “first vaccine” for new-borns, says Zhang Qianshen, a consultant neonatologist at the Department of Pediatrics of the University of Hong Kong-Shenzhen Hospital. He’s in charge of the hospital’s breast milk bank — the second of its kind in Shenzhen, which was set up in 2021.

Breast milk is seen as capable of enhancing infants’ immune functions, and is safer for their digestive systems than formula milk is. It can effectively reduce the risk of severe gastrointestinal problems like necrotizing small intestinal colitis, which is common among babies, especially those born prematurely. Human milk can also help mitigate complications, such as delayed sepsis and chronic lung diseases, and reduce mortality rates among the population.

Zhang Qianshen, a consultant neonatologist at the Department of Pediatrics of the University of Hong Kong-Shenzhen Hospital, believes there is potential for Hong Kong and other GBA cities to share stored breast milk, given the common practice of cross-boundary donations and utilization of breast milk

The Guangzhou Women and Children’s Medical Center, which opened the Chinese mainland’s first breast milk bank in 2013, saw the remarkable recovery of a 10-month-old baby suffering from lethal sepsis who was cured after two weeks of breast milk therapy.

Globally, it’s generally recommended that there should be at least one breast milk bank for every 2 million people. Zhang says the facility is necessary for Hong Kong to meet the needs of its residents.

He believes there is potential for Hong Kong and other GBA cities to share stored breast milk, given the common practice of cross-boundary donations and utilization of breast milk.

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The University of Hong Kong-Shenzhen Hospital proposes operating a breast milk distribution collaboration network with cities in the region to strengthen scientific research and medical standards through shared data. Hong Kong’s new milk bank can be one of the sources, says Zhang, adding he hopes it will raise the public’s awareness of the importance of breast milk.

However, Liu Xihong — a youth nutrition expert overseeing the breast milk bank in Guangzhou — warned that various hurdles must be overcome for the bank to realize its full potential.

One of the pressing concerns is securing funding. While Hong Kong’s Hospital Authority supports the establishment of a breast milk bank, Liu calls for additional financial backing from social organizations to guarantee that its operations can be maintained.

Meeting the yearly goal of maintaining 600 to 850 liters of donated breast milk is another challenge due to Hong Kong’s low fertility rate and limited maternity leave for mothers.

Liu Xihong, a youth nutrition expert overseeing the breast milk bank in Guangzhou, suggests that Hong Kong introduce more supportive policies to encourage greater participation in milk donation, such as extending maternity leave, offering paid leave, and improving healthcare accessibility

According to Liu, 1,240 mothers had made 10,163 donations at Guangzhou’s breast milk bank in the past 11 years, amassing 8,889.9 liters of breast milk, or an average of about 800 liters annually. But the figure is based on the Guangdong provincial capital’s relatively higher fertility rate of 11.07 births per 1,000 people in 2022 — considerably higher than Hong Kong’s 4.4 births per 1,000 people.

Hong Kong’s breast milk bank would require an average of 11 to 15 donations daily to meet its annual objective, based on the assumption that each mother contributes about 150 milliliters per donation and the bank operates 360 days a year. Last year, about 33,200 children were born in the SAR.

The eligibility of donors is another factor to consider. Prospective donors must not only have an ample milk supply, but also a clean bill of health to rule out infectious diseases.

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Policy incentives

Liu suggests that Hong Kong introduce more supportive policies to encourage greater participation in milk donation, such as extending maternity leave, offering paid leave, and improving healthcare accessibility.

The WHO recommends a minimum of 18 weeks’ paid maternity leave that can ideally be extended beyond six months. Paid breaks and designated lactation areas are also suggested for the convenience of working moms.

Like the mainland, Hong Kong will not offer financial compensation to breast milk donors for ethical reasons. Hence, the willingness to donate is solely on a voluntary basis.

Liu says it is crucial to raise awareness about the value of breast milk through extensive media outreach and educational campaigns.

Breast milk banks can team up with hospitals’ pediatric clinics to produce and distribute information brochures and leaflets to mothers.

Fathers can also play an influential role in the donation process by providing emotional support for their spouses, participating in breast milk delivery, sharing household chores, and responding to emergencies, Liu says

Under Hong Kong’s plan, hospital employees would visit donors’ homes to collect breast milk for the sake of convenience.

Fathers can also play an influential role in the donation process by providing emotional support for their spouses, participating in breast milk delivery, sharing household chores, and responding to emergencies, Liu says.

At present, there is no breast milk bank in the GBA that provides guidance on the role of fathers. Hong Kong’s facility could take the lead by introducing a reference guide to encourage fathers to take part in the process, she adds.

With the regional network, Zhang envisions that mothers living in the GBA can make donations after completing a review online, and even donate to the new Hong Kong bank whenever they travel to the city.

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In Liu’s view, a collaboration network should be set up.

She suggests that a regional breast milk bank website be established to offer a central repository for resources, such as policy briefs, bank locations, contact details, and relevant information.

“I hope we can have an ideal volume of breast milk ready to benefit more babies who are born prematurely or are seriously ill.