Milk bank project
PAKISTAN’S Council of Islamic Ideology (CII) finally opened the door to human milk banks in Sindh by endorsing the idea in principle but directing it move forward only under strict, Sharia-compliant legislation. Neonatal experts greet the ruling as overdue validation. They call it a major step towards ensuring preterm, high-risk infants receive donor milk when a mother’s own is not available, improving their survival chances. The endorsement aligns science with the principles of faith.
The question now is whether the project will succeed, and serve as a model for other provinces to adopt. The decision, taken at the CII’s 243rd meeting in Islamabad in September, comes more than a year after Pakistan’s first human milk bank — launched in 2023 by the Sindh Institute of Child Health and Neonatology in collaboration with Unicef in Karachi — was suspended just months later amid religious objections and public criticism.
It happened after a leading seminary, Jamia Darul Uloom, withdrew an initial fatwa, and the case moved to the CII. The core concern was milk-kinship, or raza’at. In Islamic law, feeding a child with another woman’s milk creates a familial bond that shapes future marriage rules.
For the Karachi milk bank to finally become operational, the CII has set out strict terms. The Sindh Assembly must pass enabling legislation, with the council directly involved in drafting rules to safeguard lineage and prevent misuse. The conditions also include fully traceable records to help families avoid future marriages between milk-siblings; a one-donor-to-one-infant model (no pooling); a ban on buying or selling; and mandatory counselling and consent from fathers or guardians before use.
Milk banks reserve donor milk for the smallest and weakest infants.
But not all experts are convinced. Lactation consultant Hareem Sumbul Bari believes the no-pooling rule could paralyse operations. Instead of efficiently pasteurising pooled batches, she says, banks would be forced to run countless small, single-donor cycles because pasteurisers are built for racks of bottles. So, without pooling, banks must either wait to collect enough from one donor, delaying supply, or run half-empty cycles, draining time, energy and staff.
Milk banks reserve donor milk for the smallest and weakest infants, that is preterm or low-birth-weight babies (born before 32 weeks or weighing less than 1,500 grams), those with gut or heart disease, and post-operative infants unable to tolerate feeds. Donor milk also helps bridge feeding gaps when a mother is ill, recovering from a C-section, on medication, or experiencing low supply.
While formula milk can provide calories and added nutrients, it cannot replicate the components of breast milk, which offers an ideal balance of proteins, fats, carbohydrates, vitamins, minerals, antibodies and hormones. For high-risk preterm babies, mother’s milk lowers the risk of gastrointestinal infections, including necrotising enterocolitis, and shortens hospital stays.
In Pakistan, based on Unicef data, neonatal mortality remains high: about 38 newborns out of every 1,000 live births die within the first 28 days, often due to infections, poor nutrition, and limited access medical care. The human milk bank seeks to tackle precisely this challenge. For now, though, its reach is confined to Sindh.
The Children’s Hospital in Lahore treats infants from the city and receives tiny patients from surrounding districts. One doctor, who requests anonymity, says they often receive cases in which mothers remain in distant villages while other family members bring the newborn to Lahore with complications. Many of those mothers undergo C-sections and are unable to travel. In such circumstances, doctors advise families to bring the mother’s milk along, but they admit that the absence of readily available breast milk is keenly felt. A milk bank, she adds, would go a long way in addressing this gap.
If the law is passed and effectively implemented, Pakistan will become the second Muslim country after Iran to establish human milk banks. Iran already operates a national network of around 13 banks, launched in April 2024, which has shown clear benefits.
Bari says professionals overseeing the Sindh milk bank project must demonstrate that the model is firmly grounded in law, operationally robust, and sustainably financed so other provinces can follow with confidence.
She is reminded of a similar project, Unicef’s Baby-Friendly Hospital Initiative launched in the 1990s, but later stalled for lack of enforcement and institutional backing — “I’m hopeful the milk bank project will be successful. I’m not certain.” For now, at least, Sindh holds the key to robust child-safety measures anchored in cultural and religious acceptance.
The writer is a freelance journalist based in Lahore.
Published in Dawn, October 7th, 2025