Breast Cancer Warning Signs

As with most diseases, much talk revolves around prevention and being proactive in diagnosing problems with your body before they become large-scale problems that will cost the healthcare industry tens of thousands of dollars.

Annual physicals and self-examinations can be important in catching many serious diseases while they can still be aggressively but reasonably treated – such as cancer. After all, cancer rarely just appears all of a sudden.

Breast cancer is one of the most insidious and prevalent cancers cutting down the human population, according to a personal injury attorney servicing Dallas, Texas. To fight it, women are instructed to do monthly self-exams, and feeling a lump and reporting it to a doctor improves recovery rates. But did you know there are other signs you can look for that may actually be a sooner warning than a lump? While catching a lump may improve recovery rates, it’s not 100 percent – it takes looking for signs before you feel the lump.

Here are some very-early warning signs you can look for that may very well keep those lumps from even forming, which may get you even closer to a 100-percent recovery rate:

  • Breast pain or tenderness. A lump is usally painless, but when a breast feels more tender than usual or is painful, that could signify the beginning of a tumor before you feel a lump.
  • Armpit swelling. This could be something involving the lymph nodes, but lymph nodes could also swell as white cells rise up to start battling a foreign invader (cancer cells, in this case). If your armpit feels swollen, always get it checked out.
  • The breast seems flat or indented. If the shape of the breast has changed, this should be checked out. Even if you don’t feel a lump or any pain, seeing a change in shape is a cause for concern, especially if you have not lost or gained any significant weight lately.
  • Redness or rash that isn’t explained. There could be several explanations, but if you feel some itching or notice a rash or some redness on your breast, cancer could be a possibility. These are signs that your cancer-fighting white-blood cells are on the attack, though it could also be a skin problem. Either way, it’s something to look at so cancer could be ruled out.
  • Watch the nipple. A couple items to notice about the nipple, which could be a weather vane about your health. If you notice your nipple becoming indented, of if you notice any kind of discharge that is not milk, then either of those are cause for concern. Do not take either thing lightly, because your nipple should be consistent regardless of your changing breast size due to weight loss or gain.

Breast cancer is one of those cancers that can be found early just from simple self-examinations – many others aren’t caught until a person feels bad or undergoes a specific test in a hospital or clinic. With the benefit of having early detection at home, there is a caution to make sure to be extra-vigilant and pay attention to any abnormalities and get them checked as soon as possible. The earlier that cancer gets caught, the closer to 100-percent recovery you get, which means the more likely you won’t be another cancer statistic.

What is Lobular Carcinoma in Situ (LCIS)?

Merriam Webster defines carcinoma -: noun, a malignant tumor of epithelial origin; medical: a type of cancer. Lobular carcinoma in situ (LCIS), however, is a condition in which abnormal cells form in the milk glands, known as lobules, in the breast, but LCIS is not cancer. The “in situ” part of the term means “in its original place” so these cells rarely spread to other parts of the breast or body. Being diagnosed with lobular carcinoma in situ is a red flag or a marker for cancer. Once these cells are identified, the risk of developing breast cancer is increased from a lifetime risk of 12.5% for the average woman to somewhere between 21-40%.

One of the scarier aspects of LCIS is that there are often no symptoms, and it is frequently missed in mammograms. LCIS doesn’t cause tell-tale lumps, so it is very difficult to detect. Usually, diagnosis is inadvertently made when a biopsy is being done for something unrelated. Plus, LCIS is very similar to ductal carcinoma in situ, which is actual breast cancer. Additional testing and/or a second opinion confirming diagnosis is a good idea before committing to treatment.

Risk Factors for Lobular Carcinoma in Situ

While it is not clear what causes the cells in a lobule of a breast to develop genetic mutations, there are risk factors that have been identified. If any of the following apply, your chances of developing LCIS may be increased:
• A family history of breast cancer – having one or more close relatives diagnosed at some point with any type of cancer seems to uniformly increase risk and LCIS is no exception.
• Hormone replacement therapy during and after menopause – HRT, while beneficial in many ways, has been blamed for increased risk of heart disease, blood clots, stroke, dementia and a host of other issues. LCIS can be added to that list. Women who use hormone replacement therapy for more than three to five years have an increased risk of LCIS.
• Being a woman in her early 40s – while LCIS is not common, when it does occur, it is most likely to do so in pre-menopausal women in their early 40s. This may be changing, however, or detection is getting better, because it is increasingly being diagnosed in older women who have undergone menopause.


LCIS is not cancer, and most women diagnosed with LCIS will never develop cancer. This means the kind of treatment we associate with cancer, like surgery, radiation therapy and chemotherapy will not usually be necessary. Some women, especially those with a family history of breast cancer, may decide to use strategies to reduce the risk of breast cancer in the future, such as medications or a preventive surgery called a prophylactic mastectomy. These are not easy decisions, and there are no one-size-fits-all answers. Each case must be assessed individually.
In general, most doctors will recommend close monitoring, to include, breast self-exams, regular office visits and routine mammograms or other tests, such as MRIs. LCIS, when it does develop into cancer, does not usually do so in the near future but will most likely wait 10 to 15 years, depending on the individual. For this reason, especially, it is important that monitoring and awareness become a lifelong commitment.

What Is A Mastectomy

Breast cancer is a big health concern for many adult women since it affects millions of women around the world each year, often in life-threatening ways. Regular breast exams are one of the absolute musts when it comes to preventative care for women. As we like to say, there are two things every adult should do: get a cancer screening and schedule an estate planning consultation with a firm like Keating Law, PLC. You never know what life is going to throw at you.

A mastectomy is one of the commonest treatments prescribed to women that develop breast cancer. It is a surgical procedure for removing either one or both breasts including the breast tissue and sometimes even tissue from the area surrounding the breasts.

A mastectomy is an invasive procedure but unlike other conditions where surgery is usually the last resort, breast cancer does not have many other less invasive treatments. People often find mastectomies less invasive than radiation treatment and chemotherapy although both are often used.

What are the Types of Mastectomies?

Simple Mastectomy: It is also referred to as total mastectomy and is the most common type. One complete breast is removed, but the muscles and lymph nodes beneath the breast are typically left intact. It is usually a one-day procedure.

Double Mastectomy: It is a procedure where both of the breasts are removed. A second breast may be removed sometimes as a precaution in case the other one develops cancer.

Radical Mastectomy: It is a procedure that involves removing every part of the breast including the chest muscles and lymph nodes under the breast. It is not very common since it is more invasive.

Skin Sparing Mastectomy: It is a procedure where the skin over the breast is left in its normal form. Implants are typically used to replace the breast tissue removed below the skin.

Modified Radical Mastectomy: It is a simple mastectomy that also involves the removal of lymph nodes under the arm.

Nipple-Sparing Mastectomy: It is similar to the skin sparing mastectomy and is usually reserved for women in the early stages of cancer. The breast tissue is usually removed, but the nipple is left intact.

Why Go For a Mastectomy?

Mastectomy is almost always used as a cancer treatment either for the removal of cancer already present or preventing future cancer in breasts. Mastectomies can be used to treat many forms of cancer including:

– Breast Cancer i.e. Stage I, Stage II or the early stages

– Breast cancer i.e. Stage III or Advanced stage

– Paget’s Disease

– Inflammatory Breast Cancer (Usually comes after unsuccessful chemotherapy treatment)


A mastectomy can be the ideal solution in several situations especially when radiation or chemotherapy are not an option. Preventative mastectomies are also quite common especially when cancer is present in one breast and not the other, so both breasts are removed to avoid the risk of cancer spreading to the healthy breast.

The Bottom Line

A mastectomy is a surgical procedure usually recommended for those that are either at a high risk of developing breast cancer or have already been diagnosed with it. Many factors help both you and your breast surgeon to determine whether a mastectomy is your best option, so consult your doctor/surgeon to find out whether this is the case.

If you are interested in learning more about mastectomies, this video should help you out:

What Is Fibroadenoma?

There is nothing good about a breast exam. It’s uncomfortable. Embarrassing. Nine times out of ten the exam room is the temperature of a walk-in cooler. None of that even registers, however, when compared to the moment the doctor pauses and returns to the same area over and over during the examination. Then come the words no one ever wants to hear, “I feel a mass in this breast.” Although not fast enough to stop your life from flashing in front of your eyes, this will quickly be followed by an explanation that it is probably a type of cyst called a fibroadenoma and is unlikely to be cancerous.

Fibroadenomas are the most common type of benign, meaning non-cancerous, tumor. Unless so small that they can only be detected through a mammogram or other test, when the breast is palpated, they feel like round, solid lumps that move freely within the breast. Because fibroadenomas often occur during pregnancy or with the use of hormone therapy and shrink when hormone levels decrease, they may be related to reproductive hormones, but that has not been proven.

Types of Fibroadenomas

There are several different classifications of fibroadenomas, including:

  • Simple fibroadenomas – these are the most common and, when examined under a microscope, look the same through and through.
  • Complex fibroadenomas – determined by reviewing tissue from a biopsy, complex fibroadenomas contain one of the following features: sclerosing adenosis, papillary apocrine hyperplasia, cystic change or epithelial calcification.
  • Juvenile fibroadenomas – found in girls between the ages of 10 and 18, these can grow relatively large, but most shrink over time and some totally disappear.
  • Giant fibroadenomas – differing from other types because of their size, giant fibroadenomas can grow larger than 2 inches (5 centimeters) in diameter. Surgery is not normally recommended for fibroadenomas, but when they grow so large that they press on or replace other breast tissue, they may need to be removed.
  • Phyllodes tumor – similar to fibroadenomas and also usually benign, some phyllodes tumors can become cancerous (malignant) and need to be followed closely by a doctor.

The top question on the mind of everyone diagnosed with any sort of tumor after “Do I have cancer?” is “Does this mean I am more likely to get cancer?” According to the American Cancer Society, “Women with simple fibroadenomas have a slightly increased risk of breast cancer – about 1½ times the risk of women with no breast changes. Complex fibroadenomas seem to increase the risk slightly more than simple fibroadenomas.”


Doctors have differing opinions about whether or not to surgically remove fibroadenomas. If the mass is small, the recommendation will likely be to wait and see whether it shrinks on its own, stays the same or grows. This is especially true during and following pregnancy and breast feeding. There is a good chance that once hormone levels drop back to normal, the lump will disappear, according to many a website.

If there is any doubt in your doctor’s mind about the lump or if it does get larger, there will probably be the decision to advise removal. This will confirm that there is no evidence of cancer. Plus, a large growth can distort the shape of the breast and affect surrounding tissue.

Whatever decisions are made about treatment, follow-up is extremely important. Awareness, self-exams and screening have made a huge difference in breast cancer survivorship. It may be a fibroadenoma today, but that may not be the case tomorrow.

If you would like to learn more about this subject, please check out the video embedded below.

What Is Gynecomastia?

Gynecomastia is not a familiar term, but it is a fairly common condition. The result of a hormonal imbalance between estrogen and testosterone, gynecomastia is a swelling or enlargement of the breast tissue in boys or men. The condition occurs in 60-90 percent of newborns, 50-60 percent of boys in puberty and as many as 70 percent of men age 50 and older. It can affect one or both breasts, sometimes unevenly.

Newborn babies end up with some of the mother’s estrogen in their blood for awhile after birth leading to short-term gynecomastia. During puberty, hormones are going through a normal change and it is not uncommon for estrogen levels to be temporarily elevated. The is also true of men as they are aging and their hormones are adjusting. Most cases are relatively short term, and the condition disappears naturally within a few years, at most.

Other Causes of Gynecomastia

While most instances of gynecomastia are normal hormonal imbalances during periods of transition, there can be other causes, like being a side effect of certain medications, such as antidepressants, antibiotics, chemotherapy, prostate cancer and cardiovascular medicines.

There are a number of medical conditions and diseases that may also cause gynecomastia. Some of these include:

  • Liver diseases
  • Kidney disease
  • Congenital disorders
  • Lung cancer
  • Testicular cancer
  • Tumors of the adrenal glands or pituitary gland
  • Thyroid disorders
  • Injury or trauma
  • Obesity

Psychological Implications of Enlarged Breasts for Men

Gynecomastia is not normally a serious problem, especially since, in most cases, it is temporary, but it can be psychologically difficult. Having enlarged breasts can be embarrassing for men and boys. Even mild gynecomastia can adversely affect boys, especially during puberty, which is chaotic and confusing on many levels. According to a study published in the Journal of the American Society of Plastic Surgeons, “Gynecomastia has a significant negative impact on primarily the psychosocial well-being of affected adolescent patients, specifically in regard to social functioning, mental health, and self-esteem. Psychosocial impact was not affected by graded severity of disease.”

Being a natural condition, there should not be such a stigma for boys and men to have enlarged breasts but, in reality, it is just the opposite. Children of all ages can be incredibly cruel when there is something different about someone. When that difference has to do with a characteristic that is considered “like a girl”, the teasing can be intense. Even when boys grow into men, they carry the same sense of shame about anything to do with their breasts. Men have a low incidence of breast cancer but a much higher mortality rate due to waiting far too long to acknowledge there might be a problem with their breast.


If gynecomastia is the result of hormonal fluctuations that go with growth or aging, there is no way to prevent it from happening. If related to a medical condition or medication, then taking steps to prevent the contributing cause would be the way to prevent breast enlargement, and treating the condition would also treat the gynecomastia.

Treatment is usually unnecessary since, in most cases, the breasts will return to their regular shape and size once the hormones have stabilized. If there is discomfort, icing and over-the-counter medications can reduce any pain. If the condition persists, there are medications as well as surgical options that your doctor may suggest.

Why You Should Pump Your Breast Milk

Like it or not, most things in life come with some sort of controversy. One would think that wanting to give your baby the health benefits of breast milk, no matter how that is accomplished, would be an exception. The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists both strongly recommend breast feeding. Research is confirming that breast milk is, by far, the best choice to feed an infant. Medical experts and common sense agree that milk from the mother contains a nearly ideal mix of nutrients, provided in a way that is most easily assimilated by the baby. Breast milk contains antibodies, specifically designed to protect against viruses and bacteria, and babies who are breastfed rather than given formula for at least the first six months have far fewer medical issues.

Unfortunately, even with breast feeding, there is disagreement. Breast feeding in public has inspired a huge outpouring of opinion, from both sides of the debate, and is unlikely to end any time soon. Less public are the issues of breast milk versus formula and breast feeding versus feeding via pumped breast milk. The formula discussion has its own issues, but pumping is a bit more subtle. There are those that contend that pumping is somewhat unnatural, and that there is something lost between mother and child when feeding is done other than directly from breast to child.

No one argues the value of bonding that takes place during breast feeding, but breast milk is breast milk, whether the baby receives it while latched to the breast or from a bottle that has been previously expressed. Many women are unable to breast feed because of medical reasons, and others simply choose not to do so.  They do recognize the tremendous value for the baby and believe that every time feeding consists of breast milk, the baby wins. This is where pumping comes in and, for many, feels like a life saver.

Reasons That Women Pump Breast Milk

Some of the more common reasons that women pump breast milk, include:

  • Return to work or some other reason that separates mother from baby but allows feeding of breast milk to be done by family member or caretaker.
  • Baby is unable to latch or feed directly from the breast. This could be a medical issue, for instance premature babies sometimes have difficulty creating enough suction to stimulate a full breast milk supply, or there may be some sort of birth abnormality, like a lip or cleft palate or muscle tone issue.
  • Prevent or relieve engorgement.
  • To donate milk to a milk bank or milk exchange program.
  • Alleviate pressure during weaning stage.
  • Need to drain breast during mastitis to facilitate healing.
  • Parents may be separated and father need breast milk if sharing custody of the baby.
  • Mother may be incarcerated and not permitted to breast feed.

In other instances, mothers recognize the value of breast milk for their baby but cannot bring themselves to actually breast feed or simply do not want to. There are a variety of reasons for this, but the important part is finding a way for the baby to receive the enhanced nutritional value of breast milk. Pumping is, currently, the best way for that to be done.

If you would like to learn more about preparing for having a baby, please watch this video:

Early Stage Breast Cancer

During an age where technology continues to improve at an alarming rate, so to do the ways in which it impacts many aspects of our lives. Communication, marketing and, of course, the healthcare fields in particular. Modern medicine has improved so much over the past several years that the days of resorting to standard methods of medical practice are steadily on the decline in favor of more personal, individualized treatment plans. Most recently, this shift in practice has been seen to affect treatments regarding breast cancer, particularly in its early stages.

In days gone by of the medical world, breast cancer – and many other cancers besides – were generally approached with only a few options for treatment: surgery and blanket treatments such as radiation, hormonal or chemotherapy. Apart from being invasive and altogether unpleasant, the side effects of such treatment plans generally came with a plethora of cons comparative to the pros. For example, in a typical treatment plan of chemotherapy, many patients can potentially look forward to the following sorts of side effects:

  • Fatigue
  • Hair loss
  • Easy bruising or bleeding
  • Skin and nail changes such as discoloration or dry skin
  • Appetite changes
  • Mood changes

And these are just minor inconveniences compared to the more problematic side effects that chemotherapy could provide.

  • Diarrhea
  • Constipation
  • Nausea and vomiting
  • Urine and bladder changes, kidney problems
  • Nerve and muscle problems such as numbness, tingling, and pain
  • Mouth, tongue and throat problems such as sores and pain with swallowing
  • Anemia
  • Infection

The reason for this being that chemotherapy, when introduced into the body via an array of drugs, targets and kills fast-growing cells. Unfortunately, as mentioned before, the medicine is a sort of blanket treatment and cannot differentiate between cancerous cells and healthy cells that just happen to grow at a faster rate, and thus many of the side effects occur because of unintentionally targeted cells in hair follicles, skin, intestines, and even bone marrow.

While the obvious upside was a better chance of beating cancer, it was a bumpy road that many people trudged precariously. Thankfully, it seems oncologists have found more alternatives for cancer treatments that have them recommending the likes of chemotherapy with less frequency to their patients. In fact, according to this intellectual article by Robert Preidt, the use of chemotherapy among a select group of early-stage breast cancer patients fell by over one third – from 34.5 percent to 21 percent – in a study conducted between 2013 and 2015.

This could be due to a rise of popular treatments and procedures that stray from the likes of chemotherapy and radiation therapy, such as immunotherapy, which predominantly utilizes the body’s own immune system to suppress cancerous growth, or targeted therapy, which incorporates medicine along an entire spectrum for targeting various and specific characteristics of cancerous cells. The latter in particular, unlike chemotherapy, lessens the likelihood that healthy cells will be targeted and thus many of the more offensive side effects from treatments such as chemotherapy can be avoided.

Taking Care of Your Breasts While Breast Feeding

Pregnancy is an experience that is different for every mom-to-be. That is equally true for one pregnancy to the next for the same woman. There are similarities, however, and for every account of it being an easy, joyful nine months, there will be dozens of others that talk about out-of-control weight gain, midnight cravings, swelling feet, never-ending bathroom calls and mood swings that change by the millisecond. This is a lot to ask of someone for such an extended period of time, but once that baby is placed in mom’s arms after delivery, there’s no question it was worth it.

Everything during pregnancy was about doing what was best for the baby growing inside the womb. Not much really changes after birth. Most of what a new mother will do for quite some time will revolve around what is best for the baby, and that includes mom making sure to take care of her own health.  It is still best to maintain a good diet, drink plenty of fluids and, impossible as it may seem, get adequate rest. It is also important to avoid alcohol, smoking, caffeine and be cautious with medications while breast feeding.

Caring for Breasts While Breast Feeding

A mother who chooses to breast feed will want to take special care of her breasts to avoid some of the more common issues, such as, sore or cracked nipples, blocked milk ducts and mastitis, which is a painful infection of the breast tissue. Some good practices are:

  • Hygiene practice good hygiene by washing your hands before touching your breasts and keep breasts and nipples clean by washing them each day with warm water. Using soap should be avoided as it can remove natural oils, which can result in cracking.
  • Wear a Nursing Bra – wear a nursing or supportive bra that is not overly tight or restrictive.
  • Correct Latching – prevent soreness and other issues by having the baby well positioned at the breast to ensure easy and proper latching.
  • Change Breast Pads – Clean and dry nursing pads can help to prevent soreness and mastitis.
  • Moisturize Nipples try rubbing breast milk on your nipples and areola after nursing to help keep them from getting dry and cracked.
  • Disengage Properly After Nursing – do not simply pull baby away from breast, which can quickly lead to soreness. Instead, break the suction by placing your finger in the corner of the baby’s mouth before gently pulling away.
  • Avoid Breast Engorgement – ensuring proper latching and draining breasts as much as possible during each feeding, or by following up with pumping, will help prevent engorgement, which can be painful and lead to infection. If breasts do become engorged, you can try a cold compress for 15 minutes every hour to reduce swelling. Just remember to place a thin cloth between the breast and the cold pack to protect skin.

If you have questions or concerns, talk to your healthcare professional about any issues, such as soreness, dry or cracked nipples, painful engorgement or other problems. Get recommendations about what products are safe to use and which to avoid. This is especially good advice for first time mothers who may have read all the manuals but are still anxious about what are the best practices.

Breast Feeding Positions for Mom and Baby

Becoming a new mom for the first time can be exciting and terrifying all at the same time. What could be more wonderful than bringing a new life into the world? And, what could be more frightening than being expected to know how to care for the defense of this tiny human who is totally dependent on you? Even with all of the manuals in the world, this is true on-the-job training.

Your new baby will likely seem hungry from the moment of birth, and you may be operating by the false belief that breast feeding will just “happen”, naturally and instinctively. This sets many young mothers up for a very difficult time. Breast feeding is a skill that must be learned. This is true for mother and for baby. Once the two of you become pros, the process will seem natural, and you will be able to breast feed and do other activities at the same time. In the beginning, however, it will be important to pay attention to how the baby is positioned to minimize problems with soreness, proper milk flow and adequate nutrition.

Breast Feeding Positions

Every mother and baby will find the variations of positions that will work for them. The lucky ones will have lots of older relatives hovering around with advice. As much as we sometimes believe we don’t want that, it’s the way that mothers in all cultures have always learned how to be mothers. The trick will be to listen and then find what works best for you and your baby. Some common positions that work for many and may be helpful include:

  • The Cradle Hold – one of the most traditional positions, also known as the Madonna Hold. The baby should be supported on the arm that is on the same side as the breast that will be used with the hand on that side supporting the rest of the body. It is important the baby’s head is aligned with the rest of his body rather than turned to the side. Cup the breast with the other hand, with your thumb just above the nipple and areola as close as possible to where the baby’s nose will touch your breast. Compress the breast using your index finger so that the nipple points slightly toward your baby’s nose. At this point the baby should now be ready to latch.
  • The Cross-Cradle Hold – this one is a variation on the cradle hold. Position the baby’s head with the hand opposite to the breast you’ll be nursing from. Rest your wrist between your baby’s shoulder blades, your thumb behind one ear, your other fingers behind the other ear. Again, be sure to rotate your baby’s entire body so it faces you and his mouth is lined up with your nipple. Use your other hand to cup your breast in the same way as the cradle hold. This can be a useful position if the baby has difficulty latching properly, because it will be easier to guide the head.
  • The Clutch Hold – also called the football hold, this position keeps the baby’s weight off the abdomen, so it can be a good choice following a cesarean birth. Imagine a football player running down the field, protecting the ball by holding it to his side — that is the basic position you will want to use. Position the baby at your side, facing you, with the baby’s legs tucked under your arm on the same side as the breast you will be nursing from. Place a pillow or something under your elbow for support and then using the hand on that side to support your baby’s head, the other hand can cup your breast the same as in the cradle hold.
  • Reclining or Laying Down –this one is good for moms who have smaller breasts. Use pillows for support while leaning back on a bed or couch. Place the baby on top of your body so that you are tummy-to-tummy and the baby’s head is near your breast. Your baby can rest on you in any direction, as long as the whole front of the body is against yours within easy reach of the breast. You may or may not have to assist in directing the baby to the nipple, but once that is done, this position can provide a very relaxing experience.

These are just a few of the variations on breast feeding positions. Every mother has had to use a little trial and error to find what works best for her and her baby.

If you would like to learn more, please watch the following video:

Latest Trend: Donating Breast Milk?

Is donating breast milk a new trend? Perhaps, not. The sharing of breast milk from one mother to the child of another has been going on for as long as babies have been being born. Without the modern day alternatives currently available, it was often all that stood between life and death for small infants. Milk banks, which are services that collect, screen, process and dispense breast milk by prescription, have been around for more than a hundred years, the first opening in Vienna, Austria in 1909.

Donating breast milk via milk banks began in the U.S. in Boston, in 1919, and other locations opened and expanded the process until the 1980s. This was when the HIV virus was creating its wave of fear and, consequently, many milk banks closed down out of fear of transmitting the deadly virus. Today, the Human Milk Banking Association of North America (HMBANA) processes more than a million ounces of milk a year in their 11 milk banks, primarily for at risk newborns.

Not everyone donates breast milk through a milk bank, however, and this is where the current controversy takes hold. For women in earlier times without another option, hardly any risk outweighed a baby starving to death. Today, however, there are alternatives, like formula, and a clear awareness of the very real risks involved. Milk sent to a milk bank is pasteurized, combined with other donors’ milk to balance the components and tested for any sign of contamination. Donors commit to certain restrictions, like no smoking or drinking, and are screened for diseases that might be passed through their milk, such as HIV and hepatitis.

Considering the thoroughness of the process, it’s not surprising that a major limitation of breast milk received through a milk bank is cost, which can be as much as $5 per ounce. Insurance coverage is inconsistent from one state to another and, even when coverage is available, rarely full reimbursement. This explains, at least in part, the burgeoning business being done on the internet where donors can sell extra breast milk, and buyers can purchase for far less than through a milk bank.

Informal exchange of breast milk is expected to grow, despite most of the medical community warning against it. According to Ari Brown, M.D., a spokesperson for the American Academy of Pediatrics, “We support breastfeeding, but if you can’t nurse, we recommend breast milk from a milk bank, or that you use formula. Even if you have a good friend who wants to donate milk, you can’t guarantee that it’s free of infections, like HIV. Breast milk is a bodily fluid, just like blood. Would you be willing to give your baby a blood transfusion without first having it tested?” Purchasing breast milk blindly off the internet would be even more rigorously discouraged by healthcare professionals. This, however, competes with the rapidly increasing belief in the health benefits of breast milk and the inability to get it from a source like an official milk bank. Not only does cost make it prohibitive, there simply isn’t adequate supply.

Just as the decision to breast feed is a personal one for the mother, donating and sharing breast milk seems to also fall in the same category. Many women who engage in milk sharing within families and communities find it a very fulfilling and bonding experience. Others cannot imagine even considering the idea of milk sharing. This is a controversy that is likely to continue, at least for the foreseeable future.