The gift of mothers’ milk
Sustained by donations from nursing women, milk banks provide a lifeline to vulnerable newborns
by Elly Fishman
1 Nov 2025Photography 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.
A technician holds a bottle of donor milk.
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.
Left: At the Mothers’ Milk Bank of the Western Great Lakes, a small sample of milk from each donor is tested for the presence of harmful bacteria. Right: Milk from multiple donors is pooled to ensure nutritional consistency and a robust antibody profile.
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.
An automated bottling line is used to fill, cap and label each bottle of donor milk.
The Mothers’ Milk Bank of the Western Great Lakes is one of the more than 30 nonprofit milk banks accredited by the association. Co-founded by a former Rotary staff member and supported with donated funds from multiple Rotary clubs over the years, the Chicago-area milk bank serves more than 90 hospitals in Illinois and Wisconsin. The organization has seen explosive growth since it opened its first processing facility in 2015, going from three employees to 25 and moving last year into a new facility, one of only two in North America with a bottling conveyor belt.
Prescreened mothers drop off their milk for donation at “milk depots” throughout the region, where volunteers ship it frozen in insulated containers to the milk bank for processing and pasteurization. “Some of our moms make tons of milk,” explains Susan Urbanski, the milk bank’s program manager. “Nobody wants to see something so precious go to waste.”
From right: Liz Courtney and Yvonne Hiskemuller speak with a nursing mother donating breast milk at a Rotary club-supported milk bank.
Image credit: Sahand Jahani
Urbanski says that some moms needed donated breast milk when their own babies were first born, but after receiving lactation support, they went on to successfully breastfeed and want to give back. In that way, milk banks don’t replace breastfeeding — they support it. Some moms discover their baby is intolerant to something in their diet. Their milk is still good, just not for their baby. And some moms donate after a loss through bereavement programs like one offered by the Chicago-area milk bank. “That’s a really special part of nonprofit milk banking that sometimes gets overlooked,” Urbanski says. “The goal is to honor the baby’s legacy, to make meaning out of a devastating situation.”
Rotarians help establish new bank
In Christchurch, New Zealand, the idea began with frustration. Yvonne Hiskemuller, a midwife and member of the Rotary Club of Garden City Christchurch, had worked with the milk bank at a hospital in town, but she quickly saw its limits. The service didn’t extend beyond the neonatal intensive care unit, and there was no plan to support mothers once they left the hospital. “It was clear that was never going to happen,” says Hiskemuller. So she turned to Rotary.
Liz Courtney, then a district governor, immediately saw the potential. As a mother of five, including a set of triplets, Courtney knew firsthand the complexity of early feeding. Together, she and Hiskemuller gathered a small group of committed women — Rotarians, lactation experts, other volunteers — and spent the next four years fundraising, navigating bureaucracy, and slowly building a community-run alternative.
The result, launched in 2018, was a community breast milk bank hosted at a different Christchurch hospital, St. George’s. The repository runs on a lean infrastructure: three freezers, a pasteurizer, and a small army of volunteers, many of them Rotarians, midwives, and nurses. But its reach has been immense.
Rotary’s impact
The Rotary Foundation has awarded nearly 100 global grants toward human milk bank projects.
On any given day, the milk bank is a flurry of motion. Donors drop off bags of frozen breast milk, each labeled, tracked, and stored meticulously. Screening is rigorous, involving questionnaires, blood tests, and freezer logs. Volunteers pasteurize an average of 8 liters per week, a process that takes six to eight hours and requires sterile gowns, temperature checks, and detailed logs.
The recipients are typically newborns in fragile health or born to people who are recovering from surgery or have delayed milk production. One baby, too frail yet for heart surgery, needed milk at home in a rural community about 150 miles north of the Christchurch milk bank. Her doctors believed that if she was fed formula, she wouldn’t survive long enough to reach the operating table. The only option was to feed the baby donated breast milk.
Left: An automated bottling line prepares donor milk for shipment. Right: A lab technician inspects and dries bottles of pasteurized donor milk.
A nurse sent word to the Rotary club-supported milk bank in Christchurch, and the team there said yes immediately, even though the request fell outside the typical service area. A refrigerated truck company, Big Chill, transported the frozen milk free of charge.
Courtney recalls other people who were diagnosed with cancer during their pregnancies, preparing for surgeries when their babies arrived and unable to breastfeed. The milk bank stepped in, providing milk for those critical first days.
Over time, the bank has become a hub not just for milk but for knowledge. With Rotary clubs’ help, a longtime midwife who volunteers at the milk bank got trained as a certified lactation consultant and began offering breastfeeding classes for expectant mothers. The sessions, hosted at St. George’s Hospital, are free and growing.
The milk bank now supports the entire Canterbury region that’s home to Christchurch. As of June, it has provided safe donated breast milk to more than 2,700 babies. And perhaps more importantly, it has changed the way people in the community talk about feeding, need, and new motherhood. “Now that there’s an alternative to formula,” adds Hiskemuller, “there’s been quite a big groundswell of movement to recognize that donor breast milk is a far superior choice.”
An emotional effort
The story of human milk banking, at its core, is a story about people. About the mothers who donate milk they’ll never see consumed. About doctors and midwives who reroute their days to hand-deliver supply. About local volunteers who track every ounce, label every cooler, and field every emergency call.
Perhaps that’s why looking back on the past decade of work in the Philippines can be an emotional experience for Renato Cantos. What began with a grant application has helped transform not just hospitals but a culture. One that treats mothers not merely as patients or providers but as partners. One that sees babies, even the tiniest and sickest, as worthy of care, of investment.
“This was the first project that I did, and continue to do, because of the love for it,” Cantos says, “realizing the impact that it provides to those who are in need.”
This story originally appeared in the November 2025 issue of Rotary magazine.