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.