Last year, the University of California sponsored AB 3059, which aimed to increase access to donor milk. Read how the new law, which went into effect on January 1st, is already improving the lives of newborns and their families in California’s hospitals.
For new mom Karen, donor milk was a lifeline for her growing family.
“My son was born six weeks early and spent a week in the NICU after his birth. In his first few days, we were lucky to have donor milk, which helped him significantly. He’s now almost eight months old and thriving. After a difficult fertility journey and an unexpected early delivery, it is incredibly gratifying and healing to be able to donate milk to help other babies and families in similar situations. We are thankful to the kind mothers who made it possible for my son to have donor milk and are so happy to be able to pay it forward.”
After experiencing the lifesaving benefits of donor milk, Karen went on to donate milk to the UC Health Milk Bank.
But access to donor milk has been unequal in certain parts of California. Through collaboration and partnership, and the passage of a new law, families across the state have increased access to donor milk at California’s hospitals.
A vision for increased access
Recognizing the regulatory barriers that were hindering access to donor milk, the University of California worked with then-Assemblymember Akilah Weber, M.D. (now Senator Akilah Weber Pierson, M.D.), to introduce legislation that would make it easier for hospitals to offer the lifesaving nutrition source.
Assembly Bill 3059 (AB 3059) aimed to solve two major barriers for parents in need of donor milk. It:
- Made donor milk an essential health benefit under commercial insurance plans, meaning that all parents with commercial insurance plans in California have access to medically necessary lifesaving donor milk and their plans will cover it, and
- Eliminated the regulatory barrier that previously required acute care hospitals to hold a tissue bank license to distribute donor milk.
With AB 3059’s passage, hospitals can now distribute donor milk to babies in their neonatal intensive care units (NICUs) when it comes from a milk bank with a tissue bank license, such as the University of California Health Milk Bank.
AB 3059, which went into effect on January 1, 2025, eased the barriers in offering donor milk, especially in smaller safety-net hospitals.
Following this UC-sponsored bill being signed into law, the UC Health Milk Bank has worked with hospitals and community partners to increase access to life-saving donor milk.
Senator Weber Pierson led the charge to fulfill the vision that AB 3059 now delivers to parents and their newborns across California. By working closely with the University of California, including touring the UC Health Milk Bank last fall, Dr. Weber’s efforts have helped ensure California has one of the nation's highest rates of NICUs with donor milk access.
During a tour of the UC Health Milk Bank, Lisa Stellwagen, M.D., FAAP, Medical Director of the UC Health Milk Bank shows the author of AB 3059, now-Senator Weber Pierson, the inside of a fridge holding pasteurized donor milk.
AB 3059’s passage demonstrates swift progress and impact
In the five months since AB 3059 was signed into law, there’s been a 10 percent increase in the number of hospital NICUs in California offering donor milk.
Now, 98 percent of all NICUs in California use donor milk or are in the process of initiating a program to include it in their operations. The national average is 69 percent.
The goal is to have 100 percent of NICUs in California offering donor milk by 2026. The UC Health Milk Bank, through a partnership with the “100% NICU, 100% California” project, also developed an implementation toolkit to aid hospitals and NICUs in offering donor milk.
According to Alison Wolf, CPNP, IBCLC, executive director of the UC Health Milk Bank, “Just four to six ounces of donated milk can provide life-saving support for an infant for 24 hours.” In addition, Wolf notes that “20 percent of the donors in the program were themselves recipients of donor milk after their own delivery” such as Karen.
The University’s milk bank
Founded in 2020 at UC San Diego Health, the UC Health Milk Bank was established as a critical resource to provide donor milk to newborns whose parents either can’t produce or do not produce enough milk to nourish their babies.
Through a simple donation process, lactating individuals who undergo thorough screening can donate excess milk to the UC Health Milk Bank, where it is then processed, pasteurized, tested and distributed to NICUs, hospitals and families when it’s medically necessary.
The UC Health Milk Bank, operated by UC San Diego Health under physicians’ supervision, is one of just three milk banks in California. In addition to the UC San Diego Health location, two new milk bank depots have recently opened: one at UC Riverside and another near UC Irvine.
There are five NICUs across the UC health system, and all offer donor milk to families in need of the lifesaving nutrition source.
The UC Health Milk Bank is one of only three milk banks in California.
A lifeline for parents and their infants
When a parent's breastmilk is not available or sufficient, pasteurized donor human milk is the next best nutrition source to support the health and survival of very low birth-weight infants. The American Academy of Pediatrics recommends donor milk if the mother is not able to provide sufficient breast milk.
Donor milk also significantly reduces the incidence of life-threatening bowel disease for very low birth weight infants – necrotizing enterocolitis (“NEC”), which has a mortality rate as high as 50 percent. According to the NEC Society, 3,500 infants develop NEC each year, and the incidence of NEC is around 60 percent higher for Hispanic and Black infants when compared to white infants, with factors like lack of donor milk, under-resourced NICUs, and transportation barriers impacting the inequitable incidence of NEC.
Working towards a healthier future
“The sad truth is that when babies are born, about 80 percent of those in the NICU need additional nutrition,” Wolf states. “Our guiding mission at the UC Health Milk Bank is to make sure that hospitals are equipped to offer donor milk for babies who need lifesaving nutrition. I’m so glad to see the UC Health Milk Bank continue to build upon that mission, made possible through our community partnerships across Southern California and a new law that went into effect this year.”
The UC Milk Bank continues to set the standard in newborn nutrition and milk banking both in California and nationwide.
With its increased footprint of newly opened depots and centers, supported by the legislative success of AB 3059, the UC Health Milk Bank program looks forward to expanding its reach to support families and newborns and set them on a path toward a healthy and happy future.
About University of California Health
University of California Health comprises six academic health centers, 21 health professional schools, a Global Health Institute and systemwide services that improve the health of patients and the University’s students, faculty and employees. All of UC’s hospitals are ranked among the best in California and its medical schools and health professional schools are nationally ranked in their respective areas.