In Defense of Milk Sharing
A recent study found nasty bacteria in unscreened shared breast milk. Read why I'm still feeding donated milk to my baby, and how I know it's safe.
When my first baby was born three years ago, I put a sign on his little hospital cart that read, “Breast milk only!” Upon my discharge, however, when I mentioned to the hospital pediatrician that I had breast reduction surgery at 17, she told me–point blank–”Oh, breastfeeding isn’t going to work for you.” The surgeon who’d performed my reduction had said it would, but, as a brand new mom, I panicked. I purchased a canister of formula on the way home and supplemented heavily from the beginning. I did my best to nurse and pump as well, but my supply was minimal. When I returned to work three months later and faced pumping in a phone booth (closet) shared between three corporate floors and without a lock, I gave up on breastfeeding altogether.
I was disappointed not to have had the breastfeeding relationship with my baby I’d hoped for, and that he’d been raised largely on formula, especially when I later learned that breastfeeding can, in fact, work after reductions. (Doctors don’t always know what they’re talking about). Some moms who’ve had the surgery even produce full milk supplies. When I became pregnant again last winter, I was determined that this next baby would be powered by breast milk, once he arrived.
I told my midwife about my history and my goals up front, and we developed a breastfeeding plan. In fact, working with a midwife was a part of that plan; like most midwives, her contract included continued, at-home baby-checks and mom-care, including hands-on breastfeeding support, well into the postpartum period. (Something that differs from the typical OB care model, and a perk I should have included in this list!) She’d had other BFAR (Breast Feeding After Reduction) clients, too, all of whom developed long-term breastfeeding relationships with their babies… even those who had to supplement their own supplies. And, thanks to her huge network of former clients, those moms supplemented with breast milk provided to them by other mamas, instead of with formula. It’s known as “Milk Sharing,” and, as studies in recent years have continued to bring attention to breast milk’s countless benefits for babies, has become an increasingly common practice.
In fact, the demand for breast milk is so great that many moms turn to the internet to buy it. Milk banks do exist (pediatricians can write prescriptions for banked milk), but they’re expensive and their supplies go first to preemies, then often run low. So websites like Milk Share and Only The Breast have, because of their accessibility, become a primary source for connecting families who need milk with moms who are willing to pump. This sounds great, but unfortunately a study published this Monday in the Journal of Pediatrics reported that nasty bacteria–including, in a few instances, Salmonella (which shouldn’t be present in breast milk at all)–was found in a large percentage of milk samples garnered from several of the big milk sharing sites. And this, of course, made headlines.
Here’s the thing. This is scary and sad, but it’s not the whole picture, and I worry that it will discourage moms from milk sharing in general. In fact, the New York Times‘ coverage of the topic included a quote from a Columbia University doc–one not connected with the study–doing exactly that; he says sharing is a bad idea, even among relatives. But the study’s authors focus more on the nature of sharing among unscreened donors (or sellers). The fact that money can be made from milk sharing means moms desperate for breast milk might, without knowing it, be getting plain cow’s milk, or formula in breast milk collection bags, or milk that’s old, tainted, or from an ill provider. The list goes on and the risks–in light of this recent research, in particular–are many.
But milk sharing among known providers is a different story. For moms who want to breastfeed, but can’t for whatever reason produce a full supply of milk for their babies (something that piles logistical and emotional challenges on top of the time and commitment required of any breastfeeding mom), it can make all the difference in the world.
I am, as of now, not producing quite enough milk to meet Otto’s needs. I’m nursing and pumping like crazy, and I’m producing most of what Otto is drinking, but I’m also receiving milk from some (generous!) donor mamas. It’s a lot of work but it’s worth it, and that donor milk is part of our successful breastfeeding picture. It’s coming from several moms who were my midwife’s clients–all of whom she’s screened for major diseases, who eat clean diets (they’re even avoiding nuts, because my older son has severe food allergies and we don’t want to expose the baby through breast milk), and who I now connect with personally for drop-offs. I’m also receiving some milk from a few of my friends who’ve had babies in the past several months.
The milk we’re receiving is fresh (no back-of-the-freezer stashes being unloaded here), and it’s being pumped just for us. I consider it a far preferable alternative to supplementing with formula, which is nutritionally inferior, and which (FYI) has also come under scrutiny for making babies really sick (just ask the CDC). This, of course, was not mentioned in the Times article, but it’s worth considering when weighing one’s options. I also prefer our donor milk to milk from the local milk bank because the banked milk is pasteurized, a process that kills many of the beneficial enzymes that make breast milk so awesome. (Plus, I’d know a lot less about the donors’ diets – in particular about their nut exposure – if I were getting my milk from the milk bank.)
My midwife said she never recommends moms get their milk over the internet. (She also cautions against buying breast milk at all.) But I can understand why some moms do. Back when I was trying to figure breastfeeding out the first time around, my options were far more limited. I hadn’t been a mom before and I didn’t know what I do now about breastfeeding in general. I didn’t have friends who were breastfeeding, as I do now, and I wouldn’t have known where to begin when it came to seeking alternatives to formula. Now I have knowledge of how to maximize my own supply, I have a support network, and I have a bunch of mom friends who happen to be lactating.
For moms who lack these resources, I hope the increasing prevalence of milk sharing will ensure that they at least get a sense of the possible options. I used to suggest milk sharing websites to moms, and I definitely won’t be doing that anymore, but there are ways to find quality milk without existing connections. I recently asked for suggestions on local breastfeeding-friendly pediatricians while at a La Leche League (LLL) meeting, for example, and found a doctor who is not only a member of LLL, but also has a fridge full of donor milk right in his office. Moms can call the LLL hotline day or night to find leaders or meetings nearby. Connecting with the breastfeeding support community will put them in touch with a huge network of people who’ve probably done some sleuthing around local supply-issue solutions already. A simple Google search can also connect moms with nearby midwives who will likely be able to help get the donor-milk ball rolling.
It’s disheartening to read that milk shared through websites isn’t always safe, and that parents’ genuine wishes to feed their babies breast milk are sometimes exploited. That said, milk sharing can fulfill those wishes safely and successfully, and I still wholeheartedly recommend it.
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