All You Need to Know About Donating (or Receiving) Breast Milk

All major health organizations, including the Academy of American Pediatrics (AAP) and World Health Organization (WHO), state that breast milk is the healthiest food for babies in their first year of life. Breast milk not only contains excellent nutrition for your baby but also tons of other good stuff like stem cells, antibodies, and antimicrobial agents.Breast milk is especially important for premature and medically fragile babies, as they are more susceptible to infections and illnesses. According to the AAP, breast milk is vital for babies weighing under 3.5 pounds and has been shown to decrease rates of necrotizing enterocolitis, a sometimes deadly intestinal infection predominantly affecting premature babies.

Both the AAP and Food and Drug Administration (FDA) recommend that mothers only obtain donor milk from accredited milk banks. While some mothers are comfortable with informal milk sharing arrangements, it’s always advised that premature babies or babies with medical issues receive donor breast milk from milk banks, which employ protocols to ensure that the milk is safe.

The Human Milk Banking Association of North America (HMBANA) is a professional association that has developed screening processes and protocols for milk collection and donation. HMBANA oversees the operation of most reputable milk banks in America and is cited by the FDA and Center for Disease Control and Prevention (CDC) as a trusted source.

Screening

HMBANA has a protocol for screening its donors. The process usually takes several weeks and involves a thorough medical and lifestyle history, as well as blood tests for infections like HIV, human T-lymphotropic virus (HTLV), syphilis, and hepatitis B and C.

Collection and distribution

Mothers who are selected to be milk donors are given very specific instructions regarding how to collect and send their milk to the milk bank nearest them. These include guidance on nipple and breast cleansing, pump sterilization, and storage.

Most donors have their milk shipped directly to a milk bank, which works with local hospitals to distribute the milk to babies in need. Usually, premature babies or babies with other medical diagnoses are prioritized.

Transportation and storage

Donor milk is delivered frozen to milk banks, where it’s thawed and medically screened. After that, the milk is pasteurized, cooled, and re-frozen. Samples are screened again after pasteurization to ensure that bacterial growth hasn’t occurred during the heating process.

A minimal amount of nutritional value is lost in the pasteurization process, but not enough to decrease the benefits of the milk.

Donors do not receive payment for donating, and they are not responsible for any supplies associated with donating or shipping costs. You are volunteering your time and gifting your milk when you are a donor.

Milk banks are nonprofit organizations and do not sell their milk. However, there are costs associated with collecting, pasteurizing, storing, and shipping milk. In most cases, the hospital that receives the milk is responsible for covering the milk bank’s costs, and it may bill the mother’s insurance company for reimbursement.

HMBANA currently has 29 member banks located across the United States. You can search for a bank near you on its website.

If your baby is hospitalized, your hospital will know which bank services them and how to receive milk. Your baby’s pediatrician is another good resource for this, as is a local lactation consultant.

There are many reasons why you may want to become a milk donor:

• Oversupply. Moms who are overproducers often look for something to do with their extra milk and fall in love with the idea of donating.
• Benevolence. Other moms feel compelled to donate because they want to share the miracle of breast milk with babies in need.
• Bereavement. Sometimes grieving moms who lost their baby during late pregnancy or soon after birth find the act of donating incredibly healing.
• Surrogacy. Surrogate moms also often feel inspired to donate.

Most moms are eligible for milk donation. However, some circumstances prohibit you from donating your milk, including if:

• you are HIV positive or have received a positive blood result for HTLV, syphilis, or hepatitis B or C
• your sexual partner puts you at risk of contracting HIV
• you smoke, use illegal drugs, or consume more than one serving of alcohol per day
• you or your sexual partner has received a blood transfusion or blood products in the past 6 months
• you or your sexual partner has received or an organ or tissue transplant in the past 12 months
• you have been exposed to Creutzfeldt-Jakob disease

In terms of milk from an accredited milk bank, donations are usually limited to premature babies or babies who have a specific medical condition. The reason for this is that milk bank milk is in short supply and babies with special needs are prioritized.

Conditions that might make your baby a good candidate for milk bank milk include:

• premature babies
• babies said to have “failure to thrive”
• babies who have allergies or an intolerance to formula
• babies who have metabolic or malabsorption issues
• babies who are immunocompromised or have an infectious disease

If your eligible baby is hospitalized, the hospital will usually be able to arrange donor milk for your baby. Alternatively, if you are home with your baby, you will likely need a prescription for donor milk from your pediatrician. Once you have that, you can contact an accredited milk bank to find out if you are eligible and how to receive the milk.

What if your baby is not a preemie or medically vulnerable? What if you are having trouble producing a full supply for your baby for some reason and would like donor milk to fill in the gaps?

These situations can get a little more complicated, as you will likely have to decide if informal milk donation is right for you and your baby. This decision will depend on your circumstances, what your options are, and what you and your healthcare provider think is best.

Moms of older, healthier babies are usually not eligible for milk from a milk bank. Many of these moms turn to informal milk donation. Although this is not the answer for every mom, many find it to be a positive experience.

It should be noted that both the AAP and FDA advise against informal milk sharing arrangements and don’t recommend feeding your baby milk other than your own unless it has been pasteurized.

However, organizations like the Academy of Breastfeeding Medicine (ABA) explain that certain precautions, such as medical screening and safe milk handling, can be taken to ensure that informally donated milk is safe for your baby. ABA advises you to speak to your healthcare provider for more information so you can make an informed decision.

It’s strongly advised that you do not buy or obtain breast milk online, and that you only use milk from someone you have connected with in person. You really never know where the milk comes from and whether it has been contaminated in some way.

Many moms, however, find their donor through online resources that connect local donors to recipients. Reputable informal milk sharing organizations include Eats on Feets, Milk Share, and Human Milk 4 Human Babies.

Starting your journey as a milk donor or milk recipient can be exciting —and let’s face it, a little stressful. You may not be sure where to get the most up-to-date information on donating, or which sources to trust when it comes to receiving breast milk for your little one.

It’s important to follow medical guidelines carefully, especially if you have a premature or medically vulnerable baby. You should know that in all cases, you have options, and your pediatrician, lactation consultant, and other healthcare providers are there to answer any questions you may have about the best choices for you and your baby.

Breast milk is an amazing gift to give babies, and everyone involved in making that happen should be commended.