A Human Milk Bank (HMB) is a facility for the collection, processing, storage and distribution of donated human milk. The first German HMB was founded in 1919 in Magdeburg by the pediatrician Marie Elise Kayser. Currently Germany there are 14 official HMB (in Berlin, Chemnitz, Cottbus, Dresden, Eisenach, Frankfurt / Oder, Jena, Görlitz, Greifswald, Leipzig, Magdeburg, Neubrandenburg, Munich and Potsdam), and more are planned. About 3500–4000 liters of donated human milk is processed and made available per year.

The donated human milk is mainly for feeding very small premature infants (<1500 g birth weight) and ill newborn children, if none or only insufficient mother's milk is available to the children.

When babies drink mothers’ own milk or donor milk the chance of getting necro - tizing enterocolitis and rare systemic infections are significantly decreased. Whereas, baby formulas tend to increase the possibilities of necrotizing enterocolitis and rare systemic infections occurring.

In order to always provide hygienic milk to premature infants and newborns, defined procedures and guidelines are required. A valid nationwide law for operating a HMB does not exist in Germany. The "Guideline for the establishment and functioning of human milk banks" published by S. Springer in 1998, is today still representative of the German HMB’s operational foundation. Furthermore, local site-specific conditions such as guidelines of the hospital hygiene departmentes, HACCP concepts or con - ditions by the government food inspection agencies are to be noted.

Suitable milk donors are healthy, lactating women who have an excess of breast milk. Current medications, lifestyle and risk factors will be some of the questions asked in a personal medical history. Chronic diseases, nicotine, drugs or alcohol consumption can be a valid reason not to be accepted as a donor. Prior to the first breast milk donation serological screening for the human immunodeficiency virus (HIV 1/2), hepatitis B, hepatitis C, cytomegalovirus (CMV) and syphilis are carried out. The tests will be repeated in the 3-month interval. Each donated bottle of milk (whether pasteurized or raw) is examined microbiologically for aerobe bacterial amounts and pathogens before use. The donated milk is cooled or frozen in the HMB and labeled (name, pumped date and time) delivered or sometimes picked up by a transport service from the donor’s home. The internationally accepted standard is the use of pasteurized donor’s milk (Holder method, for 30 minutes at 62.5 °C (Gibbs et al., 1977). Not only the number of bacteria can be reduced but also the amount or the activity of the various milk-ingredients can be reduced to varying degrees.

The mothers’ milk donation is anonymous for both donor and recipient. However, it is possible to trace the milk received from the donor to the donor child through a series of serological and microbiological tests.

Prior to administration of donated mothers’ milk, parents are informed about how to best care for and store the milk. Donated milk is only available with a doctor’s pre - scription.