Photo by Eden Lang
Last week, as I was picking up my donor milk from my friend Jenny, she wondered out loud what people must think we’re doing. We frequently meet at the back of parking lots, babies in tow, where she hands me a bag full of frozen breast milk in storage bags and I discreetly transfer it to my cooler to take home.
“Do you think they think this is some kind of weird drug deal?” she asked, grinning. I had to laugh, because I’d had the same thought on the way there. Wouldn’t you love to see the face of the cop who investigated us and found out what was actually in my bag? Fortunately, accepting another mother’s breast milk is perfectly legal, and it’s becoming a lot more common than you might think.
For as long as women have been breastfeeding, there have been those of us who have had trouble producing for various reasons, and if it weren’t for the ancient practice of milk sharing, many babies across the centuries wouldn’t have survived.
Milk sharing is, to me, a vital part of creating a mothering village. If it weren’t for three wonderful, generous women who have been donating their expressed milk for Charlie, we would be giving him about 80% formula and 20% breast milk. Because we have been able to enter milk sharing agreements with other nursing mothers, we are able to do the opposite: about 20% formula and 80% breast milk. While we recognize that feeding Charlie more formula wouldn’t be the worst thing, it was important to us to explore all of our options for providing him with as much breast milk as possible, and that’s what led us to research milk sharing.
Breast milk is unquestionably better for babies than formula. It’s the biologically normal food for human babies, the default option, and the benefits are clear:
- Babies who are breastfed have stronger immune systems.
- The risk of SIDS is lower in breastfed babies.
- Breastfeeding may improve your child’s intelligence.
- Babies who are breastfed are less likely to develop allergies.
- Breastfed babies are less at risk for obesity and diabetes.
Milk sharing can provide babies with these benefits when their mothers have trouble producing enough breast milk, but accepting the milk of another mother doesn’t come without risks.
There was a study that came out in the journal Pediatrics in October that really shook the breastfeeding community. Many lactivists were up in arms about the potential ramifications of the experiment, which took a look at breast milk samples from online purchases and found many of them contaminated with potentially dangerous bacteria. The fear was that this would make milk sharing more taboo than it already is, or prompt legislation that would regulate it out of existence. Meanwhile, the pro-formula forces came out in droves, pointing the finger at milk-sharing and saying. “We told you so!” As usual, I found myself somewhere in the middle, still determined to give Charlie the best food possible, but now concerned about how to help other mothers ensure safety when feeding their baby another mother’s milk.
The most obvious choice is to go through a milk bank, which carefully screens the milk that mothers donate, ensuring that what arrives on your doorstep will be free from contaminants and viruses like hepatitis and HIV. However, not every baby is eligible, and the price can be steep. In order to obtain milk through a bank, you must first have a doctor’s prescription. This means that the majority of the milk purchased through banks goes to babies who have medical conditions that necessitate breast milk, or babies who are in the NICU for a variety of reasons. On top of that, milk from banks can cost anywhere from $60-150 per day, which may or may not be partially covered by insurance. A staggering price tag like that just isn’t feasible for many families. We knew immediately that a milk bank wouldn’t be a good fit for us.
The caveat with getting milk from a source like Eats on Feets or Human Milk for Human Babies, which facilitate “mother-to-mother” or “community” milk sharing, is that there is no official screening process. These websites help hook up mothers in need with mothers who have an oversupply, but that’s where their participation ends. If you want the milk screened, you must do so at your expense. If you choose not to do so, you are trusting another mother to provide healthy, uncontaminated breast milk for your baby. You are trusting that she’ll abstain from alcohol and drug use while pumping for you, and that her milk handling standards provide the most sterile environment possible. And that’s a lot of trust to put in another woman. After all, the health of your baby is on the line.
For us, the job of choosing a donor came pretty easily. The women we get milk from are friends of mine, one of whom I’ve known since we were in junior high school, so we had no problem trusting them when they said they were doing things the right way. However, for a lot of women, the mothers they are considering for milk sharing agreements are either more casual acquaintances, or even complete strangers. When you’re dealing with an agreement of this kind, it’s helpful to have a list of questions to ask the potential donor. Here is a list of common questions milk banks ask, which is a good place to start:
- Is there anything that would prevent you from donating SAFE and healthy breast milk?
- Have you read the Resource for Informed MILK SHARING?
- Do you have any concerns about sharing your milk that you want to talk about?
- Have you ever tested positive for: TB, HTLV I or II, HIV I or II, Herpes Simplex, Hepatitis B or C, or Syphilis?
- Have you had close or intimate contact with anyone infected with any of the above?
- Are you or your sexual partner(s) at RISK for HIV?
- Were you born in or have you ever visited any of the following
- countries: Cameroon, Central African Republic, Chad, Congo, Equatoria, Guinea, Gabon, Niger or Nigeria?
- Has a blood relative been diagnosed with Creutzfeldt-Jakob Disease (CJD)?
- Do you have any open sores, BLISTERS, and/or cracks on the skin?
- Would you agree to have your blood screened if requested?
- Would you agree to be tested for TB if requested?
- Have you required hospitalization or blood transfusion the last 12 months?
- Have you ever received an organ transplant?
- Have you received any vaccinations in the last 12 months?
- Do you have a history of cancer?
- Do you take any prescription medications on a regular basis, including hormone replacement?
- ￼Do you take excessive amounts of prescription drugs?
- Do you have any general health concerns?
- Does your baby have any general health or weight gain concerns?
- Do you smoke?
- Do you consume more than 3 caffeinated beverages per day?
- Do you drink alcohol? How much and how often?
- Do you use recreational drugs? Which ones and how often?
- Do you use over-the-counter (OTC) medication? Which ones and how often?
- Do you use herbal supplements? Which ones and how often?
- Do you have silicone breast implants?
- Have you had body piercings, tattoos, accidental needle stick injuries, acupuncture, electrolysis or wear permanent make up?
- Do you take megavitamins?
- Do you know how to clean milk collection items?
- Do you know how to safely store milk?
While you may not feel like it is necessary to ask all of these questions, they can provide valuable insight into the mother’s lifestyle and whether there are potential risks that may make you rethink using them as a donor.
Now, we were never particularly concerned about the lifestyles of the women who donate to us. None of them are partiers, so we knew that drugs and alcohol wouldn’t be issues, and all of them lean toward the “crunchy” side, so we knew that they would be cautious about medications and other things that could potentially affect their milk. For us, the most important thing was making sure that the mothers donating for us are utilizing safe handling and storage guidelines. Once we confirmed that they were aware of the accepted techniques there, we felt perfectly comfortable using their milk.
Charlie has been eating donor milk now for about two months, and so far we haven’t had any issues at all. Of course, there is some risk in giving him donor milk, but to me the risk isn’t any worse than me feeding him my own expressed milk, because I trust our donors and know that they wouldn’t treat theirs any differently than I treat mine in terms of collecting and storing it safely. They all care about Charlie and want him to be healthy, so I know that they are extremely careful when it comes to the milk they give for him.
The reason I am able to say this with confidence, though, is that I know them so well, so my biggest piece of advice is this: Get to know your donor.
I’m not just talking about meeting once for coffee. I mean really get to know her for a couple of weeks before you enter into a milk sharing agreement. Hang out together. Watch how she interacts with her own baby. Throw on a movie and pump together, so you can see how she handles her collection and storage equipment. Ask her a bazillion questions, and send her to the Resource for Informed Milk Sharing to read up on safe donation practices. Just make sure you are totally comfortable with her before you ever give your baby an ounce of her milk, and if anything sets up a red flag for you, politely decline the offer for donation.
It’s so important to me that milk sharing remain a viable way for mothers blessed with an oversupply to give to mothers like me who struggle, but it’s even more important to me that our babies are happy and healthy, so please do your own due diligence and make sure that whatever milk you’re giving your baby, whether you expressed it yourself or got it from another amazing, generous, milk-makin’ mama, is handled safely.
Think lactivists should stand up for this too?