As a nursing mother Liang Juan must pump and freeze her extra breast milk, as she often has too much for her seven-month-old infant. As the milk can only be stored for a maximum of six months, the second-time mother uses the extra to make soap or as a fertilizer for flowers.
For mothers like Liang, there is now another way for them to ensure their unwanted milk does not go to waste, one that helps premature and underweight babies.
The "breast-milk bank" in Xi'an, run by Shaanxi Provincial No. 4 People's Hospital, is one of 17 such facilities across the Chinese mainland. The donated milk is distributed to infants deemed high risk, giving them a higher chance of survival.
"Donation is better than wasting this precious resource," said Liang, 33.
Liang said the process to becoming a milk donor was not straight forward. First she had to submit a full medical history, and undergo a blood test to check for diseases such as HIV and hepatitis.
Once she got the green light, her milk then had to be processed so that it could be despatched across the country to children in need. The process included the milk being heated to 62.5 degrees Celsius for half an hour to pasteurize it. The milk is then stored at minus 25 degrees Celsius until it is used.
One abandoned infant who gained from the milk bank was an intersex child nicknamed "Nannan." Nannan was born at 23/24 weeks gestation with severe pulmonary infection, and even worse, Nannan was allergic to milk powder.
After a month of treatment and consumption of donated breast milk, the baby now weighs 1,900 grams, increased by 400 grams.
"Nannan has ceased vomiting and over all, Nannan's condition has improved," said Zheng Fengying, a doctor with the neonatology department and one of the founders of the milk bank.
Since its establishment in May 2015, more than 360 mothers have donated around 260 liters of breast milk to the hospital's milk bank as of last year, which was given to over 700 infants including 400 premature babies.
"Breast milk is not just a food but also has medicinal properties for vulnerable babies in some cases, providing protection against bacteria and viruses," Liu Li, from the Chinese Committee on Children Health, said before National Breastfeeding Day on May 20.
The first breast milk bank in the world was founded in Vienna in 1909. Fast forward, and just over a century later there are now hundreds of milk banks in Europe and North America.
The Chinese mainland set up its first breast milk bank in Guangzhou in 2013. Other cities followed suit, including Shanghai, Chongqing, Nanjing and Beijing.
However, owing to donor and fund shortages, many are uncertain about their future.
TO PUMP OR NOT
Hong Jiangmiao rings a free number, and soon after a hospital car is on its way to her home, with a driver, nurse and the special equipment needed to collect her breast milk.
Hong has made more than twenty deposits to Beijing's first nonprofit breast milk bank, which was established in March 2016 by Taihe Maternity Hospital.
Taihe offers a home-visit service and rewards frequent donators with free baby swimming class.
"Many people don't donate because they don't know there is such a program," said Hong, 27.
Even Hong, herself, only recently heard about milk donation. She gave birth to her child in Taihe two months ago and was encouraged by nurses to donate her extra milk.
"We don't accept frozen milk, and we are aware that it is inconvenient to travel to the bank and undergo the complicated screening process," Wu Wenyi, who is in charge of the breast milk bank in Taihe, explained.
Despite strict screening, Wu said people are still concerned as, at the current time, there are no regulations managing breast milk banks in China.
"Making the system safer and ensuring that the sickest babies are given priority is also a major concern of many donors," Hong said.
Since its establishment, the Taihe non-profit milk bank has attracted 150 donors and collected around 50 liters of breast milk.
Official data showed that around seven percent of newborns in China are born premature every year. However, as Wu explained: "all banks in China face the same problem: the supply lags far behind demand."
IT REALLY COSTS
Unlike organizations abroad, which are largely philanthropic endeavors or charge for the donated milk, most Chinese breast milk banks are run by hospitals.
The cost of running a nonprofit breast milk bank is a huge outlay for public hospitals. Sometimes, they avoid encouraging eager mothers to donate at all, Zheng Fengying said.
In Taihe, a bottle of 150 ml bottle of breast milk costs the hospital needs 1,200 yuan (around 174 U.S. dollars) each. This price covers disposable breast pump, blood test, bacterial culture, pasteurization, storage and wages for staff.
According to Guo Jiazhong, president of Taihe, the private hospital has spent around 300,000 yuan on equipment and pays out an annual management fee of more than 300,000 yuan to keep the bank afloat.
"We will not close it, nor will we charge any fees," said Guo. "Breast milk banks must be nonprofit and continue to help these babies."
In 2008, only 27.6 percent of Chinese babies were breast-fed in their first six months. This had risen to 58.5 percent in 2013.
Away from these national figures, Liang Juan is more concerned about the abandoned baby Nannan.
"This poor baby is now getting the nutrients it needs from the donated breast milk. I just hope Nannan will recover soon," said Liang.
