REVIEW ARTICLE Establishment of the First Religiously-compliant Human Milk Bank in Bangladesh Mohammod Mozibur Rahman 1 , Soofa Khatun 2 , Nazneen Kabir 3 , Wahida Khanam 4 , Akhil Maheshwari 5 , Mohammod Shahidullah 6 Received on: 26 November 2022; Accepted on: 27 November 2022; Published on: 23 December 2022 A BSTRACT Human milk banks (HMBs) collect, screen, process, and dispense donated human milk (HM). There are more than 500 large HMBs in the world but only a few are functioning in Muslim countries, and that too on a limited scale. Human milk banks that are similar to those in the Western countries have been difcult to establish in Muslim countries as Islamic laws do not allow the consumption of unidentifed donated milk from multiple donors. Human milk is known to be important for nutrition in premature and critically ill infants, and so there is a well-recognized need to develop religiously compliant and conditionally identifed HMBs in Muslim countries. In these milk banks, every mother’s milk is processed and stored separately, and the milk provided by one mother can be provided to an infant from a diferent family only after appropriately counseling both families about the Islamic laws of prohibition of future marriages between milk siblings. Documents related to these issues are provided to both families and data need to be maintained for future reference. In this article, we recount the educational, fnancial, and infrastructural challenges that we faced in establishing religiously-compliant HMB in Bangladesh. There is already a noticeable reduction in infant mortality in our region. Keywords: Breastmilk, Human milk bank, Large for gestational age, Microbiological screening, Newborns, Premature, Triglycerides. Newborn (2022): 10.5005/jp-journals-11002-0047 I NTRODUCTION Human milk banks are an important asset in the care of premature and critically ill newborn infants who do not have access to their mother’s own milk (MOM). 1–3 These services collect, screen, store, process, and dispense HM donated by nursing mothers, who may be biologically related or not, for feeding the recipient infants. 3,4 The World Health Organization (WHO) emphasizes that the best alternative when a biological mother is not able to breastfeed her infant(s) is to use HM from other sources. They have estimated that if every woman all over the world optimally breastfed her baby, the lives of 800,000 young children could be saved every. 5,6 Recently published research and systematic reviews support the conclusions that breastfeeding and HM are the reference normative standards for infant feeding and nutrition. 7 Benefcial efects of donor milk remain signifcant and donor milk is still highly-preferable when MOM is not available. 8 Human milk is the best source of nutrition for all newborns, whether they are born at term or preterm; or are appropriate-, small-, or larger-for-gestational age. 3,8 It contains a variety of bioactive factors, which are known to promote the maturation of the infant’s immune and digestive systems. 6,9 Human milk is known to protect against necrotizing enterocolitis (NEC) and neonatal sepsis. 7 The American Academy of Pediatrics has also recommended donor human milk (DHM), even if in part, due to a reduction in occurrence of NEC. 4,10 A systematic review and meta‐analysis of data from clinical trials shows that DHM has a protective efect against NEC in preterm and low-birth weight when compared to formula. 11 Unfortunately, MOM is not available at all or in insufcient quantities in many infants for some social, biological (premature birth, maternal illness, or drug intake), or yet unclear reasons. 12 If MOM is not available or sufcient for an infant, milk donated by other women or a wet nurse that is processed, verifed for safety, and stored appropriately in a HMB may be of help. 13 In North America, HMBs have provided milk from a single donor or by pooling the milk from up to 5 women before distribution. 14 © The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 1 Department of Neonatology, Institute of Child and Mother Health (ICMH), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; Special Care Newborn Unit and the Neonatal Intensive Care Unit, Institute of Child and Mother Health (ICMH), Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka, Bangladesh; Human Milk Bank, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh 2,4 Department of Paediatrics, Institute of Child and Mother Health (ICMH), Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka, Bangladesh 3 Department of Obstetrics and Gynaecology, Institute of Child and Mother Health (ICMH), Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka, Bangladesh 5 Global Newborn Society, Clarksville, Maryland, United States of America 6 Department of Neonatology, Bangladesh Institute of Child Health (BICH), Dhaka, Bangladesh Corresponding Author: Mohammod Mozibur Rahman, Department of Neonatology, Institute of Child and Mother Health (ICMH), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; Special Care Newborn Unit and the Neonatal Intensive Care Unit, Institute of Child and Mother Health (ICMH), Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka, Bangladesh; Human Milk Bank, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, Phone: +880 1713409258, e-mail: rmujib75@ gmail.com How to cite this article: Rahman MM, Khatun S, Kabir N, et al. Establishment of the First Religiously-compliant Human Milk Bank in Bangladesh. Newborn 2022;1(4):376–383. Source of support: Nil Confict of interest: None