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Donor Milk Consent Form

Extra breast milkIncreasingly, evidence supports the use of human milk to promote optimal health and decrease risk of infection and NEC in VLBW infants. Working toward the goal of 100% human milk nutrition may lead to benefits in this population.

If mother is unable to pump or produce milk for her vulnerable infant, consideration of using donor milk for the early feedings for a VLBW infants may be warranted. UC San Diego Health uses this consent form for parent education and documentation of consent to use heat treated human donor milk in these instances.

Additionally, mothers producing large amounts of milk may be directed to the Human Milk Banking Association of North American (HMBANA) website for donation.