Milk Sharing: Is It Safe?
- Rebecca McCann
- Nov 18, 2024
- 5 min read
Updated: Jul 15
There are many reasons why a family might consider milk sharing - a mother may be experiencing low milk production or may be unable to breastfeed due to medical reasons, such as taking certain medications or undergoing cancer treatment. Milk sharing is also an option for families who have adopted or are welcoming a baby through surrogacy. In heartbreaking situations, the nursing parent may have passed away.
For these families, milk sharing offers a way to provide breastmilk’s nutritional and immunological benefits when nursing isn’t an option, or there isn't enough of mother's own milk. It can be a very special act - the recipient gains the optimal nutrition and protection that breastmilk provides, while the donor has the joy of nourishing a baby in need, sometimes creating a special bond between the two families.
Whether through informal arrangements between families and friends, or regulated milk banks, sharing breastmilk can be a valuable resource for parents and babies. However, like any health-related decision, it’s essential to carefully weigh the risks and benefits before proceeding.
The History of Milk Sharing
In our modern culture, some people may find milk sharing unusual or concerning. However, milk sharing has existed in some form forever - and has been vital to infant survival.
The practice of wet nursing - where one woman breastfeeds another’s child - dates back to ancient civilizations. Sometimes this was done by family members or friends - and this still happens in many cultures today. Tragically, in some historical periods, enslaved women were forced to wet nurse the children of their enslavers. In other eras and cultures, wet nurses were employed by wealthy families and wet nursing was a formalized profession with contracts and laws regulating the practice.
While wet nursing is less common today, milk sharing has persisted and evolved. Families now have options that include both informal and formal methods to share breastmilk. Let’s explore the risks and benefits of each.
Formal Milk Sharing: Milk Banks
Milk banks provide the safest, most regulated option for milk sharing. These organizations collect, screen, pasteurize, and distribute donated breastmilk to babies in need, primarily focusing on premature or medically fragile infants.
Benefits of Milk Banks:
Rigorous Health Screening: Donors undergo thorough screening for health conditions, medications, and lifestyle factors. Testing includes HIV, Hepatitis, and other communicable diseases.
Pasteurization: The pasteurization process kills harmful bacteria and viruses, significantly reducing the risk of contamination.
Quality Control: Strict protocols ensure safe collection, storage, and handling of milk.
Risks of Milk Banks:
Availability and Access: Milk banks may not be available in all areas, and there could be waitlists. Additionally, some milk banks may have strict eligibility criteria for receiving donated milk.
Cost: Many milk banks charge fees to cover screening and processing, which can be a financial barrier for some families. Insurance may help cover this cost in some cases.
Cultural and Emotional Considerations: Some families may feel uncomfortable using donor milk from strangers or have cultural/religious beliefs that influence their decision.
Informal Milk Sharing
Informal milk sharing occurs when families exchange breastmilk personally, often through social networks or communities. This can happen between family members, friends, or online groups dedicated to milk sharing. In these situations the milk is given freely, not sold.
Benefits of Informal Milk Sharing:
Accessibility: Informal milk sharing may offer quicker and easier access to breastmilk compared to milk banks.
Personal Connections: Sharing breast milk can create emotional connections between families.
Risks of Informal Milk Sharing:
Potential for Contamination: Informal sharing lacks oversight, increasing the risk of contamination or disease transmission. Without proper storage or handling, milk may contain harmful bacteria.
Lack of Screening: Donors may not undergo testing for transmissible diseases (like HIV, or Hepatitis), or disclose lifestyle factors such as substance use (including prescription medication, recreational drugs, or illegal substances) that could affect the safety of the milk.
Cultural and Emotional Considerations: Some families may feel uncomfortable using milk from another person or have cultural beliefs that influence their decision.
Organizations like Eats on Feets provide guidelines to reduce risks involved in informal milk sharing, including donor screening and safe milk handling practices. Some also recommend home pasteurization to mitigate contamination concerns.
Breastmilk for Sale
Online platforms, such as Facebook, have made it easier for individuals to sell or purchase breastmilk, but this practice remains controversial. While online marketplaces offer convenience, they lack safety controls, and unfortunately, financial incentives can lead to unethical practices.
Risks of Purchasing Breast Milk:
Safety Concerns: Milk sold online often bypasses donor screening and may be mishandled, increasing the risk of bacterial contamination. A 2013 study found significant contamination in human milk purchased over the internet.
Read the study here.
Ethical Issues: Sadly, some people resort to dishonest practices in order to make money from selling breastmilk. Milk may be diluted or improperly stored. The seller may not be transparent about their medical history or lifestyle factors that can affect the milk. In extreme cases, milk advertised as human milk may not be human milk at all.
Due to these concerns, many organizations, including The Academy of Breastfeeding Medicine, Eats on Feets, and Human Milk 4 Human Babies strongly discourage the sale of breastmilk.
What do the experts say about milk sharing?
FDA: The FDA recommends against using breastmilk acquired directly from individuals or through the internet, due to contamination and disease risks. If informal milk sharing is pursued, the FDA advises screening the donor and ensuring safe handling practices. More info from the FDA can be found here.
Academy of Breastfeeding Medicine: ABM acknowledges the potential benefits of milk sharing, but encourages medical screening of the donor and safe milk handling practices. ABM’s Position Statement on Informal Breast Milk Sharing can be found here.
TL;DR
Milk sharing can help families meet their breastfeeding goals, but it's important to consider risks and benefits.
Formal milk banks are the safest option, offering rigorous screening and pasteurization, but may be costly or limited in availability.
Informal milk sharing is more accessible but carries higher risks due to the lack of oversight and testing.
Purchasing breastmilk is a practice that should be approached with extreme caution due to significant safety and ethical concerns.
Before deciding, consult your baby’s healthcare provider and weigh the risks and benefits carefully. BRAIN is a helpful acronym for decision making:
Benefits - What are the advantages?
Risks - What are the potential harms?
Alternatives - Are there any other options?
Intuition - What feels right to you?
Nothing - What happens if we do nothing?
Informed decision-making is key. Always do what works best for you and your baby!
Have any questions about milk sharing? Don't hesitate to reach out!
Further Resources:
References:
Keim SA, Hogan JS, McNamara KA, Gudimetla V, Dillon CE, Kwiek JJ, Geraghty SR. Microbial contamination of human milk purchased via the Internet. Pediatrics. 2013 Nov;132(5):e1227-35. doi: 10.1542/peds.2013-1687. Epub 2013 Oct 21. PMID: 24144714; PMCID: PMC4530303.
Stevens EE, Patrick TE, Pickler R. A history of infant feeding. J Perinat Educ. 2009 Spring;18(2):32-9. doi: 10.1624/105812409X426314. PMID: 20190854; PMCID: PMC2684040.
