For the smallest and the sickest newborns, breast milk is often the safest, most viable nourishment. When mothers can’t breastfeed these newborns for any of a variety of reasons, milk banks provide liquid survival from donations by other moms. Learn about the fascinating history of milk banks, the meticulous safety steps, and how Rotary members are expanding milk storage for fragile infants.

The gift of mothers’ milk

Sustained by donations from nursing women, milk banks provide a lifeline to vulnerable newborns

By Elly Fishman Photography by Jeff Marini

The morning Typhoon Haiyan made landfall in 2013, the sky above Manila turned a bruised gray. At the Dr. Jose Fabella Memorial Hospital in the Philippines’ capital city, phones started ringing. Dr. Estrella “Star” Jusi, then head of the hospital’s milk bank — one of the first in the country — picked up one call after another about its stores of donated breast milk. The city of Tacloban had been devastated by one of the most powerful typhoons ever recorded. Power was out. Water was scarce. Newborns in the city’s neonatal intensive care units, especially the smallest and sickest, were in critical need.

The Department of Health needed donated breast milk fast. Jusi mobilized. She called the country’s other milk banks to pool reserves. Coolers were packed and labeled. With roads blocked and commercial flights grounded, she worked with military officials to secure space on an armed forces transport plane.

A neonatologist from Jusi’s team volunteered to accompany the frozen milk. Over multiple trips, the milk bank delivered 86 liters of pasteurized donated milk — liquid survival for babies with no other lifeline.

Lifeline for fragile infants

Milk banks exist to meet a need that often goes unspoken: What happens when a mother can’t breastfeed her newborn? Maybe the baby came early, too small to latch. Maybe the mother is recovering from surgery, or her milk hasn’t come in. Maybe it’s the first chaotic week of life, and nothing is going to plan.

Formula can be a safe alternative for healthy, full-term newborns. But for fragile infants, milk donated by nursing women who produce extra to share with other moms is often the safest, most viable option available. Breast milk has been shown to lower the risk of life-threatening conditions, including necrotizing enterocolitis, an intestinal disease common in preterm babies. The World Health Organization and UNICEF recommend donated human milk as the preferred feeding option for an infant when a mother’s own milk is unavailable, especially for low-birth weight and preterm babies.

Even before the typhoon hit, malnutrition was a critical concern in Tacloban and across the Philippines, especially among premature infants. According to WHO, more than 1 in 4 Philippine children under 5 are stunted, a condition caused by chronic undernutrition that can impair physical and cognitive development. Among low-birth weight and preterm infants, lack of access to breast milk further increases the risk of infections, developmental delays, and death.

“We want to ensure that the babies will be given or will have the best start in life, even if they are premature and sick,” Jusi says.

In the last decade, the Philippines has built one of the most robust human milk bank networks in Southeast Asia. What began as a single Rotary club’s experiment has grown into a model replicated in 39 hospitals across the archipelago, supported by more than 30 Rotary Foundation global grants.

The idea took root in 2013, when Renato Cantos, then president of the Rotary Club of Timog-Quezon City, was searching for a signature project. A fellow Rotarian’s wife suggested members visit Fabella Hospital. There, they met Jusi, who had been running a milk bank since 2008. “It was the first time that I heard about a human milk bank,” Cantos says.

That year, his club helped secure a global grant to purchase a new pasteurizer, allowing the milk bank to continue operating after its original machine began to fail. Since then, the club has helped establish milk banks in several additional hospitals and supported other area clubs as they’ve embarked on similar projects. Rotary clubs’ support, along with that of private donors and the Department of Health, has helped expand the number of facilities from five to 39. One 2019 master’s thesis by a student at De La Salle University in Manila even proposed a standardized Rotary global grant template for milk bank projects.

Modern protocols ensure safety

The concept of milk sharing is centuries old, rooted in the historical practice of wet nursing when women breastfed another person’s child. But formal breast milk banks only began to appear in the early 20th century. The world’s first was established in Vienna in 1909, followed shortly after by one in Boston. For decades, milk banking quietly served a niche role in neonatal care, until the AIDS crisis of the 1980s shuttered many programs over fears the virus could be transmitted through donors’ milk.

In the decades that followed, renewed research and new safety protocols revived the practice. Milk banks began to adopt standardized methods such as pasteurization that heats milk to a precise temperature for 30 minutes to eliminate pathogens while preserving nutrients. They also implemented rigorous donor screening processes to ensure safety, similar to when people donate blood. These protocols reassured clinicians and public health officials, helping reestablish trust in donated milk as a viable and safe feeding option.

In Western Australia, the Rotary clubs of Belmont and Thornlie, along with Belmont Rotarian Stan Perron, were behind the establishment of the country’s first modern milk bank in 2006, decades after informal milk sharing within towns’ maternity wards had faded. Similar timelines have played out in countries around the world.

Today, Brazil is widely considered the global leader in milk banking. Two dozen Rotary Foundation global grants have supported some of the 200-plus centers across the country. The Brazilian model, built into the public health system, has inspired similar efforts across Latin America, including in Colombia and Mexico. South Africa has developed a network of milk banks, often tied to hospital-based neonatal units. Still, in most low- and middle-income countries, milk banks remain rare.

North America, too, has seen a rise in milk banking. In the United States and Canada, 11 million ounces of donated breast milk were distributed in 2024 — a 10 percent increase from the previous year, according to the Human Milk Banking Association of North America, which sets guidelines for pasteurized donor milk.

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Rotary’s impact:

The Rotary Foundation has awarded nearly 100 global grants toward human milk bank projects.