Breast is still best when it comes to babies
St. John Paul II never mentioned breastfeeding in his Theology of the Body, but it’s hard to deny that it’s a form of self-gift. What happens, though, when a mother is unable or unwilling to provide milk for her baby?
The World Health Organization and the American Academy of Pediatrics recommend the use of donated breast milk as the first alternative when maternal milk is not available. (Yes, human milk from another mother is recommended over formula.) A decade ago I saw donated breast milk only being used in our neonatal intensive care unit (NICU) at St. Louis Children’s Hospital. Now, however, there’s nothing taboo about giving your baby breast milk from someone other than mom. I’ve seen it: As soon as moms learn they can’t provide breast milk for their baby, they’re on their phone looking for it. Some call a sister, or a friend or neighbor, but many will buy milk online or through an organization like Milk Share.
The growing demand for breast milk has resulted in for-profit companies like Prolacta Bioscience and Only the Breast—big businesses with financial incentives—to sell breast milk. The market for human milk has expanded beyond just sick babies—cancer patients, athletes, health enthusiasts, and even adult men with fetishes. Search Craig’s List and you’ll find it: Women selling breast milk by the ounce, with or without stipulations attached.
Before you buy, sell, or donate, or accept free breast milk, you should know the facts and science behind this industry.
The for-profit breast milk industry has raised the ire of selfless women who donate milk free-of-charge. Human Milk 4 Human Babies (HM4HB) is a not-for-profit milk sharing program that opposes the sale of human milk. They believe it is a human right for babies to be fed human milk. We don’t allow for the sale of organs, bone marrow, or whole blood in the United states, so why should we permit the sale of breast milk? But naysayers note that wet nursing for profit has been present throughout antiquity. And it is legal to sell plasma in the United States. In some states it is even legal to sell your own urine.
At St. Louis Children’s Hospital we use pasteurized, donated human milk from a not-for-profit bank associated with the Human Milk Banking Association of North America. This milk is donated, pasteurized, packaged, and sold to hospitals for a cost that covers their cost of processing. We primarily use donated human milk in our neonatal intensive care unit.
If you are looking for breast milk for your baby, ask yourself these questions:
How is this milk pasteurized and stored? A study published in the medical journal Pediatrics found high rates of bacterial contamination in human milk purchased online. The authors concluded: “Human milk purchased via the Internet exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices. Infants consuming this milk are at risk for negative outcomes, particularly if born preterm or are medically compromised. Increased use of lactation support services may begin to address the milk supply gap for women who want to feed their child human milk but cannot meet his or her needs.”
How is this milk tested for infectious diseases and chemicals? Certain infectious diseases can be transmitted through breast milk, including HIV and CMV. Also concerning is nicotine, caffeine, and alcohol that can be in donated milk depending on the mother’s diet. Prescription and illicit drugs can be passed into human milk in concentrations dangerous to infants. The American Academy of Pediatrics has a list of common chemicals transmitted into human milk and causes for concern. Most milk banks will test for these chemicals. Before you accept donated milk or purchase milk be sure to inquire as to the testing procedures used.
What is the risk/benefit ratio to your baby from drinking human milk? We know that there are clear advantages of human milk over formula for certain babies, especially premature infants, immunocompromised infants, and infants with digestive problems. What’s unclear is how important donated breast milk is for healthy babies. Most studies on breastfeeding are done on women feeding their own babies, not babies being bottle fed human milk produced by a woman other than their mother. The potential benefits of human milk need to be balanced with the risks of drinking milk contaminated with bacteria, viruses, and chemicals.
What are the policies regarding donor milk at your hospital or birthing center? Many community hospitals and birthing centers are not set up to accept, store, and dispense donor breast milk to infants. Although they may permit you to give donor milk, they will likely require that it is pasteurized and tested. If you plan to use donor milk at a community hospital, you will probably need to acquire it yourself and bring it to the hospital.
Want to donate or sell your breast milk?
Breast milk donation is a generous and selfless act that can be lifesaving, especially for sick infants. Before you donate or sell, consider the following:
Who is really drinking your milk? There is a growing market for breast milk for people other than babies: chemotherapy patients, people with digestive and nutritional problems, athletes, health enthusiasts, and people with sexual fetishes. Are the people buying your milk really going to feed it too a baby? Companies like Only the Breast do sell milk to people who use it for purposes other than infant nutrition. Does this bother you?
Are you donating to person or company that is going to resell your milk for-profit? If you are donating your milk make sure that your buyer is not simply reselling your milk. If you privately donate through an organization like Milk Match, you might be giving milk to someone who simply sells it online. Large for-profit companies like Only the Breast will gladly accept donated human milk and then resell it for profit. Prolacta bioscience is a large for-profit human milk processing company. It has collection depots in major children’s hospitals and reputable facilities and buys the milk from these depots. If you are donating milk to be used by sick infants, be sure to donate it to a bank associated with the not-for-profit organization The Human Milk Banking Association of North America.
Kathleen M. Berchelmann, MD, is an Assistant Professor of Pediatrics at Washington University School of Medicine in St. Louis, and a mother of five young children. Connect with Dr. Berchelmann at: KathleenBerchelmannMD.com.
