Breast milk sharing: What you need to know

 

A growing awareness of the importance of breast milk for babies has accelerated the demand for human milk at a time when processed donor milk is scarce and costly. Only 26 public milk banks currently exist in the United States and Canada, with 5 more in development.

Given the limited availability of human milk, babies with serious medical conditions such as prematurity are given priority, leaving few options other than infant formula for healthy babies whose mothers are unable to breastfeed fully or at all.

Although some insurance companies will cover the cost of human milk when there’s a documented medical need, mothers of babies without a medical condition must pay $3 to $5 per ounce to cover collection, processing, and distribution costs. An 8-pound baby consumes approximately 20 ounces of milk a day. At a cost of $60 to $100 a day, it’s easy to understand why mothers without enough milk for their babies are bypassing milk banks and turning to another source—other mothers with milk to spare. 

What is milk sharing? 

Milk sharing is the donation of breast milk from peer to peer, from a mother who’s willing to share to another mother who’s in need of milk. Online resources like MilkShare, Eats On Feets, and Human Milk 4 Human Babies Global Network (HM4HB) connect mothers with extra milk, from small amounts to large, with moms who need the milk for their babies.

What are the risks associated with milk sharing? 

Because of risks involved, any decision to give donated breast milk to your baby should be discussed with your baby’s health care provider in advance. Despite human milk’s many benefits, peer-to-peer milk sharing is cause for concern for a variety of reasons:

• Disease transmission. Human milk can be a source of infection such as bacteria, or viruses like HIV, HTLV I/II, and CMV. To minimize risk: All donors should be screened, and all milk should be pasteurized. A simple, low-tech form of pasteurization known as “flash-heating” can be used to kill bacteria and viruses such as HIV, yet preserve important ingredients in human milk. See this information and video on flash-heating. 

• Transfer of drugs or medications. Human milk can be a vehicle for transferring drugs from donor to child. Although most medicines are safe for breastfeeding mothers and babies, some medicines can be harmful, even in small amounts. To minimize risk: All donors should be screened. 

• Contamination. When human milk is collected and stored, as with any food, there are many opportunities for contamination. For example, a study published in 2015 in Pediatrics found that 10 percent of samples analyzed were contaminated with cow’s milk, most likely deliberately since the amounts of cow’s milk were so high. To minimize risk: All donors should be screened. Mothers should be taught how to express, collect, and store their milk safely. 


Is milk sharing regulated? 

In 2010, media coverage of milk-sharing organizations caught the attention of the Food and Drug Administration (FDA). The agency responded with a warning about the potential risks of milk sharing, including contamination, the spread of disease, and the transfer of harmful medications. The FDA later convened a meeting of its Pediatric Advisory Committee to explore regulatory issues.

The HMBANA and the FDA have written guidelines (click here to purchase a copy of the HMBANA guidelines and here to access those from the FDA) for the sharing of human milk. Both advocate use of a mother’s own milk or human milk processed by established milk banks, but neither endorses peer-to-peer sharing of human milk between mothers.

If considering the use of donated breast milk, mothers should be sure to inform themselves of the risks and benefits of peer-to-peer milk sharing and of the steps needed to increase its safety. Decisions should be made in consultation with a baby’s health care provider.