|A Chicago milk station, ca. 1917. This station was at the Chicago Hebrew Institute.|
By Elizabeth Hanink, RN, BSN, PHN
Today, with the widespread availability of infant formula, it seems unfathomable that at one time, virtual armies of women would gather together, pump their breast milk and donate it to infants they never even knew. Yet that is exactly what Gertrude Plotzke organized for the Chicago Board of Health in 1938, creating a complete system for collecting, sterilizing, storing and distributing milk to at-risk infants.
Plotzke was one of 10 children and a lifelong resident of the greater Chicago area. After completing her nursing training at Jackson Park Hospital, she went to work as a public health nurse, caring for mothers and babies in their homes. While there were earlier breast milk stations serving sickly infants in other parts of the country, the Mothers' Breast Milk Station organized by Plotzke was unique, targeting premature infants as part of a concerted effort to reduce the city's infant mortality rate.
Chicago was already a center of innovative preemie care under the direction of Evelyn Lundeen, RN, then the supervising nurse at Michael Reese Hospital's premature nursery. It was Lundeen's firm conviction that only human breast milk was suitable for her precious charges until they weighed at least 4.5 pounds, which became the standard of care. The Breast Milk Station was developed to ensure that human milk would be available at all times.
Paid by the Ounce
Potential donors were identified by physicians or nurses, who noted when a recently delivered mother under their supervision had an abundance of milk. Almost all of the donor women were African-American, both because the station was located in a predominantly black neighborhood and because African-American women were more likely to breastfeed. Despite the bitter racial disharmony of this period, this program was colorblind.
Much like the wet nurses of an earlier era, donors gave milk as a way to earn money. Each woman donated between 16 and 45 ounces per day for 5 cents per ounce, later increased to 13 cents per ounce. Mothers also received transportation and a free quart of dairy milk per day. Plotzke required donors to drink at least half of the milk before leaving the station to ensure that the milk was not distributed to others. The program also subjected donors to rigorous medical and dental health monitoring.
Plotzke implemented an unvarying procedure for donors: Each mother lined up at a sink to scrub her fingernails, hands, arms and breasts. The donors then gowned, masked and covered their hair. After placing disinfected towels under their breasts, the women hand-expressed the milk into sterile cups, usually for about an hour. So indoctrinated were the donors in this ritual that they often found fault with the habits of visiting nurses.
After the donors were finished, nurses measured each donor's milk, placed it in bottles and then put the bottles on ice. Later, the nurses, gowned and masked much like the donors, pasteurized the milk. Orders were filled as they arrived, but hospitals and families needing the milk had to transport it themselves.
At the height of the program, 45 donors came to the station each day, all of them usually within six to nine months of giving birth to their own children. In 1943, the station collected 108,000 ounces of milk, which was distributed to more than 1,100 infants.
Babies at home were carefully monitored for weight and care. In many instances, the supervising medical personnel credited the donated breast milk with saving the infant's life.
Throughout its existence, the station was a model of its kind, with nurses coming from many other communities around the country to learn the art of retrieving and distributing breast milk. The Board of Health later promoted Plotzke to superintendent of nurses, responsible for supervising well-baby clinics throughout Chicago, as well as the Mothers' Breast Milk Station.