- In a survey on 650 mothers from the American Academy of Pediatrics found that more than 50 percent were not concerned about the safety of sharing breast milk.
- But breast milk can expose infants to disease or drugs or other substances ingested by the donor.
- Women who cannot produce enough breast milk can supplement with formula or use donor milk that comes from a milk bank.
Sharing breast milk informally is a potentially unsafe practice, but one that some parents resort to in an effort to give their infant the best nutrition possible.
With more parents interested in sharing breast milk, the American Academy of Pediatrics (AAP) is learning more about these shifting attitudes.
An AAP survey of 650 mothers found that more than 50 percent were not concerned about the safety of sharing breast milk. Nearly 80 percent did not screen donors because they “trusted them.” The mothers responded anonymously to a survey on Facebook.
Informally sharing breast milk refers to transferring breast milk—already expressed or via direct nursing — to an infant when the breast milk has not been screened or gone through milk bank protocols.
More than half of the respondents said they did not use a milk bank due to costs, as well as concerns about quality or the ability to obtain a prescription for breast milk.
The research was presented at the AAP’s national conference.
“Breast is best” has been the mantra for health officials for years, but there are several reasons why parents do not breastfeed their child. Many parents may be unable to breastfeed their child for medical reasons or they may not feel it is the right choice for them.
While health experts stress that formula can be a healthy option for infants, many parents may see donated breast milk as a better option.
Here’s why that can make experts nervous. The AAP does not encourage using informally shared breast milk, citing the risks of spreading disease.
It can also expose an infant to medications, alcohol, drugs, or other contaminants. According to the AAP, women who cannot produce enough breast milk can supplement with formula or use donor milk that comes from a milk bank.
“Informal milk sharing is becoming increasingly popular and widespread,” said Nikita Sood, a researcher at Cohen Children’s Medical Center/Northwell Health in New York. “It is therefore crucial that physicians become aware of this practice and the associated risks so that they can educate patients and address this growing concern.”
Dr. Ruth Milanaik, a physician at Cohen Children’s Medical Center/Northwell Health, said in a statement that people are not only unaware of the risks, they’re not talking to their physicians about it.
“In addition to educating patients, physicians must underscore the importance of discussing these habits with medical professionals so that we have the necessary information to make accurate diagnoses should a medical need arise,” Milanaik said.
Currently, formal breast milk sharing is conducted via human milk banks located all over the world. However, in most cases, donor breast milk is usually reserved for sick and/or premature babies who need to meet certain criteria for insurance coverage. While there are some cases where donor breast milk is available for babies who are not hospitalized, often times this can be cost prohibitive.
The Human Milk Banking Association of North America (HMBANA) has guidelines for screening and processing donated breast milk, which are guided by the Centers for Disease Control and Prevention and the Food and Drug Administration.
“These precautions are necessary as milk is screened, processed, pooled and cultured to make sure that recipient babies are not exposed to harmful bacteria,” added Dr. Natasha K. Sriraman, an associate professor of pediatrics at Eastern Virginia Medical School/Children’s Hospital of The King’s Daughters. She was not affiliated with the research.
“The milk donor screening guidelines the milk banks use are established to protect the most sick and fragile infants, so they are intentionally strict,” Sarah A. Keim, PhD, an associate professor at the Center for Biobehavioral Health at The Abigail Wexner Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, told Healthline. “More research would help quantify some of the risks and may help inform future guidelines.”
Dr. Keim noted that women can transmit diseases via donated milk, even if they don’t feel sick. These can include HIV and cytomegalovirus, and others. If an infant receives that milk, their life could be at risk.
She advised women to talk with their doctors about procuring milk with their doctors.
That includes women who may want to share their milk.
“Because you have extra milk, you may want to help out someone who is seeking milk, but it’s important to know that your milk could be risky to someone else’s baby even if you feel healthy and were healthy during pregnancy,” she said.
“The nonprofit milk banks in the U.S. need more milk donors to have enough milk for hospitalized babies,” Keim said. Sometimes places that need milk may need to ship it in to meet demand.
“If there was greater awareness about donation and more opportunity, there could be less inefficiency,” she noted.
Additionally Sriraman endorses getting doctors involved even in informal situations because sharing breast milk will happen. This way doctors can play an important role in trying to ensure it is done as safely as possible and they can educate families about the risks and benefits.
Sriraman noted in a position paper for the Academy of Breastfeeding Medicine in 2017 what parents and potential breast milk donors should consider before sharing breast milk
Donors should not have any illness where breastfeeding could be harmful, nor should they be on any medication or herbal substance that is incompatible with breastfeeding. The donor should not have HIV, hepatitis B virus, or human T-cell leukemia virus type 1.
Sriraman’s paper lays out other protocols to assist mothers in finding appropriate donors. Flash pasteurization can also help guard against infection, but again the AAP does not recommend informal sharing and cites certified milk banks as the safe source for donated breast milk.
And there is one place never to use to source donated breast milk: the internet.
“First and foremost, do not acquire nor buy milk over the internet,” Sriraman said. “Numerous studies have shown breast milk purchased over the internet is not suitable for consumption and often contaminated with other substances. Any exchange of breast milk for money should be discouraged.”