Is Informal Breast Milk Sharing Safe? Understanding the Debate – SheKnows

Practice share or donate breast milk was a common thing across time and cultures as long as there were few foraging mouths. The stigmas associated with it are complex: Stemming from a lack of resources, communication, and support from the larger medical community, shamed mothers constantly hear “Breasts are the best” may feel like they’re not producing enough (or any milk) for their infant – and of course, an absolute lack of information on how to do it and how to do it safely. That’s the part, doing it safely, that can be as much of a concern to parents as we correct the infant formula shortage in an already challenging time for parents.

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And, in the end, the choice to donate breast milk is essentially human – out of an absolutely genuine desire to help mothers continue to breastfeed – as well as the choice to breastfeed your baby. With more and more people connect over the internet to informally share breast milkIt is important to fully understand the safety concerns in the medical community about the practice, how advocates argue the practice can be made safer, and the places where camps different really agree.

Where does ‘official’ donated breast milk go?

Families with premature babies, insufficient maternal supplies, or other medically necessary reasons can access pasteurized donor milk from nonprofit milk banks managed by The Human Milk Bankers Association of North America (HMBANA)Diane Spatz, clinical director of the milk bank and faculty advisor to student nurses for the breastfeeding program at Children’s Hospital of Philadelphia, told SheKnows. This is donated milk that has been carefully screened against their criteria, processed and deemed safe to use on the most delicate of babies in intensive care units for children. neonates (NICU).

However, she added, the cost can be very high. In the absence of insurance to cover the bill, an ounce of donor milk can run for $3 – $5 – and growing children can drink about 25 ounces of milk a day, give or take. Spatz notes that insurance often doesn’t cover proper breastfeeding care.

Even then, she said, families who still need milk for their infants but are not eligible to receive milk through HMBANA, can turn to other measures to maintain their baby’s milk supply. There are for-profit milk banks and online communities for people selling their breast milk – this can be controversial in itself, given its complexity and often overlooked history of exploiting women of color as wet nurses. And, again, it can be financially difficult for many families.

This leads to an increasing number of parents engaging in informal sharing through their communities and extended networks – find them through friends, family, Facebook or other dedicated sites. dedicated to connecting donors with parents in need.

Is It Safe To Informally Share Breast Milk?

The American Academy of Pediatrics (AAP) and the US Food and Drug Administration (FDA) both discourage informal sharing due to the risk of spreading disease or exposing infants to drugs, alcohol, drugs or pollutants.

“Risks to the baby include exposure to infectious diseases, including HIV, to chemical contaminants, such as certain illegal drugs, and to certain prescription drugs such as may be present in breast milk, if the donor has not been adequately screened,” each FDA website. “In addition, if breast milk is not handled and stored properly, like any milk, it can become contaminated with bacteria and not be safe to drink.”

According to recent research presented at the AAP National Expo & Conference 2019 that looked at parents’ views on choosing informal breast milk sharing over milk banks, researchers found that Some mothers did not report concerns about the safety of unofficially donated milk.

Of the 650 mothers surveyed anonymously on Facebook, more than half said they were not worried, and nearly 80% said they don’t screen breast milk donors because they “trust them”.

“Informal milk sharing is becoming increasingly common and widespread,” said Nikita Sood, a researcher at Cohen/Northwell Health Children’s Medical Center in New York. in an AAP press release. “It is therefore important that physicians are aware of this practice and the associated risks so that they can educate patients and address this growing concern.”

Screening, stigmatizing and embarrassing mothers

In some circles, informal sharing of breast milk is still seen as a “crude,” controversial, or unsafe substitute for the seemingly tightly regulated infant formula industry. , Maria Armstrong, a community consultant on sharing breast milk affiliated with Eat on your feettold SheKnows.

Smita R., a New York mother of a toddler, was in her forties when she became a first time mother. She said she struggled with the choice of whether or not to give her baby formula while she was trying to breastfeed, because The AAP Guidelines suggest, during the first six months.

“I’m trying to maintain my milk production and feel like a failure,” she says. “Until someone says to me: ‘It’s the recipe not the poison’ – it’s easy to lose perspective. Breast milk has so many advantages that I feel like I’m making my baby a troublemaker by not making enough.”

The popularity of breastfeeding, says Smita, has steered other mothers in her parenting team to European, non-GMO formula instead of informal sharing. And, to some extent, that makes sense: The formula is tightly curated with expiration dates, ingredients revealed, and verified reviews versus the challenges of getting the milk. donor – when you are dealing with a close or perfect friend, acquaintance or stranger. may not comply with certain quality controls, she said.

Although Armstrong is not in favor of formula, because of its high cost – and automatic exclusion -, she says she fully supports the existence of traditional milk banks and sharing networks. community-based to promote safety best practices.

“We started doing our own safety research and quickly realized that the standard for milk sharing had been set by the milk banks and we couldn’t just present this information without stating why. something is considered standard, what that means and what alternatives might be,” she said. “For example, what is not safe for premature and at-risk infants – the largest group of milk banks – may be perfectly fine for healthy, full-term infants… Someone drinking a little alcohol is not. donate to a milk bank, while a mother who drinks milk can, for example, donate to another mother who also drinks milk. The same applies to herbal supplements.”

Infectious disease tests or blood tests can be done privately through a lab or through a supportive pediatrician, she adds. As a searchable database, she says Eats on Feets has helped facilitate productive conversations between pediatricians and parents – an important issue that parents identified advocates when it comes to larger milk-sharing discourse.

Why parents and doctors Still Are you struggling to have these milk sharing conversations?

Naomi Bar-Yam, managing director at Northeast Breast Milk Bank told SheKnows that a lack of education about breast milk – especially among pediatricians – has made it more difficult for caregivers to have an open conversation about sharing milk in a safe way.

Pediatricians, with no formal training in breast milk, spend half an hour or less researching the topic at school, says Bar-Yam. She adds that the biggest barrier to helping parents make better choices about sharing milk comes from gaps in knowledge about breast milk. pairing with the aggressiveness of companies selling formula milk.

“Doctors are increasingly understanding that they are part of a team, and I hope pediatricians can refer parents to another specialist if they don’t know much about sharing,” she said. milk. “But there needs to be a change in the way the medical community thinks about these things and there needs to be a gap between the pharmaceutical industry and medical practices.”

Ruth Milanaik, DO, at Cohen/Northwell Health Children’s Medical Center in New York also said in an AAP press release that conversations between doctors and patients about their breastfeeding decisions are essential. needed to make informed decisions for a child.

“Not only are our patients unaware of the potential risks they are taking in participating in these informal milk-sharing practices, but they often fail to inform their doctors,” says Milanaik. me. “In addition to patient education, physicians must stress the importance of discussing these habits with medical professionals so that we have the information we need to make an accurate diagnosis if the need arises. medical.”

Overall, Spatz said she still supports the use of breast milk for infants and emphasizes its role as a “life-saving medical intervention”. However, she and her team have developed a waiver that parents must sign if they want to choose to informally share breast milk – to emphasize the importance of fully understanding what you’re choosing to do.

“Parents should be aware of the risks of informal milk sharing and how to minimize the risks,” says Spatz. “Know your donor, know the lab, their health history, make sure they know how to pump, label, store the milk properly, know how to wash and sterilize their pumping equipment.”

A version of this story was published in December 2019.

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