Brazil Turned Donated Breast Milk Into a Public Health Resource
Brazil has built one of the world’s largest networks for collecting and distributing donated human milk. The system primarily supports premature and low-birth-weight newborns who cannot receive enough milk from their mothers, connecting volunteer donors with hospital neonatal units through the public health service.
What began as a single human milk bank in Rio de Janeiro in 1943 has grown through decades of research and public policy into a national network. Under the leadership of the Oswaldo Cruz Foundation (Fiocruz), Brazil’s milk bank network distributes donated milk, promotes breastfeeding, and educates healthcare workers nationwide.
Brazil built a national network around milk donation
The country’s first milk bank opened at what is now the Fernandes Figueira Institute in Rio de Janeiro. Other facilities eventually followed, but Brazil initially lacked a unified system for processing and distributing donated milk.
The system began to take shape in the 1980s. Researchers led by João Aprígio Guerra de Almeida developed processing methods adapted to Brazil’s public health infrastructure. Their work helped establish the technical basis for a national system.
In 1998, the Ministry of Health and Fiocruz established the Brazilian Human Milk Bank Network. Once folded into the Unified Health System (SUS), the network quickly expanded across the entire country.
Today, these facilities handle more than milk collection. They offer hands-on breastfeeding support, help mothers navigate lactation challenges, teach safe milk expression, and counsel families with hospitalized infants. Some services also arrange home collection, allowing registered donors to give milk without traveling to a facility.
Premature babies are the main recipients
Donated milk is primarily provided to hospitalized premature and low-birth-weight infants. These newborns can have difficulty breastfeeding and face increased health risks associated with prematurity.
When a mother cannot supply enough milk, doctors can prescribe pasteurized donor milk. The system prioritizes a baby’s own mother’s milk whenever it is available, using donated milk when that supply is insufficient or unavailable.
This gives Brazilian milk banks two connected functions. They provide donor milk to babies who need it while helping mothers establish or maintain breastfeeding. Staff can assist women whose babies are receiving intensive medical care, including mothers who need to express milk instead of breastfeeding directly.
The donor network therefore depends on mothers who produce more milk than their own babies require. That surplus can be collected, processed, and made available to other newborns.
Donated milk goes through several controls
Quality control begins with donor screening. Fiocruz says donors should be healthy, breastfeeding their own children, and not taking medications that prevent donation. Milk banks guide hygiene, expression, and safe storage at home.
Once collected, the milk undergoes several checks. Staff evaluate its sensory and physicochemical characteristics, pasteurize it, and conduct microbiological testing before it can be distributed. The milk is then stored under controlled conditions until it is prescribed for a recipient.
The process also includes traceability. Information about the donor, collection, and processing allows the milk to be tracked through the different stages before reaching a newborn.
Fiocruz estimates that 200 milliliters of donor milk is enough to feed up to 10 vulnerable newborns, tailored to their individual requirements.
Brazil developed its own technology
Brazilian researchers developed processing and quality-control techniques suited to the country’s public health system. The work included methods for pasteurization and quality assessment that could be used across a network operating in different regions.
The approach also extends to some of the basic materials used by milk banks. Fiocruz guides donors on using suitable glass jars with plastic lids for safe milk collection and storage. Examples include jars previously used for products such as instant coffee and mayonnaise, provided they meet the required criteria.
Milk banks need trained staff and specialized equipment, but they also need procedures and supplies that can be used consistently in different parts of the country.
The milk is treated as a public resource
Brazil’s system is based on voluntary donation rather than commercial sales. Donors do not receive financial payment for their milk, and public health institutions manage its collection, processing and distribution.
This represents a change from earlier models. Brazilian milk banks once operated under arrangements that allowed financial or material compensation. The country later moved toward voluntary donation within the public health system.
That change also broadened the role of milk banks. They became services that promote and support breastfeeding while providing processed donor milk to newborns who need it.
Brazil has also shared its experience internationally. Fiocruz and Brazilian health authorities have worked with other countries on training, technical standards and the development of human milk banks. The cooperation has included countries in Latin America and Portuguese-speaking nations.
The system still depends on mothers who donate
The network’s laboratories and collection services depend on a steady supply of donated milk. That supply begins with mothers who produce more milk than their own babies need and decide to donate the surplus.
For that reason, donor recruitment remains a continuing part of the system. Fiocruz runs campaigns to encourage donations and provides information about eligibility, collection and storage. Home collection services can also reduce the practical difficulties involved in transporting milk to a bank.
Brazil has spent decades building the infrastructure needed to collect, process and distribute human milk through its public health system. Keeping that network supplied still depends on the mothers who choose to donate.